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[Superficial cutaneous nevus lipomatosus (Hoffmann-Zurhelle)].

Neviform hand-sized yellowish or skin colored plaques or linear lesions with flattened papules or folded surface in the gluteal regions, especially in females, point out to nevus lipomatosus superficialis (Hoffmann-Zurhelle). These nevi consisting of mature fat cells among the dermal collagen are rare lesions. The case report of two female patients should remind of this clinical and histological picture.

Adult↗

Nevus lipomatosus cutaneous superficialis.

Nevus lipomatosus cutaneus superficialis (Hoffman-Zurhelle) is a distinct clinical entity. A case is reported in which the lesions were large, appeared early in childhood and were linear in distribution along the natal cleft.

Adipose Tissue↗

Metastatic melanoma to the skin simulating blue nevus.

Cutaneous metastases from melanoma can mimic primary melanoma and melanocytic nevi. Recognition of a metastatic lesion is of great importance for proper staging and treatment decisions. In this study, a potential diagnostic pitfall is described and discussed: dermal metastases from cutaneous melanoma simulating blue nevus, a phenomenon that has received little attention. Ten blue nevus-like lesions from three patients are presented. All contained pigmented melanocytes and melanophages in variable proportions arranged in a blue nevus-like growth pattern. The blue nevus-like metastases occurred in the same anatomic region as the primary tumor or, as in one patient, near the skin scar of a dissected lymph node metastasis. Histologic clues of metastatic melanoma included the presence of atypical epithelioid melanocytes, mitotic figures, and an associated inflammatory cell infiltrate at the periphery of the lesion. Although such histologic features facilitate the recognition of a metastasis, clinical correlation is essential for a definitive diagnosis.

Adult↗

Nevus lipomatosus cutaneous superficialis with perifollicular fibrosis.

Nevus lipomatosus cutaneous superficialis (NLCS) is a rare hamartomatous skin lesion histopathologically characterized by the presence of mature fat tissue even within the upper dermis. Clinically, two types of NLCS can be distinguished; a multiple type and a solitary type. We here report a 10-month-old girl showing multiple type NLCS as a collection of a nodule and papules on her right abdomen. Histological examination revealed that the lesion was composed of a lobular proliferation of fat tissue throughout the dermis and immature hair follicle-like structures with perifollicular fibrosis. Histological alterations of the dermal connective tissue components were also seen, including thickening of collagen bundles and increased numbers of both fibroblasts and blood vessels. This is the first reported case of NLCS with perifollicular fibrosis.

Female↗

Nevus lipomatosus cutaneous superficialis of the clitoris.

BACKGROUND: Nevus lipomatosus cutaneous superficialis (NLCS) is a relatively rare condition. Although NLCS can affect any region of the entire body, no case of NLCS in the clitoris has ever been reported. OBJECTIVE: To report a case of NLCS of the clitoris that presented manifestations that were similar to female pseudohermaphrodism. METHODS: This is a case report and review of the literature. RESULTS: A congenital, soft, skin-colored lesion of the clitoris in a 1-year-old girl resembled female pseudohermaphrodism. It was resected, and the histologic diagnosis was NLCS. Postoperatively, there was no subsequent change in the lesion during the 3-year follow-up period. CONCLUSION: We reported a case of congenital solitary NLCS of the clitoris. Although NLCS might be a relatively rare condition, we should consider it in the differential diagnosis of female pseudohermaphrodism.

Clitoris↗

Nodal melanocytic nevi in sentinel lymph nodes. Correlation with melanoma-associated cutaneous nevi.

Melanocytic nevi occurring in lymph nodes create diagnostic difficulty by mimicking metastases. Few studies describe nodal nevi in sentinel lymph nodes (SLNs) excised for melanoma. We evaluated 72 cases in which patients had undergone SLN biopsy for melanoma. Lymph nodes and cutaneous melanomas were evaluated according to a standard protocol. Nodal nevi were identified in 8 patients (11%). Of these, 6 (75%) had an associated cutaneous nevus (P = .006). Of 21 patients with an associated nevus, 4 (19%) with nodal nevi had a cutaneous nevus with congenital features (P = .01). The incidence of nodal nevus correlated with a Breslow thickness greater than 2.5 mm (P = .02). Nevi were not seen in non-SLNs. Nodal nevi appear more frequently in patients with melanoma-associated cutaneous nevi, particularly if congenital features are present. The increased frequency of nodal nevi in SLNs relative to non-SLNs suggests an etiology of mechanical transport of nevus cells.

Adolescent↗

Etiologic and other factors predicting nevus-associated cutaneous malignant melanoma.

Cutaneous malignant melanomas with histologic evidence of an associated nevus (N+) may have a different risk factor profile from that of melanomas without it (N-). To address this question, a case-only analysis of 932 people with cutaneous malignant melanoma was done to identify etiologic and other factors associated with N+ melanoma. Evidence of an associated nevus was found in 36% of melanomas. N+ melanomas were thinner (Ptrend=0.0009) and more likely to be of the superficial spreading type than other types of melanoma. Subjects with N+ melanomas were younger (Ptrend<0.0001) and reported a higher nevus density on their skin than subjects with N- melanomas [odds ratio (OR), 3.1; 95% confidence interval (CI), 1.6-6.0, for high nevus density versus no nevi]. Indicators of high accumulated sun exposure were less prevalent among subjects with N+ melanomas (OR, 0.3; 95% CI, 0.2-0.4, for melanoma location on the head and neck versus location on trunk; OR, 0.2; 95% CI, 0.1-0.4, for severe solar elastosis adjacent to the melanoma versus no elastosis; OR, 0.2; 95% CI, 0.1-0.4, for lentigo maligna melanoma subtype versus superficial spreading subtype). With the exception of solar elastosis and age, all of the aforementioned variables remained significantly associated with N+ melanomas in multivariate analyses. No associations with self-reported measures of sun exposure, sunburn, or pigmentation phenotype were apparent. Our findings provide some support for the hypothesis of etiologically separate pathways for melanoma, with N+ melanomas appearing less likely to develop in the presence of characteristics suggesting high accumulated sun exposure than N- melanomas. However, it is possible that high UV exposure causes involution of nevi, thus reducing the density of nevi in exposed skin and thereby the probability of N+ melanoma.

Adult↗