title: Atypical histopathologic features in a melanocytic nevus after cryotherapy and pregnancy.
abstract: Melanocytic nevi can undergo clinical and histopathologic changes during pregnancy, as well as after various forms of surgical and nonsurgical trauma. We report the case of a 9-month postpartum 29-year-old female who presented to her dermatologist with a clinically worrisome nevus. This nevus had been treated with liquid nitrogen by her primary care physician 6 months prior to presentation. Histopathologic evaluation revealed a crowded proliferation of atypical melanocytes at the dermal-epidermal junction overlying a scar. The dermal component contained scattered mitotic figures. A combined MART-1, tyrosinase and Ki-67 immunohistochemical study showed foci of increased melanocytic proliferation. These atypical features were interpreted as associated with both the prior cryotherapy, as well as her recent pregnancy. Knowledge of the clinical context in evaluating difficult melanocytic lesions is essential.
authors.affiliation: Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX, USA; Department of Dermatology, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Casey E
authors.initials: CE
authors.lastname: Wilford
authors.forename: Julie S
authors.initials: JS
authors.lastname: Brantley
authors.forename: A Hafeez
authors.initials: AH
authors.lastname: Diwan
mesh_terms: D000328:Adult; D017679:Cryotherapy; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000378:metabolism; D058965:MART-1 Antigen / Q000378:metabolism; D008544:Melanocytes / Q000473:pathology; D058950:Melanoma-Specific Antigens / Q000378:metabolism; D009508:Nevus, Pigmented / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy / Q000648:ultrastructure; D009584:Nitrogen / Q000009:adverse effects / Q000627:therapeutic use; D011247:Pregnancy; D012878:Skin Neoplasms / Q000175:diagnosis / Q000473:pathology; D058951:gp100 Melanoma Antigen
chemical_list: D019394:Ki-67 Antigen; D058965:MART-1 Antigen; D058950:Melanoma-Specific Antigens; C548637:PMEL protein, human; D058951:gp100 Melanoma Antigen; D009584:Nitrogen
keywords: Ki-67; cryotherapy; melanocytic nevus; pregnancy; simulant