The particular colouring results from dermal melanocytosis the presence of functional melanocytes in the dermis. Fibroblastic connective tissue naevus typically presents in the first decade of life, often as a poorly defined plaquelike cutaneous thickening arising most commonly on the trunk and headneck of girls histology of fibroblastic connective tissue naevus. Clinical, dermoscopic and histopathological evaluation of. Fibroblastic connective tissue naevus pathology dermnet nz. The intradermal nevus is in the large group common nevus.
Some cases of dermal melanocytosis do not fit into any of these morphologic categories, however. A point mutation in the braf gene most often v600e is usually the initiating genetic mutation. Malignant tumours may arise within a nevus sebaceous. Histopathology skin compound clarks nevus dysplastic nevus this feature is not available right now. Dermal melanocytosis rarely occurs in unusual regions or covers extensive areas of the body 1. In rare cases malignant melanoma may develop in the skin or the uvea. Nevi of ota and ito occur most frequently in individuals of asian descent, with an estimated prevalence of 0. Hyperpigmentation of parts of the eye may occur sclera, cornea, iris, retina naevus of hori is similar to naevus of ota but affects both sides of the face. Unilateral nevus of ota with bilateral nevus of ito and. Nevus of ota nevus fuscoceruleus ophthalmomaxillaris is a bluegray or brown irregular, often spotted skin discoloration located on the face in the distribution of the first and second branches of the trigeminal nerve i.
Clinical criteria for ilven were defined by altman and mehregan in 1971. Naevus of ota is on the forehead and face around the eye area. The prognosis is usually excellent with appropriate treatment, since these moles are generally benign. Some sources equate the term mole with melanocytic nevus, but there are also sources that equate the term mole with any nevus form.
Naevus of ito is on the shoulder and upper arm area shoulder girdle. Nevus of ota, which originally was described by ota and tanino in 1939, is a hamartoma of dermal melanocytes. Characteristic findings on physical examination nevus of ito is similar to nevus of ota from both a pathologic and pathophysiologic perspective. There have been only few studies of clinical and histopathologic characteristics of nd, and the etiopathogenesis is not fully established. It also occurs on the forehead, nose, cheek, periorbital region, and temple. The eyelid is darkened, pigment can be observed on the white of the eye and that iris may be darker compared to the contralateral iris. Ilven inflammatory linear verrucous epidermal nevus, also known as ilven, is clinicopathological subgroup of epidermal nevus. Histopathology of compound nevus wikimedia commons. We report a very rare case that is the third to be described in the literature. The nevus appears as a bluehued patch and occurs within the distribution of the posterior supraclavicular and lateral cutaneous brachial nerves.
Media in category histopathology of compound nevus the following 7 files are in this category, out of 7 total. Sebaceous nevi and verrucous epidermal nevi are closely related, and many authors regard them as variants. Nevus of ito also known as nevus fuscoceruleus acromiodeltoideus is a skin condition with similar features to the nevus of ota, but occurring in a different distribution. A melanocytic nevus also known as nevocytic nevus, nevus cell nevus and commonly as a mole is a type of melanocytic tumor that contains nevus cells. Sep 28, 2011 nevus of ito is a colored birth mark that is usually slatebrown or bluegray. Soepronos textbook is available on and includes detailed information on over 600 entities and includes four dvd diskettes with highresolution images that provide a. Inflammatory linear verrucous epidermal nevus responsive. Inflammatory linear verrucous epidermal nevus with. The authors present a rare case of bluepigmented macules in the upper right periorbital region with involvement of the hard palate that were diagnosed as nevus. Bilateral distribution of nevus of ito is seldom reported in the literature. Seizures of various types were present in 53% of cases.
