Is melanocytic nevus with focal atypical epithelioid components (clonal nevus) a superficial variant of deep penetrating nevus?
BACKGROUND
We compare features of two similar nevi which may be confused with melanoma: deep penetrating nevus (DPN), and nevus with focal atypical epithelioid component (NFAEC).


METHODS
Clinical/demographic and histologic information regarding 146 DPN and 81 NFAEC were compared. Patient outcomes were ascertained via a questionnaire solicited to the referring physicians.


RESULTS
Clinical features were similar for each type of nevus. Histologically, all lesions demonstrated identical aggregates of epithelioid melanocytes. DPN more often extended into the deep dermis or subcutaneous tissue, while NFAEC was typically confined to the superficial dermis. NFAEC more often demonstrated a junctional component (P < .001) and coexistent common nevus with congenital features (P = .035). DPN more often demonstrated adnexal spread (P < .001). A subgroup with overlapping features was identified. With an average of 6.4 years follow-up, there were just two recurrences, and no metastases.


CONCLUSIONS
This retrospective study utilized tissue specimens from a single reference laboratory; ergo, some inherent selection bias exists. Specimens were randomly selected for P53 immunostaining, leading also to potential sampling error.


CONCLUSIONS
DPN and NFAEC show considerable similarity, differing mainly in the depth of extent for the lesion. It is possible that NFAEC represents a more superficial variant of DPN. A subgroup with overlapping features, but intermediate depth, supports such a relationship.
High
Whitney A
WA
Department of Dermatology, University of Colorado Health Sciences Center, Denver, Colorado 80045-0510, USA. wahigh50@hotmail.com
Alanen
Kenneth W
KW
Golitz
Loren E
LE
D000293:Adolescent; D000328:Adult; D000368:Aged; D002467:Cell Nucleus / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D020405:Dermis / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D008938:Mitosis; D009361:Neoplasm Invasiveness / Q000473:pathology; D009508:Nevus, Pigmented / Q000145:classification* / Q000378:metabolism / Q000473:pathology*; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000145:classification* / Q000378:metabolism / Q000473:pathology*; D040521:Subcutaneous Tissue / Q000473:pathology; D014018:Tissue Distribution; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism
D016159:Tumor Suppressor Protein p53