Sclerosing nevus with pseudomelanomatous features: Dermoscopic and confocal aspects

C Bombonato, R Pampena, C Franceschini, S Piana, F Perino, A Di Stefani, M Ardigò, M C Fargnoli, P Frascione, S Borsari, G Pellacani, K Peris, C Longo

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BACKGROUND: Sclerosing nevus with pseudomelanomatous features (SNPF) is a clinical and pathologic entity that mimics melanoma both clinically and histologically. The lesion is a melanocytic nevus, histologically characterized by fibrosis and a pseudo-melanomatous proliferation. It is typically seen in young to middle-aged individuals, mainly on the back, where microtrauma or inflammatory changes are more frequent. Dermoscopic description of SNPF has been reported so far in one case series.

OBJECTIVE: The aim of our study was to describe the dermoscopic and confocal features of SNPF.

METHODS: Histopathologically confirmed cases of SNPF were retrospectively collected from 3 referral centers in Italy. Only lesions with available clinical, dermoscopic and histopathological data were included; confocal images were also retrieved, when available. Lesions were evaluated for the presence of 12 dermoscopic and 5 confocal criteria previously described.

RESULTS: The study population included 93 lesions in as many patients (71 men and 22 women; median age: 38 years). Dermoscopically, we found a predominance of dark colours, in particular brown and blue, which were found in all lesions and the vast majority of the lesions (86/93; 92.5%) displayed at least one structureless area. By the combination of colours and structures, we observed that the majority of the lesions (67/92; 72%) were characterized by more than 1 structure and more than 1 colour. Confocal evaluation was performed on a subset of 24/93 lesions showing a regular architecture pattern (19/24 cases, 79%), with a predominance of the ringed pattern. The presence of focal cytologic atypia at the dermal-epidermal junction was present in 12/24 cases (50%) with a prevalent dendritic shaped cell proliferation.

CONCLUSIONS: The current study demonstrated that SNPF was frequently characterized, on dermoscopic examination, by more than 1 structure and more than 1 colour and on confocal microscopy by a regular ringed pattern with focal dendritic atypical cells. This article is protected by copyright. All rights reserved.

Original languageEnglish
JournalJournal of the European Academy of Dermatology and Venereology
Publication statusE-pub ahead of print - Oct 13 2018


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