Case and Research Letters
Acquired Nonfacial Dermal Melanocytosis
Melanocitosis dérmica adquirida extrafacial
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Ríos-Martín, W. Pinto-Morales, Á. Marcos-Domínguez, R. González-Cámpora" "autores" => array:4 [ 0 => array:4 [ "nombre" => "J.J." "apellidos" => "Ríos-Martín" "email" => array:1 [ 0 => "jjrios@us.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "W." "apellidos" => "Pinto-Morales" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Á." "apellidos" => "Marcos-Domínguez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "R." "apellidos" => "González-Cámpora" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Departamento de Anatomía Patológica, Hospital Universitario Virgen Macarena, Sevilla, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Departamento de Dermatología, Hospital Universitario Virgen Macarena, Sevilla, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Melanocitosis dérmica adquirida extrafacial" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1073 "Ancho" => 800 "Tamanyo" => 110842 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Bluish-gray macule on the right side of the back.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Dermal melanocytosis includes a wide variety of congenital and acquired, histologically indistinguishable entities characterized by an intradermal proliferation of fusiform pigment-bearing melanocytes in the absence of melanophages.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a> Clinically the lesions appear as brown or bluish macules, depending on whether the melanin pigment is located predominantly in the superficial or deep dermis. Congenital dermal melanocytosis includes Mongolian spots and nevi of Ota and of Ito. Nevus of Ota (nevus fusoceruleus ophthalmomaxillaris) typically develops on the face in the area of distribution of the trigeminal nerve, whereas nevus of Ito (nevus fusoceruleus acromioclavicularis) affects the shoulder and neck region. These nevi, which are present at birth in around 60% of cases, rarely disappear in later years. Mongolian spots occur on the lower back or buttocks and are also usually present at birth, but generally regress in the first years of life.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Acquired dermal melanocytoses are rare. Hori et al<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> first described acquired bilateral Ota-like nevus in 1984. Although acquired melanocytoses tend to affect the face, they have also been reported on nonfacial sites (the upper and lower extremities, back, hands, and feet). Prevalence is highest among Asian women, and appearance in white individuals is very rare.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">We describe the case of a 49-year-old woman with an 8-year history of an asymptomatic bluish-gray skin lesion, 25<span class="elsevierStyleHsp" style=""></span>cm in diameter, located on the right side of the upper back (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). The patient stated that she was taking no drugs and that she had not experienced any trauma or inflammatory disorders in the affected area. Two years before the consultation, she had undergone surgery for Astler-Coller stage B2 colorectal cancer. Two biopsies of the skin lesion were fixed in formalin and embedded in paraffin for conventional histology study. Both samples revealed a proliferation of pigmented fusiform dermal melanocytes between collagen bands (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>A). Staining was positive for Melan-A, HMB-45 and S-100 (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>B). There was no evidence of an increase in epidermal melanocytes or of melanophages in the dermis. These histologic findings confirmed our clinical diagnosis of acquired dermal melanocytosis.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Nonfacial acquired dermal melanocytoses are very rare, particularly in white persons. There have been fewer than 30 cases reported, of which only 3 were in white individuals.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> The disorder predominantly affects middle-aged adults, typically Asian females. Malignant transformation of these lesions has occasionally been described.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The pathogenesis of acquired dermal melanocytosis is uncertain. The existence of latent dermal melanocytes resulting from abnormal migration from the neural crest or from the hair bulbs or epidermis (a process known as “dropping off”) has been suggested as a possible cause.