Rasner Cody J, Zhou Yan, Giubellino Alessio
Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN 55455, USA.
Dermatopathology (Basel). 2023 Jun 30;10(3):201-206. doi: 10.3390/dermatopathology10030028.
The recurrent nevus phenomenon represents the persistence of a nevus within a scar from a prior biopsy site, with the acquisition of clinical and histologic features frequently overlapping with those of melanoma, posing relevant diagnostic challenges. Similar features are recognized in nevi that have undergone recent or chronic trauma and in sclerosing nevi. Any type of nevus may be subject to this phenomenon. Keloids are exuberant scars with an exaggerated accumulation of dense dermal collagen. Here we report a case of a 42-year-old woman with the incidental finding of an atypical melanocytic proliferation developing within a keloidal scar. The patient presented with a progressively enlarging auricular lesion three years after a piercing procedure. Upon histological examination, attentive scrutiny of the margin revealed an atypical compound melanocytic proliferation, predominantly single-celled at the junction but occasionally nested, with cytologic atypia and architectural disorder. This atypical proliferation was found emerging above a keloid. We interpreted the lesion as an atypical melanocytic lesion with features resembling the recurrent nevus phenomenon. This case raises awareness in recognizing these melanocytic lesions as benign, thereby avoiding overdiagnosis and unnecessary treatment.
复发性痣现象表现为先前活检部位的瘢痕内痣持续存在，其获得的临床和组织学特征常与黑色素瘤重叠，带来了相关诊断挑战。在近期或慢性创伤后的痣以及硬化性痣中也可观察到类似特征。任何类型的痣都可能出现这种现象。瘢痕疙瘩是一种过度增生的瘢痕，真皮致密胶原过度堆积。在此，我们报告一例42岁女性病例，其在瘢痕疙瘩性瘢痕内偶然发现非典型黑素细胞增生。该患者在穿刺手术后三年出现耳部病变且逐渐增大。组织学检查时，对边缘进行仔细检查发现非典型复合性黑素细胞增生，在交界处主要为单细胞，但偶尔呈巢状，伴有细胞学异型性和结构紊乱。这种非典型增生出现在瘢痕疙瘩上方。我们将该病变解释为具有类似复发性痣现象特征的非典型黑素细胞病变。该病例提高了对将这些黑素细胞病变识别为良性病变的认识，从而避免过度诊断和不必要的治疗。
