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Recurrent nevi: report of three cases with dermatoscopic-dermatopathologic correlation

Dermatology Practical & Conceptual
Publication Date
DOI: 10.5826/dpc.0301a08
  • Observation
  • Biology
  • Medicine


Dermatology: Practical and Conceptual DERMATOLOGY PRACTICAL & CONCEPTUAL Observation | Dermatol Pract Concept 2012;3(1):8 29 Introduction Because of their similar appearance to melanoma, recurrent and persistent nevi may pose diagnostic difficulties. We pres- ent three cases of recurrent nevi and their clinical, dermato- scopic and dermatopathologic findings. Case 1 A 40-year-old patient presented with a papule on the calf with irregular brown pigmentation (Figure 1). On dermatos- copy the lesion was composed of segmental radial lines and structureless zones. Discrete reticular lines were also seen but they were also present in the surrounding normal skin. The pigmentation did not extend towards the edge of the visible scar. Disregarding the clinical history of a previous surgery of a nevus the differential diagnosis based solely on the derma- toscopic presentation includes recurrent melanoma, basal cell carcinoma and recurrent nevus. Histopathologically one can spot inconspicuous dermal nests of melanocytes on site and heavily pigmented melanocytes at the dermoepidermal junc- tion on the other. The epidermal melanocytes are arranged as single cells of which some can be found in higher levels of the epidermis including the stratum corneum, resembling melanoma in situ. The fact that this area is present above a scar of an otherwise inconspicuous “superficial and deep” congenital nevus, as well as the patient history of a previous shave biopsy, led to the diagnosis of a recurrent nevus. Case 2 A 23-year-old woman presented with a brown macule on the chest (Figure 2). Dermatoscopically there are segmental radial lines, brown clods and structureless zones. The pig- mented structures correspond to junctional nests of melano- cytes. The scar is visible dermatoscopically at the periphery of the lesion. The pigmentation is not present beyond the scar. The histopathologic findings of unsuspic

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