Clinical and histopathologic characteristics of nevus. The lesions commonly present on the legs with onset during childhood. Fibroblastic connective tissue naevus is situated primarily in the reticular dermis, and often shows extension into the superficial. Some degree of lightening can be achieved with lasers. These cells have failed to reach their proper location in the basal layer of the epidermis during embryonic migration from the neural crest. Although a nevus of ito usually occurs as an isolated lesion, it may be accompanied by a nevus. Naevus of ota and ito primary care dermatology society uk.
In the papillary and upper reticular dermis, dendritic melanocytes are present and surrounded by fibrous sheaths which are not present in other dermal melanocytosis, such as blue nevus. Nevus of ito genetic and rare diseases information center. Although it was originally described as a purely cutaneous disease, subsequent studies describing hi reported a 33% to 94% association with multiple extracutaneous manifestations, mostly of the central nervous and musculoskeletal systems. Malignant transformation in dermal melanocytosis is extremely rare, with only isolated case reports. Other skin alterations in addition to the typical hypomelanosis were observed in 38% of our cases. More accurately grouped with dermal melanocytoses nevus of ito, nevus of ota, hori nevus, socalled mongolian spot emedicine nevi of ota and ito although melanocytic, it is not a true nevus different entity from hypomelanosis of ito, a neurocutaneous disorder j. A clinical and histopathological study of nevus sebaceous. The most common forms include the mongolian spot, blue nevus, nevus of ota, and nevus of ito. In 1895, jadassohn first described nevus sebaceous see the image below, a circumscribed hamartomatous lesion predominantly composed of sebaceous glands. Nevus of ito is less common than nevus of ota, although the true incidence is unknown. Sun exposure is a causative factor, particularly in childhood. The large plaque blue nevus pilar neurocristic hamartoma may occasionally be associated with a background of lentigo simplex. Ilven usually occurs in young adults, but has also been reported in childhood.
Epidermal nevi may occur almost anywhere on the head, neck, legs, or trunk. In the oral cavity these are known as intramucosal nevi. Nevus of ito also known as nevus fuscoceruleus acromiodeltoideus is a skin condition with similar features to the nevus of ota, but occurring in a different distribution 700. Mar 26, 2019 nevi of ota and ito occur most frequently in individuals of asian descent, with an estimated prevalence of 0.
Nevus of ito nevus fuscoceruleus acromiodeltoideus is a similar pathologic process to nevus of ota in which unilateral pigmentation is located over the supraclavicular, deltoid, and scapular regions. Usually pigmented, biphasic tumor with component of classic blue nevus and distinct cellular areas composed of spindled to oval melanocytes with clear or finelypigmented cytoplasm arch pathol lab med 2011. The mongolian spot, nevi of ota and ito are the most common. The deep penetrating nevus may be considered a unique form of blue nevus, but some would include this lesion in the category of spitz nevus. A and b, classic example of blue nevus showing dermal sclerosis desmoplastic blue nevus and admixture of dendritic cells and type b melanocytes. Nevus depigmentosus nd is known to be a rare congenital, nonprogressive disorder characterized by a hypopigmented lesion that remains stable over time. Its association with nevus of ito, another dermal melanocytic nevus, is extremely rare. Nevus of ito is a benign melanocytic nevus that i occasionally encounter in both my the woodlands dermatology and conroe dermatology offices.
Blue nevi are often grouped together with hamartomatous dermal dendritic melanocytic proliferations such as nevus of ota, nevus of ito, and mongolian spot. In contrast to mongolian spot these hyperpigmentations do not disappear. Nevus of ito is a rare dermal melanocytic nevus that is predominantly observed in asian and darker skinned races. The name is not quite right, as the hypomelanotic patches of an achromic naevus are not completely white, unlike the areas of depigmentation in vitiligo. Examination of the oral cavity in the setting of nevus of ota is imperative, as it can present as a developmental lesion of the oral mucosa. A clinical and histopathological study of nevus sebaceous neerja puri consultant dermatologist, punjab health systems corporation, punjab, india abstract objective to study the clinical and histopathological features of nevus sebaceous ns. Jul 31, 20 a dense inflammation inflammatory linear verrucous epidermal nevus looking for more information, highresolution images, or differential diagnoses on this entity. Also known as dermal melanocytosis, mongolian spots, naevus of ota and naevus of ito are histopathologically similar to blue naevi and are characterized by a sparse population of scattered dendritic melanocytes in the reticular dermis without stromal alteration figure 1.
