The ultrastructure of congenital nevocytic nevi

Summary As only few previous investigations considered size-dependent differences in the histology of congenital nevocytic nevi (CNN) or focused on their ultrastructure, a light- and electron-microscopic study of six giant and six medium-sized CNN was performed. Histologically, giant CNN showed minimal junctional nevus elements and a pandermal, diffuse nevus cell extension including the subcutaneous tissue, while medium-sized CNN exhibited more abundant junctional nests and a rather focal pattern of nevus cell extension into the reticular dermis. Ultrastructurally, giant CNN often showed nevus cells with irregular and indented nuclei and also nevus cells with highly complicated dendrites. Nuclear inclusions, multiple cilia and centrioles, and collagen phagocytosis in nevus cells were found in both groups of CNN. Direct contacts between nevus cells and nerve fibers were observed in mediumsized CNN only. The findings provided no clear morphological indication why giant CNN have a higher risk for malignant degeneration than medium-sized CNN or acquired nevocytic nevi (ANN). On the other hand, the histological differences speak in favor of a different ontogenesis of the various size classes of CNN and ANN.     

Current management approaches for congenital melanocytic nevi

Lack of information and misinformation abounds regarding the potential risks of malignancy, management approaches, benefits of surgical intervention, follow-up strategies, and overall prognosis for individuals with congenital melanocytic nevi (CMN). This review is intended to provide answers to questions that frequently arise shortly after the birth of individuals with CMN, especially of larger types.     

黑素细胞痣的形成机制

黑素细胞痣临床常见,通过对发疹性黑素细胞痣与免疫抑制剂的关系分析,认为黑素细胞痣的产生与免疫抑制有关.促黑素细胞激素-α能促进黑素细胞的增殖,在黑素细胞痣形成中发挥作用.其可通过环磷腺苷途径上调小眼畸形相关转录因子的表达,促进黑素细胞的增殖.促黑素细胞激素-α和免疫抑制剂影响朗格汉斯细胞、T细胞及IL-10、IL-12等细胞因子,可能作用于促分裂原激活蛋白激酶信号通路,上调小眼畸形相关转录因子的表达,从而导致黑素细胞痣的形成.     

The ultrastructure of congenital nevocytic nevi. I. Nevus cells in walls of blood vessels and lymphatics

Summary As congenital nevocytic nevi have an increased risk of malignant degeneration, nevus-cell involvement in blood vessels and lymphatics is of particular interest. The present histological and ultrastructural studies revealed nevus-cell nests in the walls of venules in 1 out of 11 patients with medium-sized nevi, and in subcutaneous veins in 3 out of 8 patients with garment nevi. In all cases, the nests histologically consisted of benign-appearing subendothelial B-type cells. Ultrastructurally, the features of these nevocytes essentially corresponded to those of nevocytes in the surrounding area. In 1 patient with a garment nevus, in whom affected vessels of the lumbar area as well as of the neck were examined, the nevus-cell nests were exclusively situated between the endothelium and its basal lamina. These nevocytes appeared to be more electron dense, but had no unequivocally atypical features. In the region of these nests, the endothelium was often discontinuous; thus, the nevus-cells were in direct contact with the lumen. Some of these cells exhibited slight degenerative changes. The lymphatics were affected in 6 of the 18 cases of garment nevi and in 2 of the 11 cases of medium-sized nevi. The morphological findings were comparable to those for blood vessels. It is concluded that, in garment nevi, morphologically benign nevocytes may be carried off hematogenously as well as lymphogenously.This study was supported by the EMDO Foundation, Zurich     

先天性皮脂腺痣1例

患儿男,45d。左侧额头、颊部、颞部和耳廓及下颌部出现淡红色斑块和丘疹45d。全部皮损组织病理学检查均提示皮脂腺痣。予手术切除皮损。现愈合良好,继续随访中。     

Melanocytic nevi with features of Spitz nevi and Clark's/dysplastic nevi (Spark's nevi)

