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Melanocytic proliferations associated with lichen sclerosus
J Andrew Carlson1, Xiao C Mu, Andrzej Slominski
1Division of Dermatology, Albany Medical College, Campus Box MC-81, Albany, NY 12208, USA. CarlsoA@mail.amc.edu
Archives of Dermatology
|January 16, 2002
Summary
Melanocytic nevi in lichen sclerosus (LS) share features with benign nevi but can resemble melanoma. These LS-associated nevi show an "activated" phenotype, suggesting a stromal influence.
Area of Science:
- Dermatology
- Dermatopathology
- Oncology
Background:
- Lichen sclerosus (LS) is a chronic inflammatory skin condition.
- Melanocytic proliferations can occur in association with LS, posing diagnostic challenges.
- Distinguishing benign from malignant melanocytic lesions in LS is crucial for patient management.
Purpose of the Study:
- To characterize the clinicopathologic features of melanocytic proliferations in patients with lichen sclerosus.
- To compare these features with those of control melanocytic lesions.
- To elucidate the potential role of LS in altering melanocytic behavior.
Main Methods:
- A cohort study design was employed.
- Cases were collected from dermatology and dermatopathology services.
- Melanocytic proliferations associated with LS were compared to persistent melanocytic nevi and malignant melanomas.
Main Results:
- Eleven female patients presented with pigmented lesions on the vulva, perineum, or chest, clinically suspected of melanoma.
- Melanocytic nevi were superimposed on LS in 10 cases; LS was adjacent to melanoma in one case.
- LS-associated nevi resembled persistent nevi and could be distinguished from melanoma histologically, though they showed increased melanin, HMB-45 expression, and Ki-67 index.
Conclusions:
- Melanocytic nevi in LS exhibit an "activated" phenotype, potentially induced by the surrounding sclerotic stroma.
- These lesions can mimic malignant melanoma, necessitating careful histopathologic evaluation.
- LS-associated melanocytic nevi did not recur after complete excision.