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Dermatology

Benign Melanocytic Neoplasms and Melanotic Lesions

Built from Dermatology, 5th Edition

What’s inside

9 sections · 191 slides

  1. 01

    Overview

    • What this topic covers
    • Two families of pigmented spot

    2 slides

  2. 02

    Circumscribed Melanotic Lesions

    Flat pigmented spots caused by extra melanin, not extra melanocytes

    • Ephelides (freckles)
    • Ephelides: pathology and outlook
    • Comparative clinical features of ephelides and solar lentigines
    • Comparative clinical features of ephelides and solar lentigines (continued)
    • Comparative clinical features of ephelides and solar lentigines (continued)
    • Comparative clinical features of ephelides and solar lentigines (continued)
    • Comparative clinical features of ephelides and solar lentigines (continued)
    • Cafe-au-lait macules (CALMs)
    • Cafe-au-lait macules
    • When multiple CALMs raise a flag
    • Segmental cafe-au-lait macules
    • Cafe-au-lait macules: pathology and care
    • Becker melanosis (Becker nevus)
    • Becker melanosis: what it looks like
    • Becker melanosis: three presentations
    • Becker melanosis: border and hair pattern
    • Becker melanosis: differential and treatment
    • Solar lentigines
    • Solar lentigines
    • Solar lentigines: dermoscopy
    • Solar lentigines, second example
    • Solar lentigo: histopathology
    • Lentigo simplex
    • Mucosal melanotic macules
    • Genital lentiginosis
    • Labial melanotic macule: histopathology
    • Conjunctival and other mucosal melanosis
    • Penile lentiginosis
    • Labial melanotic macule: histopathology (second example)
    • Lentigo simplex: differential and treatment
    • Disorders associated with multiple lentigines
    • Disorders associated with multiple lentigines (continued)
    • Disorders associated with multiple lentigines (continued)
    • Disorders associated with multiple lentigines (continued)
    • Disorders associated with multiple lentigines (continued)
    • Disorders associated with multiple lentigines (continued)
    • Disorders associated with multiple lentigines (continued)
    • Noonan syndrome with multiple lentigines (LEOPARD)
    • Cafe-noir macule in Carney complex
    • Carney complex and Peutz-Jeghers syndrome
    • Multiple lentigines: Carney complex and Peutz-Jeghers syndrome
    • Laugier-Hunziker syndrome and partial unilateral lentiginosis
    • Laugier-Hunziker syndrome: lip and palm lentigines
    • Laugier-Hunziker syndrome: oral and acral lentigines

    44 slides

  3. 03

    Dermal Melanocytosis

    Blue-gray discoloration from pigment cells trapped deep in the dermis

    • Mongolian spot (congenital dermal melanocytosis)
    • Mongolian spot: pathology and mimics
    • Dermal melanocytosis in a child with neurofibromatosis 1
    • Nevus of Ota
    • Nevus of Ota: clinical and histopathologic features
    • Nevus of Ota: risk and management
    • Nevus of Ota
    • Nevus of Ota: eye involvement
    • Nevus of Ito and related patches

    9 slides

  4. 04

    Melanocytic Nevi: The Biology and the Blue Nevus Family

    True clusters of melanocytes, driven by oncogene mutations

    • What makes something a melanocytic nevus
    • Genes and gene fusions implicated in the development of melanocytic nevi
    • Genes and gene fusions implicated in the development of melanocytic nevi (continued)
    • Genes and gene fusions implicated in the development of melanocytic nevi (continued)
    • Genes and gene fusions implicated in the development of melanocytic nevi (continued)
    • Genetic syndromes associated with numerous acquired melanocytic nevi
    • Genetic syndromes associated with numerous acquired melanocytic nevi (continued)
    • Blue nevus: overview
    • Common blue nevus
    • Common blue nevi: clinical and histopathologic features
    • Cellular blue nevus and its atypical form
    • Cellular blue nevi: clinical and histopathologic features
    • Pigmented epithelioid melanocytoma (PEM)

    13 slides

  5. 05

    Common Acquired, Special-Site, and Acral Nevi

    How ordinary moles form, look, and where their appearance changes with location

    • How many moles do we get, and why
    • What switches a melanocyte into a nevus
    • Triggers for the development and/or growth of melanocytic nevi
    • Triggers for the development and/or growth of melanocytic nevi (continued)
    • Triggers for the development and/or growth of melanocytic nevi (continued)
    • Three faces of the common mole
    • Common acquired melanocytic nevi: clinical and histopathologic features
    • Junctional nevus by dermoscopy
    • Intradermal nevus by dermoscopy
    • Nevi in special settings
    • Longitudinal melanonychia from a benign nail-matrix nevus
    • Common nevi: pathology, mimics, and treatment
    • Genital nevus and nevi of special sites
    • Acral nevus
    • Furrows and ridges of acral skin
    • Parallel furrow pattern on dermoscopy
    • Lattice-like pattern in an acral nevus
    • Acral melanocytic nevus: histopathology
    • Acral nevi – common dermoscopic patterns

    19 slides

  6. 06

    Spitz Nevus and Related Spindle/Epithelioid Nevi

    Distinctive childhood nevi that are the hardest lesions to tell apart from melanoma