Background: Nevi with cytologic characteristics of Spitz nevus and architectural features of Clark's/dysplastic nevus are not well recognized in the literature.
Methods: Twenty-seven nevi with characteristics of Spitz nevus and Clark's/dysplastic nevus are reviewed.
Results: The patients' mean age was 33 years, and 17/27(63%) patients were female. Lesions were most frequent on the trunk and lower extremities. Histopathologically, these nevi were composed of large, monomorphous spindled and/or epithelioid melanocytes. Spindle cells were often oriented parallel to the epidermis, with fused rete and lamellar fibroplasias. Lateral extension of the junctional component was a feature of compound lesions. An average of 10 years of clinical follow up in 12 patients revealed no recurrence or metastasis.
Conclusions: Recognition of this type of nevus is important to avoid confusion with malignant melanoma.     

E-cadherin expression in the subepithelial nevus cells of the giant congenital nevocellular nevi (GCNN) correlates with their migration ability in vitro

BACKGROUND: Giant congenital nevocellular nevi (GCNN) are histologically characterized by the broad distribution of nevus cells in the epidermis and dermis. OBJECTIVE: To characterize E-cadherin in GCNN and define its role in nevic cell migrations. METHODS: Twenty-four cases were immunohistochemically examined and in five cases cells were isolated for primary culture for migration assays. RESULTS: The nevus cells in the superficial region showed the immunoreactivity of E-cadherin in a membranous pattern, but those in the deep part of dermis had little immunoreactivity. Ultra-structural analysis of the superficial nevus cells revealed that E-cadherin immunodeposits in the fibrillar processes around the cell body in a spotted pattern. This distribution pattern is quite different from that in the adherens junction of skin squamous epithelial cells. Boyden chamber experiments were performed using primary cultures of intradermal nevus cells. EDTA pretreatment reduced cell migration to the E-cadherin positive side when the E-cadherin positive population was relatively large in the primary cultures. CONCLUSIONS: These results indicate that E-cadherin in the nevus cells may affect nevus cell motility rather than intercellular attachment.     

皮脂腺痣并发生乳头汗管囊腺瘤1例

报告1例皮脂腺痣并发生乳头汗管囊腺瘤、患者男，16岁。生下即发现左侧头部斑块并左侧颞部肿物，随年龄增长而增大。斑块约4cm×20cm，表面粗糙呈疣状、结节状。颞部肿物呈菜花状，约1.5cm×1.5cm，质软，见脓性、血性分泌物肿物组织病理由囊壁及绒毛状突起构成，衬有两层上皮细胞，可见顶浆分泌。手术切除肿瘤治愈。     

Dermoscopic examination of the nail bed and matrix

Abstract Background Dermoscopy has furthered advances in the differential diagnosis of longitudinal melanonychia; however, fewer details observed in the nail, as compared to skin lesions, make interpretation difficult. Methods Ten cases of longitudinal melancholia, from several etiologies, were submitted to direct dermoscopic examination of the nail bed and matrix. Results We observed the presence of globules, streaks, and pigment network in the nail bed and matrix, which are dermoscopic features not seen in the nail plate. Conclusions This procedure enables visualization of dermascopic features not seen in the nail plate, making the diagnosis of melanocytic lesions easier.     

Multiple Nevus Sebaceous Occurring on the Scalp and on the Contralateral Side of the Face

Nevus sebaceous (NS) is a benign neoplasm occurring mainly on the face and scalp. It commonly occurs as a solitary, well-demarcated lesion. This paper presents a case of multiple nevus sebaceous, which presented as multiple lesions occurring on the temporal scalp and on the contralateral side of the chin. Multiple NS have only rarely been reported.     

头面部痣样良性黑素肿瘤的外科治疗

目的 观察不同部位、不同大小、不同形状的痣样良性黑素肿瘤选择不同术式的治疗效果.方法 从2005年2月至2008年2月,共有180例痣样良性黑素肿瘤患者接受外科手术治疗.针对头部、鼻部、面颊、眼睑等部位,依具体情况分别选择了直接切除、部分切除、植皮、皮肤软组织扩张器以及局部皮瓣(间位皮瓣、菱形皮瓣、A-T皮瓣、风筝皮瓣等)的手术方法治疗,所有患者均随访3～6个月.结果 直接切除及分次切除的痣样良性黑素肿瘤切口愈合良好,无感染和复发;局部皮瓣及扩张器治疗的痣样良性黑素肿瘤复发3例,头部2例,面部1例,头部感染2例.结论 头面部的痣样良性黑素肿瘤选用不同的手术方法加以治疗,可以达到更好的美容效果.     

