Background: Melanocytic nevi with eccentric foci of hyperpigmentation (“ Bolognia sign” ) can be considered as a melanoma-simulating type of acquired melanocytic nevus. We report on the morphologic changes of this t...Background: Melanocytic nevi with eccentric foci of hyperpigmentation (“ Bolognia sign” ) can be considered as a melanoma-simulating type of acquired melanocytic nevus. We report on the morphologic changes of this type of melanocytic nevus over a 39-month period of dermoscopic follow-up. Observations: A 5-year-old girl had a 4-mm brown papule with a peripheral blue-black area on her right upper arm. The eccentric focus of the hyperpigmentation corresponded dermoscopically to a blue-gray area of pigmentation associated with irregular brown-black globules or dots and partially with a superficial black network. After 39 months, a globular type of acquired melanocytic nevus was detectable, which clinically and dermoscopically appeared to be completely benign. A nearly identical situation was observed in 5 other melanocytic nevi, underlining the involution of the pigmented foci in these nevi. The histopathologic diagnoses of 2 lesions were consistent with a compound type of acquired melanocytic nevus with eccentric foci of hyperpigmentation. Conclusions: Dermoscopy allows identification of a morphologic pathway of modifications, probably typical for this type of melanocytic nevus in children, and therefore enables avoidance of surgical excision with attendant hypertrophic scarring in children. Conversely, in adults, when dermoscopic follow-up of melanocytic nevi reveals eccentric foci of hyperpigmentation, surgical excision of the lesion is indicated.展开更多
Background. Actinic prurigo (AP) is a photodermatosis with a restricted ethnic distribution, mainly affecting Mestizowomen (mixed Indian and European). The le sions are polymorphic and include macules, papules, crusts...Background. Actinic prurigo (AP) is a photodermatosis with a restricted ethnic distribution, mainly affecting Mestizowomen (mixed Indian and European). The le sions are polymorphic and include macules, papules, crusts, hyperpigmentation an d lichenification. Thalidomide, an effective immunomodulatory drug, was first us ed successfully to treat AP in 1973. In this work we descri be the effect that t halidomide had on TNF-αsera levels and on IL-4-and IFN gamma (IFNγ)-produc ing lymphocytes of actinic prurigo (AP) patients. Methods. Actinic prurigo patie nts were analyzed before and after thalidomide treatment. The percentage of IL- 4+or IFNγ+CD3+lymphocytes was analyzed in eight of them by flow cytometry. T NFαin sera was measured by ELISA in 11 patients. Results. A direct correlation was observed between resolution of AP lesions and an increase in IFNγ+CD3+per ipheral blood mononuclear cells (P ≤0.001) and a decrease in TNFαserum levels (no statistical difference). No IL-4+CD3+cells were detected. Conclusions. Ou r findings confirm that AP is a disease that has an immunological component and that thalidomide clinical efficacy is exerted not only through inhibition of TNF αsynthesis, but also through modulation of INFγ-producing CD3+cells. These c ells could be used as clinical markers for recovery.展开更多
文摘Background: Melanocytic nevi with eccentric foci of hyperpigmentation (“ Bolognia sign” ) can be considered as a melanoma-simulating type of acquired melanocytic nevus. We report on the morphologic changes of this type of melanocytic nevus over a 39-month period of dermoscopic follow-up. Observations: A 5-year-old girl had a 4-mm brown papule with a peripheral blue-black area on her right upper arm. The eccentric focus of the hyperpigmentation corresponded dermoscopically to a blue-gray area of pigmentation associated with irregular brown-black globules or dots and partially with a superficial black network. After 39 months, a globular type of acquired melanocytic nevus was detectable, which clinically and dermoscopically appeared to be completely benign. A nearly identical situation was observed in 5 other melanocytic nevi, underlining the involution of the pigmented foci in these nevi. The histopathologic diagnoses of 2 lesions were consistent with a compound type of acquired melanocytic nevus with eccentric foci of hyperpigmentation. Conclusions: Dermoscopy allows identification of a morphologic pathway of modifications, probably typical for this type of melanocytic nevus in children, and therefore enables avoidance of surgical excision with attendant hypertrophic scarring in children. Conversely, in adults, when dermoscopic follow-up of melanocytic nevi reveals eccentric foci of hyperpigmentation, surgical excision of the lesion is indicated.
文摘Background. Actinic prurigo (AP) is a photodermatosis with a restricted ethnic distribution, mainly affecting Mestizowomen (mixed Indian and European). The le sions are polymorphic and include macules, papules, crusts, hyperpigmentation an d lichenification. Thalidomide, an effective immunomodulatory drug, was first us ed successfully to treat AP in 1973. In this work we descri be the effect that t halidomide had on TNF-αsera levels and on IL-4-and IFN gamma (IFNγ)-produc ing lymphocytes of actinic prurigo (AP) patients. Methods. Actinic prurigo patie nts were analyzed before and after thalidomide treatment. The percentage of IL- 4+or IFNγ+CD3+lymphocytes was analyzed in eight of them by flow cytometry. T NFαin sera was measured by ELISA in 11 patients. Results. A direct correlation was observed between resolution of AP lesions and an increase in IFNγ+CD3+per ipheral blood mononuclear cells (P ≤0.001) and a decrease in TNFαserum levels (no statistical difference). No IL-4+CD3+cells were detected. Conclusions. Ou r findings confirm that AP is a disease that has an immunological component and that thalidomide clinical efficacy is exerted not only through inhibition of TNF αsynthesis, but also through modulation of INFγ-producing CD3+cells. These c ells could be used as clinical markers for recovery.
