|Year : 2017 | Volume
| Issue : 1 | Page : 70-72
SkIndia Quiz 33: Solitary pigmented plaque containing a blue-gray papule
Cody J Connor1, Brian L Swick2
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 Publication||20-Jan-2017|
Dr. Brian L Swick
Department of Dermatology, University of Iowa, 200 Hawkins Drive, 40025 PFP, Iowa City, Iowa - 52245
Source of Support: None, Conflict of Interest: None
|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 Jun 20];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|
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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)|
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|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)|
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| What Is the Diagnosis?|| |
- Cellular blue nevus
- Clonal nevus (inverted type A nevus)
- Common blue nevus
- Deep penetrating nevus
- Epithelioid blue nevus
| References|| |
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.
Huynh PM, Glusac EJ, Bolognia JL. The clinical appearance of clonal nevi (inverted type A nevi). Int J Dermatol 2004;43:882-5.
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.
Cooper PH. Deep penetrating (plexiform spindle cell) nevus. A frequent participant in combined nevus. J Cutan Pathol 1992;19:172-80.
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.
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.
Phadke PA, Zembowicz A. Blue nevi and related tumors. Clin Lab Med 2011;31:345-58.
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.
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.
Groben PA, Harvell JD, White WL. Epithelioid blue nevus: Neoplasm Sui generis or variation on a theme? Am J Dermatopathol 2000;22:473-88.
[Figure 1], [Figure 2], [Figure 3]