Toddler with Black Nevus

This 18 month by was seen for a pigmented lesion of 2 - 3 months duration.  It has growm over this

O/E:  Light complected Caucasian with 6 mm in diameter black papule right anterior thigh.  The dermatoscopic appearance shows a somewhat starburst appearance at the periphery.

Photomicrographs (courtesy of Deon Wolpowitz, Boston University Skin Path)

Diagnosis:  Clinically and dermatoscopically and pathologically, this is a Reed Nevus.

Plan: The lesion has been excised with modest margins..

Reference:

Dermatol Pract Concept. 2016 Apr 30;6(2):37-41. (Full Text)

Spitz/Reed nevi: a review of clinical-dermatoscopic and histological correlation.

Pedrosa AF et. al.

Abstract

BACKGROUND: Spitz/Reed nevi are melanocytic lesions that may mimic melanoma at clinical, dermatoscopic and histopathological levels. Management strategies of these lesions remain controversial.

OBJECTIVES:

We aim a correlation among clinical-dermatoscopic and histological features of a series of Spitz/Reed nevi diagnosed during 7 years at the Department of Dermatology.

METHODS: Clinical, dermatoscopic and histological features of Spitz/Reed nevi diagnosed at our tertiary hospital from 2008 to 2014 were reviewed in order to seek correlation.

RESULTS: All described dermatoscopic patterns for Spitz/Reed nevi were found among the 47 enrolled patients; starburst and atypical/multicomponent patterns prevailed (57.4%). Reticular pattern predominated among children younger than 12 years, whereas homogeneous pattern was more frequent in patients older than 12 years, although these differences were not statistically significant (P=0.785). Among histological atypical lesions, all dermatoscopic patterns were represented, but the atypical/multicomponent predominated (56.3%). Two out of 11 dermatoscopically atypical lesions did not show histopathological counterpart.

CONCLUSIONS: The excision of Spitz/Reed nevi in adults is supported, given the inability to accurately predict those with histopathological atypia, based on clinical and dermatoscopic features, which may raise concern about malignancy.

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