Thursday, January 24, 2008

Black Papule in a Child

Abstract: 11 yo boy with long history of black lesion left arm
History: The lesion has been present for years, little change but patient and parent are worried bout it.
O/E: 5 mm diameter papule with a peculiar serrated border
Clinical Photo(s)


Dermoscopic Image

Lab:
Pathology:

Diagnosis or DDx: Reed Nevus (aka Pigmented spindle cell nevus)
Questions: For inerest
Reason(s) Presented: When I first saw this patient, I thought it was a blue nevus. I sent the history and digital images to a few friends. Drs. Ian McColl and Stelios Minas thought it was a Reed nevus and recommended excision. Biopsy was done and confirmed their opinion.
References: The Reed Nevus is considered a variant of the Spitz nevus. It presents as a well-circumscribed deeply pigmented nodule on the extremities of young adults. Under the microscope, it resembles the Spitz nevus but is composed of spindled melanocytes with heavy melanin pigmentation. As in a Spitz nevus, this nevus is symmetrical with maturation and lack of deep dermal mitotic figures. Excision of suspected Reed nevi is recommended. For more information see: The Doctor's Doctor
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