头面部痣样良性黑素肿瘤的外科治疗

目的 观察不同部位、不同大小、不同形状的痣样良性黑素肿瘤选择不同术式的治疗效果.方法 从2005年2月至2008年2月,共有180例痣样良性黑素肿瘤患者接受外科手术治疗.针对头部、鼻部、面颊、眼睑等部位,依具体情况分别选择了直接切除、部分切除、植皮、皮肤软组织扩张器以及局部皮瓣(间位皮瓣、菱形皮瓣、A-T皮瓣、风筝皮瓣等)的手术方法治疗,所有患者均随访3～6个月.结果 直接切除及分次切除的痣样良性黑素肿瘤切口愈合良好,无感染和复发;局部皮瓣及扩张器治疗的痣样良性黑素肿瘤复发3例,头部2例,面部1例,头部感染2例.结论 头面部的痣样良性黑素肿瘤选用不同的手术方法加以治疗,可以达到更好的美容效果.     

头面部痣样良性黑素肿瘤的外科治疗

目的 观察不同部位、不同大小、不同形状的痣样良性黑素肿瘤选择不同术式的治疗效果.方法 从2005年2月至2008年2月,共有180例痣样良性黑素肿瘤患者接受外科手术治疗.针对头部、鼻部、面颊、眼睑等部位,依具体情况分别选择了直接切除、部分切除、植皮、皮肤软组织扩张器以及局部皮瓣(间位皮瓣、菱形皮瓣、A-T皮瓣、风筝皮瓣等)的手术方法治疗,所有患者均随访3～6个月.结果 直接切除及分次切除的痣样良性黑素肿瘤切口愈合良好,无感染和复发;局部皮瓣及扩张器治疗的痣样良性黑素肿瘤复发3例,头部2例,面部1例,头部感染2例.结论 头面部的痣样良性黑素肿瘤选用不同的手术方法加以治疗,可以达到更好的美容效果.     

头面部痣样良性黑素肿瘤的外科治疗

目的 观察不同部位、不同大小、不同形状的痣样良性黑素肿瘤选择不同术式的治疗效果.方法 从2005年2月至2008年2月,共有180例痣样良性黑素肿瘤患者接受外科手术治疗.针对头部、鼻部、面颊、眼睑等部位,依具体情况分别选择了直接切除、部分切除、植皮、皮肤软组织扩张器以及局部皮瓣(间位皮瓣、菱形皮瓣、A-T皮瓣、风筝皮瓣等)的手术方法治疗,所有患者均随访3～6个月.结果 直接切除及分次切除的痣样良性黑素肿瘤切口愈合良好,无感染和复发;局部皮瓣及扩张器治疗的痣样良性黑素肿瘤复发3例,头部2例,面部1例,头部感染2例.结论 头面部的痣样良性黑素肿瘤选用不同的手术方法加以治疗,可以达到更好的美容效果.     

头面部痣样良性黑素肿瘤的外科治疗

目的 观察不同部位、不同大小、不同形状的痣样良性黑素肿瘤选择不同术式的治疗效果.方法 从2005年2月至2008年2月,共有180例痣样良性黑素肿瘤患者接受外科手术治疗.针对头部、鼻部、面颊、眼睑等部位,依具体情况分别选择了直接切除、部分切除、植皮、皮肤软组织扩张器以及局部皮瓣(间位皮瓣、菱形皮瓣、A-T皮瓣、风筝皮瓣等)的手术方法治疗,所有患者均随访3～6个月.结果 直接切除及分次切除的痣样良性黑素肿瘤切口愈合良好,无感染和复发;局部皮瓣及扩张器治疗的痣样良性黑素肿瘤复发3例,头部2例,面部1例,头部感染2例.结论 头面部的痣样良性黑素肿瘤选用不同的手术方法加以治疗,可以达到更好的美容效果.     

