title: Dermoscopy and in vivo reflectance confocal microscopy of a congenital nevus of the nipple.
abstract: We report a 26-year-old male with a 4 mm diameter, asymmetric, irregularly pigmented and bordered, brown maculopapular lesion on the right nipple present since childhood with enlargement of the lesion within the last 3 months. Dermoscopy revealed a global globular pattern with the presence of focally light brown globules and irregular black globules in its centre. In vivo reflectance confocal microscopy (RCM) revealed dense junctional and dermal melanocytic nests of different sizes and shapes that appeared as sharply demarcated round to oval reflective structures; cellular outlines of single melanocytes were not always detected. In the centre of the lesion within the upper dermis, irregularly shaped, homogeneously reflecting structures were observed. As a clear differentiation between clusters of melanophages and melanocytic nests could not be made with certainty, an excisional biopsy was performed to establish the diagnosis of compound nevus with features of congenital nevus. Therefore, to prove that dermoscopic globules correlated with melanophages, the correlation between dermoscopic RCM and histopathology was necessary.
authors.affiliation: University Department of Dermatology and Venereology, Zagreb University Hospital Centre, Zagreb, Croatia.
authors.forename: Zrinjka
authors.initials: Z
authors.lastname: Pastar
authors.forename: Cesare
authors.initials: C
authors.lastname: Massone
authors.forename: Verena
authors.initials: V
authors.lastname: Ahlgrimm-Siess
authors.forename: Silvia
authors.initials: S
authors.lastname: Koller
authors.forename: Ramin
authors.initials: R
authors.lastname: Mofarrah
authors.forename: Rainer
authors.initials: R
authors.lastname: Hofmann-Wellenhof
mesh_terms: D000328:Adult; D015703:Antigens, CD / Q000032:analysis; D015214:Antigens, Differentiation, Myelomonocytic / Q000032:analysis; D046169:Dermoscopy; D006801:Humans; D008297:Male; D008544:Melanocytes / Q000473:pathology; D008545:Melanoma / Q000175:diagnosis; D018613:Microscopy, Confocal / Q000379:methods; D009113:Muramidase / Q000032:analysis; D009508:Nevus, Pigmented / Q000151:congenital / Q000473:pathology* / Q000601:surgery; D009558:Nipples / Q000473:pathology*; D010733:Phosphoglucomutase / Q000032:analysis; D012878:Skin Neoplasms / Q000151:congenital / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome; D000097382:CD68 Molecule
chemical_list: D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D009113:Muramidase; D010733:Phosphoglucomutase; C067980:CD68 antigen, human; D000097382:CD68 Molecule; C488050:PGM1 protein, human