Background: Melanotic pigmentations in scars consecutive to the excision of melanocytic tumours can be secondary to a reactive phenomenon related to the scar tissue or to a recurrence of the melanocytic lesion excised...Background: Melanotic pigmentations in scars consecutive to the excision of melanocytic tumours can be secondary to a reactive phenomenon related to the scar tissue or to a recurrence of the melanocytic lesion excised in the first case. Recurrent naevi may sometimes adopt unusual features that make them difficult to differentiate from a melanoma. Objectives: To describe the clinical, dermoscopic and histological features of melanotic pigmentations in scars consecutive to the excision of melanocytic tumours, and to correlate the histological diagnosis with the dermoscopic features. Methods: This was a prospective cohortstudy using macrophotography, dermoscopy and histopatho- logical study. Ninety-five melanotic pigmentations (77 patients) in scars secondary to the excision of melanocytic tumours were prospectively collected in the Department of Dermatology at the Instituto Valenciano de Oncologa in Valencia, Spain. Histopathological study was performed in 57 scars. Results: Thirteen dermoscopic structures were identified. Four criteria allowed a differentiation between reactive and specific melanocytic pigmentations. Presence of globules and presence of heterogeneous pigmentation were features associated with specific melanocytic pigmentations (P < 0.0001). Presence of a regular network and presence of streaks weremore frequently found in reactive pigmentations (P = 0.023 and 0.026, respectively). Conclusions: Dermoscopic examination of melanotic pigmentations in excision scars of melanocytic tumours provides useful information about the origin of that pigmentation. Based on such information, recurrent naevi can be differentiated from reactive pigmentations in most cases. Excision and histopathological diagnosis continue to be imperative in some cases of recurrent naevi with atypical clinical features.展开更多
Anetoderma is characterized by circumscribed oval macules with overlying wrinkled skin that is slightly depressed or bulges outwards. Skin biopsy shows a decrease of elastic dermal fibers. It may not be associated wit...Anetoderma is characterized by circumscribed oval macules with overlying wrinkled skin that is slightly depressed or bulges outwards. Skin biopsy shows a decrease of elastic dermal fibers. It may not be associated with an underlying disease (primary anetoderma) or may be related to many dermatoses (secondary anetoderma). We report a 7-year-old girl who presented at birth with yellowish brown papules on the upper trunk, neck and head, which within days evolved to yellowish orange papules. A skin biopsy was carried out and the presence of an histiocytic infiltrate with foam cells and Teuton cells in the dermis that were CD68+, factor XIII+and S-100-, confirmed the diagnosis of Juvenile Xanthogranuloma (JXG). After 4 years the lesions began to evolve to asymptomatic oval and round atrophic skin areas. Histopathologic evaluation showed decrease of elastic fibers in the dermis, diagnostic of anetoderma. The mechanisms of anetoderma are unknown. Although many different dermatoses have been associated with anetoderma we have only found two reported cases of anetoderma and JXG.展开更多
文摘Background: Melanotic pigmentations in scars consecutive to the excision of melanocytic tumours can be secondary to a reactive phenomenon related to the scar tissue or to a recurrence of the melanocytic lesion excised in the first case. Recurrent naevi may sometimes adopt unusual features that make them difficult to differentiate from a melanoma. Objectives: To describe the clinical, dermoscopic and histological features of melanotic pigmentations in scars consecutive to the excision of melanocytic tumours, and to correlate the histological diagnosis with the dermoscopic features. Methods: This was a prospective cohortstudy using macrophotography, dermoscopy and histopatho- logical study. Ninety-five melanotic pigmentations (77 patients) in scars secondary to the excision of melanocytic tumours were prospectively collected in the Department of Dermatology at the Instituto Valenciano de Oncologa in Valencia, Spain. Histopathological study was performed in 57 scars. Results: Thirteen dermoscopic structures were identified. Four criteria allowed a differentiation between reactive and specific melanocytic pigmentations. Presence of globules and presence of heterogeneous pigmentation were features associated with specific melanocytic pigmentations (P < 0.0001). Presence of a regular network and presence of streaks weremore frequently found in reactive pigmentations (P = 0.023 and 0.026, respectively). Conclusions: Dermoscopic examination of melanotic pigmentations in excision scars of melanocytic tumours provides useful information about the origin of that pigmentation. Based on such information, recurrent naevi can be differentiated from reactive pigmentations in most cases. Excision and histopathological diagnosis continue to be imperative in some cases of recurrent naevi with atypical clinical features.
文摘Anetoderma is characterized by circumscribed oval macules with overlying wrinkled skin that is slightly depressed or bulges outwards. Skin biopsy shows a decrease of elastic dermal fibers. It may not be associated with an underlying disease (primary anetoderma) or may be related to many dermatoses (secondary anetoderma). We report a 7-year-old girl who presented at birth with yellowish brown papules on the upper trunk, neck and head, which within days evolved to yellowish orange papules. A skin biopsy was carried out and the presence of an histiocytic infiltrate with foam cells and Teuton cells in the dermis that were CD68+, factor XIII+and S-100-, confirmed the diagnosis of Juvenile Xanthogranuloma (JXG). After 4 years the lesions began to evolve to asymptomatic oval and round atrophic skin areas. Histopathologic evaluation showed decrease of elastic fibers in the dermis, diagnostic of anetoderma. The mechanisms of anetoderma are unknown. Although many different dermatoses have been associated with anetoderma we have only found two reported cases of anetoderma and JXG.