头面部痣样良性黑素肿瘤的外科治疗

目的 观察不同部位、不同大小、不同形状的痣样良性黑素肿瘤选择不同术式的治疗效果.方法 从2005年2月至2008年2月,共有180例痣样良性黑素肿瘤患者接受外科手术治疗.针对头部、鼻部、面颊、眼睑等部位,依具体情况分别选择了直接切除、部分切除、植皮、皮肤软组织扩张器以及局部皮瓣(间位皮瓣、菱形皮瓣、A-T皮瓣、风筝皮瓣等)的手术方法治疗,所有患者均随访3～6个月.结果 直接切除及分次切除的痣样良性黑素肿瘤切口愈合良好,无感染和复发;局部皮瓣及扩张器治疗的痣样良性黑素肿瘤复发3例,头部2例,面部1例,头部感染2例.结论 头面部的痣样良性黑素肿瘤选用不同的手术方法加以治疗,可以达到更好的美容效果.     

头面部痣样良性黑素肿瘤的外科治疗

目的 观察不同部位、不同大小、不同形状的痣样良性黑素肿瘤选择不同术式的治疗效果.方法 从2005年2月至2008年2月,共有180例痣样良性黑素肿瘤患者接受外科手术治疗.针对头部、鼻部、面颊、眼睑等部位,依具体情况分别选择了直接切除、部分切除、植皮、皮肤软组织扩张器以及局部皮瓣(间位皮瓣、菱形皮瓣、A-T皮瓣、风筝皮瓣等)的手术方法治疗,所有患者均随访3～6个月.结果 直接切除及分次切除的痣样良性黑素肿瘤切口愈合良好,无感染和复发;局部皮瓣及扩张器治疗的痣样良性黑素肿瘤复发3例,头部2例,面部1例,头部感染2例.结论 头面部的痣样良性黑素肿瘤选用不同的手术方法加以治疗,可以达到更好的美容效果.     

头面部痣样良性黑素肿瘤的外科治疗

目的 观察不同部位、不同大小、不同形状的痣样良性黑素肿瘤选择不同术式的治疗效果.方法 从2005年2月至2008年2月,共有180例痣样良性黑素肿瘤患者接受外科手术治疗.针对头部、鼻部、面颊、眼睑等部位,依具体情况分别选择了直接切除、部分切除、植皮、皮肤软组织扩张器以及局部皮瓣(间位皮瓣、菱形皮瓣、A-T皮瓣、风筝皮瓣等)的手术方法治疗,所有患者均随访3～6个月.结果 直接切除及分次切除的痣样良性黑素肿瘤切口愈合良好,无感染和复发;局部皮瓣及扩张器治疗的痣样良性黑素肿瘤复发3例,头部2例,面部1例,头部感染2例.结论 头面部的痣样良性黑素肿瘤选用不同的手术方法加以治疗,可以达到更好的美容效果.     

头面部痣样良性黑素肿瘤的外科治疗

目的 观察不同部位、不同大小、不同形状的痣样良性黑素肿瘤选择不同术式的治疗效果.方法 从2005年2月至2008年2月,共有180例痣样良性黑素肿瘤患者接受外科手术治疗.针对头部、鼻部、面颊、眼睑等部位,依具体情况分别选择了直接切除、部分切除、植皮、皮肤软组织扩张器以及局部皮瓣(间位皮瓣、菱形皮瓣、A-T皮瓣、风筝皮瓣等)的手术方法治疗,所有患者均随访3～6个月.结果 直接切除及分次切除的痣样良性黑素肿瘤切口愈合良好,无感染和复发;局部皮瓣及扩张器治疗的痣样良性黑素肿瘤复发3例,头部2例,面部1例,头部感染2例.结论 头面部的痣样良性黑素肿瘤选用不同的手术方法加以治疗,可以达到更好的美容效果.