Naevi of ota and ito are bluegrey to slatebrown patches of hyperpigmentation. Nevus or nevi if multiple is a nonspecific medical term for a visible, circumscribed, chronic lesion of the skin or mucosa. Unilateral nevus of ota with bilateral nevus of ito and palatal lesion. Intradermal nevus abbreviated idn, also intradermal melanocytic nevus, is a common benign melanocytic lesion. Clinical, dermoscopic and histopathological evaluation of the. Methods we selected 20 cases of nevus sebaceous for clinical and histopathological evaluation. It resembles linear psoriasis both clinically and histologically.
Nevus of ito also known as nevus fuscoceruleus acromiodeltoideus is a skin condition with similar features to the nevus of ota, but occurring in a different distribution 700 see also. Because of their similar histology, differentiating dermal melanocytic. Nevus of ito is a dermal melanocytosis of the acromioclavicular and upper chest area. Nevus of ota and nevus of ito are rare dermal melanocytoses. These lesions may cause diagnostic difficulty in case of large size, involvement of subcutaneous tissue, asymmetrical pigmentation and presence of lymphnode metastasis. Nevus of ito occurs most frequently in asian populations and the true incidence is unknown. Inflammatory linear verrucous epidermal nevus ilven is a unilateral, persistent, linear, pruritic eruption that usually appears on an extremity in infancy or childhood. More accurately grouped with dermal melanocytoses nevus of ito, nevus of ota, hori nevus, socalled mongolian spot emedicine nevi of ota and ito although melanocytic, it is not a true nevus different entity from hypomelanosis of ito, a neurocutaneous disorder j child neurol 2000. Media in category histopathology of nevus the following 2 files are in this category, out of 2 total. Common terms, including mole, birthmark, and beauty mark, are used to describe nevi, but these terms do not distinguish specific. The histopathological examination of the skin from the affected areas showed the presence of elongated dendritic dermal melanocytes.
Nevus comedonicus is a rare nevoid malformation, characterized by hyperkeratotic comedonal lesions scattered in several parts of the body. It is part of the nevus comedonicus syndrome, a neurocutaneous disorder with ocular, skeletal, and central nervous symptoms. Nevus of ito is often unilateral and clinically similar to nevus of ota. Both of these lesions present as bluish macules which are present at birth or shortly thereafter. Clinically, a nevus of ito is very similar to a nevus of ota but the blueblack patch overlies the side of the neck, supraclavicular area and the shoulder. Lee jy, lee js, kim yc 2010 histopathological features of acquired. The majority of moles appear during the first two decades of a persons life, with about one in every 100. Both nevi are similar in all respect apart from the area of distribution. Epithelioid cells are admixed with dendritic cells and resemble clear cells of cellular blue nevus hematoxylineosin, original magnifications 320 a, c, and e and 3400 b, d, and f. No nevus cells found in surround connective tissue. Inflammatory linear verrucous epidermal nevus ilven is a rare cutaneous disease that presents as linear psoriasiform plaques with associated prominent pruritus. In exceptional cases nevus of ito may be present simultaneously with the nevus of ota.
Pathology of epidermal nevus and inflammatory linear. The lesion presents as persistent linear, pruritic eruptions. Patients with the nevus of ota should be examined at least every 6 months by an eyecancer specialist and a neurologist. They may be associated with capillary malformations. May 22, 2007 histopathology skin cellular blue nevus. Nevus of ito most commonly is seen overlying the distribution of the posterior supraclavicular and cutaneous brachii lateralis nerves. Age and sex distribution a neurotized nevus may be present at birth or form at any age in an individual.
