• Users Online: 519
  • Print this page
  • Email this page


 
  Table of Contents  
SKINDIA QUIZ
Year : 2017  |  Volume : 8  |  Issue : 1  |  Page : 70-72  

SkIndia Quiz 33: Solitary pigmented plaque containing a blue-gray papule


1 Carver College of Medicine, University of Iowa, Iowa City Veterans Affairs Medical Center, Iowa, USA
2 Department of Dermatology and Pathology, University of Iowa, Iowa City Veterans Affairs Medical Center, Iowa, USA

Date of Web Publication20-Jan-2017

Correspondence Address:
Dr. Brian L Swick
Department of Dermatology, University of Iowa, 200 Hawkins Drive, 40025 PFP, Iowa City, Iowa - 52245
USA
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2229-5178.193928

Rights and Permissions

How to cite this article:
Connor CJ, Swick BL. SkIndia Quiz 33: Solitary pigmented plaque containing a blue-gray papule. Indian Dermatol Online J 2017;8:70-2

How to cite this URL:
Connor CJ, Swick BL. SkIndia Quiz 33: Solitary pigmented plaque containing a blue-gray papule. Indian Dermatol Online J [serial online] 2017 [cited 2019 Oct 21];8:70-2. Available from: http://www.idoj.in/text.asp?2017/8/1/70/193928

A 35-year-old woman presented with a new dark papule that had arose within a previously stable tan plaque on her right thigh. There was no history of itching or bleeding from the lesion. Her past medical and family history were unremarkable. On examination, there was a 1.1 cm sharply demarcated tan plaque on the right anterior thigh containing an eccentric blue-gray papule [Figure 1].
Figure 1: Tan plaque containing an eccentric blue-gray papule on the right anterior thigh

Click here to view


Low-power histopathologic examination revealed a nested proliferation of cytologically bland appearing melanocytes focally along the dermoepidermal junction and more extensively in the dermis with a second population of pigmented epithelioid appearing melanocytes with surrounding melanophages in the upper reticular dermis [Figure 2]. High-power viewing confirmed the presence of two populations of melanocytes; the first was the small amelanotic population and the second consisted of localized nests of epithelioid melanocytes with conspicuous cytoplasmic melanization. There were prominent pigmented melanophages [Figure 3].
Figure 2: Compound melanocytic nevus with a focus of pigmented epithelioid appearing melanocytes with surrounding melanophages (H and E, original magnification ×100)

Click here to view
Figure 3: Focus of pigmented epithelioid appearing melanocytes with enlarged atypical appearing nuclei and surrounding pigmented melanophages with adjacent nests of smaller nonpigmented type B melanocytes (H and E, original magnification ×400)

Click here to view



   What Is the Diagnosis? Top


  1. Cellular blue nevus
  2. Clonal nevus (inverted type A nevus)
  3. Common blue nevus
  4. Deep penetrating nevus
  5. Epithelioid blue nevus




Click here to view answer. View Answer


 
   References Top

1.
Ball NJ, Golitz LE. Melanocytic nevi with focal atypical epithelioid cell components: A review of seventy-three cases. J Am Acad Dermatol 1994;30:724-9.  Back to cited text no. 1
    
2.
Huynh PM, Glusac EJ, Bolognia JL. The clinical appearance of clonal nevi (inverted type A nevi). Int J Dermatol 2004;43:882-5.  Back to cited text no. 2
    
3.
Skelton HG 3rd, Smith KJ, Barrett TL, Lupton GP, Graham JH. HMB-45 staining in benign and malignant melanocytic lesions. A reflection of cellular activation. Am J Dermatopathol 1991;13:543-50.  Back to cited text no. 3
    
4.
Cooper PH. Deep penetrating (plexiform spindle cell) nevus. A frequent participant in combined nevus. J Cutan Pathol 1992;19:172-80.  Back to cited text no. 4
    
5.
High WA, Alanen KW, Golitz LE. Is melanocytic nevus with focal atypical epithelioid components (clonal nevus) a superficial variant of deep penetrating nevus? J Am Acad Dermatol 2006;55:460-6.  Back to cited text no. 5
    
6.
Pulitzer DR, Martin PC, Cohen AP, Reed RJ. Histologic classification of the combined nevus. Analysis of the variable expression of melanocytic nevi. Am J Surg Pathol 1991;15:1111-22.  Back to cited text no. 6
    
7.
Phadke PA, Zembowicz A. Blue nevi and related tumors. Clin Lab Med 2011;31:345-58.  Back to cited text no. 7
    
8.
Carney JA, Ferreiro JA. The epithelioid blue nevus. A multicentric familial tumor with important associations, including cardiac myxoma and psammomatous melanotic schwannoma. Am J Surg Pathol 1996;20:259-72.  Back to cited text no. 8
    
9.
Moreno C, Requena L, Kutzner H, de la Cruz A, Jaqueti G, Yus ES. Epithelioid blue nevus: A rare variant of blue nevus not always associated with the Carney complex. J Cutan Pathol 2000;27:218-23.  Back to cited text no. 9
    
10.
Groben PA, Harvell JD, White WL. Epithelioid blue nevus: Neoplasm Sui generis or variation on a theme? Am J Dermatopathol 2000;22:473-88.  Back to cited text no. 10
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

Top
 
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
    What Is the Diag...
   Answer
   Discussion
    References
    Article Figures

 Article Access Statistics
    Viewed832    
    Printed14    
    Emailed0    
    PDF Downloaded121    
    Comments [Add]    

Recommend this journal