    • Spitz nevus: overview
    • Spitz nevus: what triggers it, what it looks like
    • Spitz nevi: four clinical presentations
    • Spitz nevus on the ear
    • Spitz nevus, pink and symmetric
    • Agminated and disseminated Spitz nevi
    • Agminated Spitz nevi
    • Atypical Spitz tumor and Spitz melanoma
    • Spitz nevus: pathology clues
    • Spitz nevus: histopathologic features
    • Spitz nevus vs. melanoma: Spitz nevus features
    • Spitz nevus vs. melanoma: Spitz nevus features (continued)
    • Spitz nevus vs. melanoma: Spitz nevus features (continued)
    • Spitz nevus vs. melanoma: Spitz nevus features (continued)
    • Spitz nevus vs. melanoma: Spitz nevus features (continued)
    • Spitz nevus vs. melanoma: melanoma features
    • Spitz nevus vs. melanoma: melanoma features (continued)
    • Spitz nevus: treatment approach
    • Assessment of atypical Spitz tumors in children and adolescents for risk for metastasis
    • Assessment of atypical Spitz tumors in children and adolescents for risk for metastasis (continued)
    • Pigmented spindle cell nevus (nevus of Reed)
    • Pigmented spindle cell nevus: histopathology
    • Pigmented spindle cell nevus: pathology and care
    • WNT-activated deep penetrating/plexiform nevus
    • WNT-activated nevus: treatment
    • BAP1-inactivated melanocytic nevus
    • BAP1-inactivated melanocytic nevus
    • BAP1-inactivated nevus: pathology
    • Combined BAP1-inactivated melanocytic nevus
    • BAP1-inactivated nevus: differential and screening
    • BAP1-inactivated melanocytic nevus (BAPoma) with mesothelioma
    • Epithelioid BAP1-loss nevus: histopathology

    32 slides

  7. 07

    Atypical (Dysplastic) Melanocytic Nevus

    A controversial gray zone between the ordinary mole and early melanoma

    • A controversial term, 40 years in the making
    • Melanocytic nevus phenotypes
    • Atypical nevi: how common, and does BRAF still drive them
    • What an atypical nevus looks like
    • Atypical melanocytic nevi: fried-egg and eclipse patterns
    • Atypical melanocytic nevi: asymmetry and multiplicity
    • Reading the dermoscopy of an atypical nevus
    • Atypical nevi with dermoscopic patterns typical of benign nevi
    • Atypical nevus: reticular-disorganized dermoscopy pattern
    • Atypical nevi with dermoscopic patterns often seen in melanoma
    • Melanoma risk associated with clinically atypical melanocytic nevi: comparison of occurrence in melanoma patients versus controls
    • Atypical nevus: architecture under the microscope
    • Atypical nevus: cytology and stroma
    • Atypical melanocytic nevus: bridging nests on histopathology
    • Two atypical-nevus variants worth naming
    • Erythematous variant of atypical melanocytic nevus
    • Eclipse nevus on the scalp
    • Treatment: the excision decision
    • Re-excision: when a biopsy margin is positive
    • Following patients with many atypical nevi
    • Follow-up schedule for clinically atypical melanocytic nevi

    21 slides

  8. 08

    Congenital Melanocytic Nevus

    Nevi present at birth, sized from a freckle to covering the whole trunk

    • Congenital melanocytic nevus: classification
    • Congenital nevus: how common, and what drives it
    • Congenital melanocytic nevi with neurocutaneous melanosis
    • What a congenital nevus looks like
    • Medium-sized congenital melanocytic nevi: four presentations
    • Medium-sized congenital nevus by dermoscopy
    • Neurotization in a giant congenital nevus
    • Neurocutaneous melanosis
    • Neurocutaneous melanosis: who is highest risk
    • Approach to multiple medium-sized or a large/giant congenital nevus
    • Melanoma arising in congenital nevi
    • Congenital nevus: pathology
    • Congenital melanocytic nevus: histopathologic features
    • Congenital nevus: differential diagnosis
    • Small congenital melanocytic nevus, second example
    • Giant congenital melanocytic nevus with multiple satellite nevi
    • Congenital nevus: treatment principles
    • Management of children with giant congenital melanocytic nevi (GCMN)

    18 slides

  9. 09

    Nevus Spilus, Halo Nevus, Combined Nevus, and Recurrent Nevus

    Four distinctive patterns that each teach a different diagnostic lesson

    • Nevus spilus (speckled lentiginous nevus)
    • Nevus spilus: risk and treatment
    • Nevus spilus: range of presentations
    • Nevus spilus: large tan patch with speckles
    • Halo nevus (Sutton nevus)
    • Halo nevus: the four-stage course
    • Halo melanocytic nevi: stages I-IV
    • Halo nevus by dermoscopy
    • Combined nevus
    • Combined melanocytic nevus: a discrete dark focus within a tan nevus
    • Combined nevus: pathology and workup
    • Combined nevus: histopathologic features
    • Recurrent melanocytic nevus (pseudomelanoma)
    • Recurrent nevus: pathology and red flags
    • Recurrent melanocytic nevus: clinical and histopathologic features
    • Recurrent nevus by dermoscopy
    • Recurrent nevus: treatment
    • Two questions to ask of any pigmented spot
    • The recurring red flags across this topic
    • What to remember
    • References
    • References (continued)
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    • References (continued)
    • Dermatology, 5th Edition (2-Volume Set)

    33 slides