Background. The term "clonal nevus" is used to describe a variant of melanocyt ic nevus that histologically exhibits a localized proliferation of pigmented epi thelioid dermal melanocytes within an otherwise...Background. The term "clonal nevus" is used to describe a variant of melanocyt ic nevus that histologically exhibits a localized proliferation of pigmented epi thelioid dermal melanocytes within an otherwise ordinary nevus (Ball NJ, Golitz LE. Melanocytic nevi with focal atypical epithelioid cell components:a review o f seventy-three cases. J Am Acad Dermatol 1994; 30:724-729). Reports to date have focused on the histologic appearance of these lesions. Aim. To characterize the clinical appearance of clonal nevi. Methods. Clinical and histologic examin ations were performed of a single clonal nevus from each of five patients (two m en and three women; age range, 37-80 years). Results. All nevi were round to ov al in shape with smooth, well-defined borders. They were uniformly tan to light brown in color, except for a single blue-gray to blue-black focus of hyperpig mentation. The diameters of the nevi ranged from 2.5 to 10 mm. In individual nev i, the hyperpigmented focus was either centrally or eccentrically located and me asured 1-2 mm in diameter. Histologically, these lesions showed banal melanocyt es associated with a localized proliferation of melanocytes with abundant pigmen ted cytoplasm in the dermis, admixed with melanophages. Conclusions. The appeara nce of clonal nevi-tan with a focus of blue-gray to blue-black pigmentation- allows one to recognize the lesion clinically.展开更多
An 86-year-old African-American man presented with tonicclonic seizures.Intravenous phenytoin was urgently administered into the dorsum of the right hand.The patient developed a raised purple area of discoloration aro...An 86-year-old African-American man presented with tonicclonic seizures.Intravenous phenytoin was urgently administered into the dorsum of the right hand.The patient developed a raised purple area of discoloration around the intravenous insertion site within 2 h and edema and vesiculobullous lesions of the distal forearm, hands, and fingers within 8 h.Microscopic sections from a biopsy at 12 h revealed epidermal necrosis, superficial ulceration, and a mild superficial and deep perivascular lymphoid infiltrate, associated with numerous thrombi of small vessels throughout the dermis.The findings were judged to be consistent with soft-tissue injury associated with intravenous administration of phenytoin, also termed purple glove syndrome.Purple glove syndrome, named for its distinctive purple discoloration and swelling of the hands in the distribution of a glove, is an uncommon complication of intravenous phenytoin administration through small dorsal veins of the hands.It is comprised by pain, discoloration, and edema in the vicinity of intravenous infusion of phenytoin through dorsal veins of the hand.The histopathologic features of fully developed lesions have been reported; however, early-stage findings have not been previously described, and the histogenesis of this lesion is controversial.The presence of thrombi in this earlystage lesion suggests that thrombosis plays a role in the initial pathogenesis of this condition.展开更多
Background: Nevi on certain areas of the body such as the acral, genital, and flexural regions may exhibit uncommon but characteristic histopathologic features. The purpose of this study was to characterize the distin...Background: Nevi on certain areas of the body such as the acral, genital, and flexural regions may exhibit uncommon but characteristic histopathologic features. The purpose of this study was to characterize the distinctive features of nevi with a junctional component located on and around the ear. Materials and methods: A total of 101 compound and junctional nevi of the ear received at the Yale Dermatopathology Laboratory during a 10- year period were examined in this study. The most characteristic feature of the majority of these nevi was irregularity of nesting pattern, with nests, which varied in size and shape and which were sometimes located between rete ridges. Results: Forty- two (42% ) of nevi on and around the ear showed poor circumscription, lateral extension of the junctional component beyond the dermal component, and elongation of rete ridges with bridging between them. A subset of these nevi (26 cases)showed uniformly large melanocytes with large vesicular nuclei without prominent nucleoli, and abundant pale, finely granular cytoplasm. These lesions did not show a tendency to recur. Conclusions: This study supports the existence of a subset of nevi on or near the ear that, like certain nevi located on other special sites, exhibit unusual but characteristic features, which may be misinterpreted as atypical or malignant.展开更多
文摘Background. The term "clonal nevus" is used to describe a variant of melanocyt ic nevus that histologically exhibits a localized proliferation of pigmented epi thelioid dermal melanocytes within an otherwise ordinary nevus (Ball NJ, Golitz LE. Melanocytic nevi with focal atypical epithelioid cell components:a review o f seventy-three cases. J Am Acad Dermatol 1994; 30:724-729). Reports to date have focused on the histologic appearance of these lesions. Aim. To characterize the clinical appearance of clonal nevi. Methods. Clinical and histologic examin ations were performed of a single clonal nevus from each of five patients (two m en and three women; age range, 37-80 years). Results. All nevi were round to ov al in shape with smooth, well-defined borders. They were uniformly tan to light brown in color, except for a single blue-gray to blue-black focus of hyperpig mentation. The diameters of the nevi ranged from 2.5 to 10 mm. In individual nev i, the hyperpigmented focus was either centrally or eccentrically located and me asured 1-2 mm in diameter. Histologically, these lesions showed banal melanocyt es associated with a localized proliferation of melanocytes with abundant pigmen ted cytoplasm in the dermis, admixed with melanophages. Conclusions. The appeara nce of clonal nevi-tan with a focus of blue-gray to blue-black pigmentation- allows one to recognize the lesion clinically.
文摘An 86-year-old African-American man presented with tonicclonic seizures.Intravenous phenytoin was urgently administered into the dorsum of the right hand.The patient developed a raised purple area of discoloration around the intravenous insertion site within 2 h and edema and vesiculobullous lesions of the distal forearm, hands, and fingers within 8 h.Microscopic sections from a biopsy at 12 h revealed epidermal necrosis, superficial ulceration, and a mild superficial and deep perivascular lymphoid infiltrate, associated with numerous thrombi of small vessels throughout the dermis.The findings were judged to be consistent with soft-tissue injury associated with intravenous administration of phenytoin, also termed purple glove syndrome.Purple glove syndrome, named for its distinctive purple discoloration and swelling of the hands in the distribution of a glove, is an uncommon complication of intravenous phenytoin administration through small dorsal veins of the hands.It is comprised by pain, discoloration, and edema in the vicinity of intravenous infusion of phenytoin through dorsal veins of the hand.The histopathologic features of fully developed lesions have been reported; however, early-stage findings have not been previously described, and the histogenesis of this lesion is controversial.The presence of thrombi in this earlystage lesion suggests that thrombosis plays a role in the initial pathogenesis of this condition.
文摘Background: Nevi on certain areas of the body such as the acral, genital, and flexural regions may exhibit uncommon but characteristic histopathologic features. The purpose of this study was to characterize the distinctive features of nevi with a junctional component located on and around the ear. Materials and methods: A total of 101 compound and junctional nevi of the ear received at the Yale Dermatopathology Laboratory during a 10- year period were examined in this study. The most characteristic feature of the majority of these nevi was irregularity of nesting pattern, with nests, which varied in size and shape and which were sometimes located between rete ridges. Results: Forty- two (42% ) of nevi on and around the ear showed poor circumscription, lateral extension of the junctional component beyond the dermal component, and elongation of rete ridges with bridging between them. A subset of these nevi (26 cases)showed uniformly large melanocytes with large vesicular nuclei without prominent nucleoli, and abundant pale, finely granular cytoplasm. These lesions did not show a tendency to recur. Conclusions: This study supports the existence of a subset of nevi on or near the ear that, like certain nevi located on other special sites, exhibit unusual but characteristic features, which may be misinterpreted as atypical or malignant.
