Cas dermatoscopique
Severe dysplasia of a melanocytic nevus during pregnancy
In a 34-year-old female patient a light brown, distinct asymmetric and regular pigmented skin tumour was found at her right breast (4x6 mm). She had skin type II, more than 100 small, non suspicious nevi in clinic and dermoscopy. No history of a melanoma in his own history or his family.
In dermoscopy an asymmetric light brown pigmented tumour with different thin and irregular network was visible. Isolated small globules as well as distinct greyish pigmented homogeneous areas were found. Beginning of radial streaks could be suggested in the upper right part (FotoFinder dermoscope, 20fold magnification).
The re-image was performed six months later during the pregnancy: in dermoscopy a symmetric increase of growth of the entire melanocytic tumour was found. However the differential structures were changed in asymmetric pattern: different pigmented and atypical network with different sizes of ridges and beginning of radial streaks. No globules were seen, but some black dots and homogeneous areas, partly with an initial milkyway pattern (FotoFinder dermoscope, 20fold magnification).
Diagnosis based histopathology
Dysplastic melanocytic nevus
Remarks
Changes of pigmented and non-pigmented skin tumours during the pregnancy should always be diagnosed critically and an initial melanoma must be considered and excluded.
References
Lea CS, Holly EA, Hartge P, Lee JS, DuPont Guerry IV, Elder DE, Halpern A, Sagebiel RW, Tucker MA (2007) Reproductive Risk Factors for Cutaneous Melanoma in Women: A Case-Control Study. Am J Epidemiol;165:505?513
Prof. Dr. A. Blum
Seestrasse 3a
78464 Konstanz
Alemagne