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Recurrence of mycosis fungoides on multiple melanocytic nevi: a case report and review of the literature.

Brazzelli V, Grasso V, Rivetti N, Fiandrino G, Lucioni M, Borroni G - Case Rep Dermatol (2012)

Bottom Line: Melanocytic nevi represent a widespread cutaneous finding.Eight years after therapy discontinuation, he presented epidermal scaling and an erythematous perinevic halo on 3 old melanocytic lesions, the clinical aspect of which was highly suggestive for Meyerson nevi.The finding of patches of mycosis fungoides superimposed on melanocytic nevi is a rare event; the confounding clinical appearance with eczematous changes around a pre-existing nevus may recall the halo dermatitis known as Meyerson phenomenon; this highlights the importance of clinical and histological examination to make the correct diagnosis of dermatological diseases.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric Sciences and Human and Hereditary Pathology, Institute of Dermatology, Pavia, Italy.

ABSTRACT
Melanocytic nevi represent a widespread cutaneous finding. Nevertheless, the presence of mycosis fungoides and melanocytic nevi in the same location is an extremely rare event. We report the case of a patient affected by mycosis fungoides and treated with PUVA therapy, with complete remission of the disease. Eight years after therapy discontinuation, he presented epidermal scaling and an erythematous perinevic halo on 3 old melanocytic lesions, the clinical aspect of which was highly suggestive for Meyerson nevi. The histological and immunohistochemical examination of an excised melanocytic lesion revealed histological features consistent with the diagnosis of mycosis fungoides superimposed on junctional melanocytic nevi. The finding of patches of mycosis fungoides superimposed on melanocytic nevi is a rare event; the confounding clinical appearance with eczematous changes around a pre-existing nevus may recall the halo dermatitis known as Meyerson phenomenon; this highlights the importance of clinical and histological examination to make the correct diagnosis of dermatological diseases.

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a–c A dense infiltrate at the dermoepidermal junction composed by lymphocytes with hyperchromatic nuclei, exocytosis, and focal epidermotropism, together with junctional melanocytic nests. d Immunohistochemistry showing S-100 protein-positive staining in melanocytic nevus cells.
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Figure 2: a–c A dense infiltrate at the dermoepidermal junction composed by lymphocytes with hyperchromatic nuclei, exocytosis, and focal epidermotropism, together with junctional melanocytic nests. d Immunohistochemistry showing S-100 protein-positive staining in melanocytic nevus cells.

Mentions: One of the lesions was surgically removed for histological examination with complete elliptical excision followed by primary suture. The nevus was mostly composed of melanocytic nests at the dermoepidermal junction, associated with particularly abundant band-like lymphocytic infiltrates obscuring the dermoepidermal junction, and characterized by focal epidermotropism of hyperchromatic, enlarged, convoluted lymphocytes (fig. 2a–c). Immunohistochemistry confirmed S-100 protein-positive staining in melanocytic nevus cells (fig. 2d), while the infiltrate was predominantly composed of CD3+, CD4+ and CD5+ T cells (fig. 2e, f), with low CD7 expression. These findings were consistent with the diagnosis of MF superimposed on a junctional melanocytic nevus.


Recurrence of mycosis fungoides on multiple melanocytic nevi: a case report and review of the literature.

Brazzelli V, Grasso V, Rivetti N, Fiandrino G, Lucioni M, Borroni G - Case Rep Dermatol (2012)

a–c A dense infiltrate at the dermoepidermal junction composed by lymphocytes with hyperchromatic nuclei, exocytosis, and focal epidermotropism, together with junctional melanocytic nests. d Immunohistochemistry showing S-100 protein-positive staining in melanocytic nevus cells.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3362184&req=5

Figure 2: a–c A dense infiltrate at the dermoepidermal junction composed by lymphocytes with hyperchromatic nuclei, exocytosis, and focal epidermotropism, together with junctional melanocytic nests. d Immunohistochemistry showing S-100 protein-positive staining in melanocytic nevus cells.
Mentions: One of the lesions was surgically removed for histological examination with complete elliptical excision followed by primary suture. The nevus was mostly composed of melanocytic nests at the dermoepidermal junction, associated with particularly abundant band-like lymphocytic infiltrates obscuring the dermoepidermal junction, and characterized by focal epidermotropism of hyperchromatic, enlarged, convoluted lymphocytes (fig. 2a–c). Immunohistochemistry confirmed S-100 protein-positive staining in melanocytic nevus cells (fig. 2d), while the infiltrate was predominantly composed of CD3+, CD4+ and CD5+ T cells (fig. 2e, f), with low CD7 expression. These findings were consistent with the diagnosis of MF superimposed on a junctional melanocytic nevus.

Bottom Line: Melanocytic nevi represent a widespread cutaneous finding.Eight years after therapy discontinuation, he presented epidermal scaling and an erythematous perinevic halo on 3 old melanocytic lesions, the clinical aspect of which was highly suggestive for Meyerson nevi.The finding of patches of mycosis fungoides superimposed on melanocytic nevi is a rare event; the confounding clinical appearance with eczematous changes around a pre-existing nevus may recall the halo dermatitis known as Meyerson phenomenon; this highlights the importance of clinical and histological examination to make the correct diagnosis of dermatological diseases.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric Sciences and Human and Hereditary Pathology, Institute of Dermatology, Pavia, Italy.

ABSTRACT
Melanocytic nevi represent a widespread cutaneous finding. Nevertheless, the presence of mycosis fungoides and melanocytic nevi in the same location is an extremely rare event. We report the case of a patient affected by mycosis fungoides and treated with PUVA therapy, with complete remission of the disease. Eight years after therapy discontinuation, he presented epidermal scaling and an erythematous perinevic halo on 3 old melanocytic lesions, the clinical aspect of which was highly suggestive for Meyerson nevi. The histological and immunohistochemical examination of an excised melanocytic lesion revealed histological features consistent with the diagnosis of mycosis fungoides superimposed on junctional melanocytic nevi. The finding of patches of mycosis fungoides superimposed on melanocytic nevi is a rare event; the confounding clinical appearance with eczematous changes around a pre-existing nevus may recall the halo dermatitis known as Meyerson phenomenon; this highlights the importance of clinical and histological examination to make the correct diagnosis of dermatological diseases.

No MeSH data available.


Related in: MedlinePlus