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Year : 2015  |  Volume : 6  |  Issue : 7  |  Page : 50-52  

Dermpath quiz: An irregularly colored papule on the back of an adolescent female

1 New York University School of Medicine, New York, NY, USA
2 Polley Clinic of Dermatology and Dermatologic Surgery, Wilson, NC, USA
3 Ackerman Academy of Dermatopathology, New York, NY, USA

Date of Web Publication4-Dec-2015

Correspondence Address:
Dirk M Elston
Ackerman Academy of Dermatopathology, 145 E. 32nd Street, 10th Floor, New York, NY
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2229-5178.171043

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This learning exercise challenges clinicians and dermatopathologists to consider the differential diagnosis of an unevenly colored solitary papule over the upper back of an adolescent female.

Keywords: Halo nevus, leukoderma acquisitum centrifugum of Sutton, pigmented nevus

How to cite this article:
Price A, Polley DC, Sabol ME, Elston DM. Dermpath quiz: An irregularly colored papule on the back of an adolescent female. Indian Dermatol Online J 2015;6, Suppl S1:50-2

How to cite this URL:
Price A, Polley DC, Sabol ME, Elston DM. Dermpath quiz: An irregularly colored papule on the back of an adolescent female. Indian Dermatol Online J [serial online] 2015 [cited 2021 May 11];6, Suppl S1:50-2. Available from: https://www.idoj.in/text.asp?2015/6/7/50/171043

A 12-year-old female patient presented with an asymptomatic, 0.5 cm × 0.5 cm variably colored pink and brown papule on the right suprascapular back [Figure 1]. The lesion first appeared 10 years ago and remained stable until two years ago when it began to enlarge and change color. The patient's medical history was unremarkable except for a history of hypothyroidism.
Figure 1: A variably colored pink and brown papule on the right suprascapular back

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A shave biopsy was performed. Histopathologic examination of the lesion demonstrated a well-defined proliferation of nested melanocytes with bland nuclei and superficial dermal nests with moderately atypical nuclei [Figure 2] and [Figure 3]. A bandlike lymphoid infiltrate extended through the lesion [Figure 2].
Figure 2: Well-defined proliferation of nested melanocytes with bland nuclei and bandlike lymphoid infiltrate (H and E, ×100)

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Figure 3: Moderately atypical nuclei are present within superficial dermal nests (H and E, ×400)

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The lesion most likely represents

  • Halo nevus
  • Melanoma
  • Pigmented spindle cell nevus of Reed
  • Spitz nevus
  • Wiesner's nevus.

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   References Top

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Ortonne JP, Mosher DB, Fitzpatrick TB. Leukoderma acquisitum centrifugum: Halo nevus and other hypomelanoses associated with neoplasm. Vitiligo and Other Hypomelanoses of Hair and Skin. New York and London: Plenum Medical Book Company; 1983. p. 567-607.  Back to cited text no. 15
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  [Figure 1], [Figure 2], [Figure 3]


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