The diagnosis of these conditions is most often made on clinical grounds, and a skin biopsy is rarely, if ever, needed to make the diagnosis. Nevus of ito genetic and rare diseases information. Naevus of ota, naevus of ito and naevus of hori dermnet nz. Dec 08, 2018 treatment is generally not required for neurotized nevus, unless it presents cosmetic issues. Dec 23, 2009 the term dysplastic naevus was then proposed and remains the term in most common use. It is characterized by the presence of nevus cell nests in the basilar region of epithelium. Achromic naevus american spelling nevus is also called naevus depigmentosus and nonpigmented naevus. Histopathology of nevus of ito and ota are identical, showing pigmented, spindleshaped, bipolar or dendritic melanocytes within the upper and mid dermis.
The nevus of ito develops in the territory supplied by the acromioclavicular nerve. Naevi from the auricular region, breast, conjunctiva and ankle sometimes have a rather atypical proliferation of melanocytes in the epidermis, often with pagetosis and cytological atypia. Nevus of ito nevus fuscoceruleus acromiodeltoideus. Pdf nevus of ota is a dermal melanocytic nevus seen. Acquired melanoyctic naevus or mole is a common benign tumour, usually appearing during childhood and adolescence. Inflammatory linear verrucous epidermal nevus typically is refractory to treatment. Lesions evolve with age, the initial lesion being macular with nests of proliferating. Bilateral nevus of ito is an extremely rare condition. Histopathology skincompound clarks nevus dysplastic nevus.
Nevus of ota may be very rarely associated with the nevus of ito and other extra cutaneous features. The nevus of ota appears as increased pigmentation of one eye and its eyelids. These are scattered in the upper parts of the reticular dermis. Sep 05, 2018 in 1895, jadassohn first described nevus sebaceous see the image below, a circumscribed hamartomatous lesion predominantly composed of sebaceous glands. Blue naevus was first described by tiesche in 1906. Clinically, nevus of ota presents as a blue or gray patch on the face, which is congenital or acquired and is within the distribution of the ophthalmic and maxillary branches of. Histologic findings for nevi of ota and ito have some similarities. Although both nevus depigmentosus and nevus of itooccur commonly, their coexistence in a manner represen.
Inflammatory linear verrucous epidermal nevus ilven is a rare disease characterized by pruritic, erythematous scaly lesions following blaschkos lines. Association of nevus sebaceus with an unusual type of combined nevus the histologic spectrum of pigmented spindle cell nevus. This type of birthmark is usually located on the shoulder and upper arm area on one side of the body. Nevus of ito is a large bluish discoloration of the skin, in. Nevus of ota is a blue dubious discuss hyperpigmentation that occurs on the face, most often appearing on the white of the eye.
Nevus of ito is a colored birth mark that is usually slatebrown or bluegray. Skeletal abnormalities, central nervous system defects. Therapies range from topical treatments to lasers and surgical options. Note location of biopsy both clinical and histopathology pigmented dendritic melanocytes, usually sparser than blue nevus ddx. Blue nevi are often grouped together with hamartoma tous dermal dendritic melanocytic proliferations such as nevus of ota, nevus of ito, and mongolian spot. It is an unusual birthmark in which the melanocytes pigment cells are found deeper than normal in the skin. Histologically there are nodular and diffuse collection of melanocytes. The term hypomelanosis of ito hi is applied to individuals with skin hypopigmentation along the lines of blaschko. We discuss salient clinical and pathologic features of blue nevi, with emphasis on the most diagnostically challenging aspects involving recognition of some rare variants and. Benign melanocytic naevi in various sites may show unusual histopathological features that may mimic melanoma. May 22, 2007 histopathology skin compound clarks nevus dysplastic nevus this feature is not available right now. The nevus of ito is usually located in the supraclavicular and deltoid region. We discuss salient clinical and pathologic features of blue nevi, with emphasis on the most diagnostically challenging aspects.
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