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"Clark/dysplastic" nevi with florid fibroplasia associated with pseudomelanomatous features
Christine J Ko1, Jean L Bolognia, Earl J Glusac
1Department of Dermatology and Pathology, Yale University School of Medicine, New Haven, CT, USA. christine.ko@yale.edu
Background:
Melanocytic nevi may exhibit histologic features in common with cutaneous melanoma, creating diagnostic difficulties.
Objective:
We sought to assess the clinical behavior of melanocytic nevi with pseudomelanomatous features in association with dermal fibrosis.
Methods:
Forty-two melanocytic nevi with pronounced fibrosis and associated pseudomelanomatous changes were collected and studied clinically and histologically.
Results:
The fibrosis was centrally located and laminated in appearance. It imparted a trizonal appearance: a junctional component with prominent single cells and/or irregular nests, underlying fibrosis, and a mature dermal component. No recurrence or metastases were evident over an average follow-up period of 2 years.
Limitations:
The follow-up period was short.
Conclusions:
The central location and laminated appearance of the fibrosis suggest that this may represent the extreme end of a spectrum of fibroplastic changes in "Clark/dysplastic" nevi. Adjacent features of "Clark/dysplastic" nevi and limitation of pseudomelanomatous features to the perifibrotic focus are important in accurately identifying these lesions. Although melanocytic nevi with exaggerated fibroplasia may show foci with melanoma-like features, they do not appear to exhibit aggressive clinical behavior.
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