<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4,8,9</span></a> The dormant melanocytes may be reactivated by exogenous agents such as solar radiation, local inflammation, trauma, drugs, hormone therapy with estrogen or progesterone, or other, as yet undefined, stimuli. We could associate none of these factors with the development of the dermal melanocytosis in our patient. Colorectal cancer was the only relevant element in the patient's personal history. Dermal melanocytosis associated with malignancy has only been described in 2 cases of bladder cancer.<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8,10</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">We are of the opinion that the dermal melanocytosis in our patient was not linked to the adenocarcinoma, as the skin lesion was present many years before the cancer was excised. The data at our disposal are insufficient, in any case, to establish a clear link between dermal melanocytosis and visceral malignancies.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Please cite this article as: Ríos-Martín JJ, et al. Melanocitosis dérmica adquirida extrafacial. Actas Dermosifiliogr.2011;102:556-57.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1073 "Ancho" => 800 "Tamanyo" => 110842 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Bluish-gray macule on the right side of the back.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1400 "Ancho" => 950 "Tamanyo" => 225566 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Histology study. A, Pigmented fusiform intradermal melanocytes (hematoxylin-eosin, original magnification x400). 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Fenske" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Cutis" "fecha" => "1993" "volumen" => "51" "paginaInicial" => "194" "paginaFinal" => "196" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8444053" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010200000007/v1_201304241231/S1578219011000382/v1_201304241231/en/main.assets" "Apartado" => array:4 [ "identificador" => "6169" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Cases and Research Letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010200000007/v1_201304241231/S1578219011000382/v1_201304241231/en/main.pdf?idApp=UINPBA000044&text.app=https://www.actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219011000382?idApp=UINPBA000044" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 October | 85 | 44 | 129 |
| 2024 September | 77 | 39 | 116 |
| 2024 August | 99 | 61 | 160 |
| 2024 July | 92 | 61 | 153 |
| 2024 June | 86 | 53 | 139 |
| 2024 May | 87 | 50 | 137 |
| 2024 April | 88 | 38 | 126 |
| 2024 March | 88 | 46 | 134 |
| 2024 February | 67 | 34 | 101 |
| 2024 January | 53 | 41 | 94 |
| 2023 December | 73 | 21 | 94 |
| 2023 November | 63 | 38 | 101 |
| 2023 October | 78 | 26 | 104 |
| 2023 September | 83 | 48 | 131 |
| 2023 August | 60 | 24 | 84 |
| 2023 July | 98 | 47 | 145 |
| 2023 June | 85 | 30 | 115 |
| 2023 May | 83 | 35 | 118 |
| 2023 April | 50 | 28 | 78 |
| 2023 March | 56 | 38 | 94 |
| 2023 February | 55 | 20 | 75 |
| 2023 January | 51 | 37 | 88 |
| 2022 December | 64 | 44 | 108 |
| 2022 November | 29 | 25 | 54 |
| 2022 October | 36 | 22 | 58 |
| 2022 September | 29 | 33 | 62 |
| 2022 August | 26 | 32 | 58 |
| 2022 July | 30 | 34 | 64 |
| 2022 June | 24 | 44 | 68 |
| 2022 May | 55 | 48 | 103 |
| 2022 April | 49 | 36 | 85 |
| 2022 March | 86 | 71 | 157 |
| 2022 February | 79 | 49 | 128 |
| 2022 January | 84 | 60 | 144 |
| 2021 December | 48 | 54 | 102 |
| 2021 November | 56 | 47 | 103 |
| 2021 October | 60 | 76 | 136 |
| 2021 September | 51 | 63 | 114 |
| 2021 August | 78 | 48 | 126 |
| 2021 July | 61 | 46 | 107 |
| 2021 June | 35 | 42 | 77 |
| 2021 May | 52 | 60 | 112 |
| 2021 April | 106 | 90 | 196 |
| 2021 March | 88 | 41 | 129 |
| 2021 February | 80 | 35 | 115 |
| 2021 January | 36 | 37 | 73 |
| 2020 December | 26 | 32 | 58 |
| 2020 November | 27 | 25 | 52 |
| 2020 October | 33 | 17 | 50 |
| 2020 September | 30 | 29 | 59 |
| 2020 August | 35 | 24 | 59 |
| 2020 July | 24 | 13 | 37 |
| 2020 June | 39 | 27 | 66 |
| 2020 May | 38 | 27 | 65 |
| 2020 April | 37 | 21 | 58 |
| 2020 March | 44 | 23 | 67 |
| 2020 February | 5 | 6 | 11 |
| 2020 January | 0 | 3 | 3 |
| 2019 December | 0 | 12 | 12 |
| 2019 October | 0 | 7 | 7 |
| 2019 September | 0 | 7 | 7 |
| 2019 August | 0 | 6 | 6 |
| 2019 July | 0 | 4 | 4 |
| 2019 June | 0 | 27 | 27 |
| 2019 May | 0 | 47 | 47 |
| 2019 April | 2 | 14 | 16 |
| 2019 March | 0 | 8 | 8 |
| 2019 February | 0 | 5 | 5 |
| 2018 December | 1 | 6 | 7 |
| 2018 November | 1 | 0 | 1 |
| 2018 September | 2 | 0 | 2 |
| 2018 August | 0 | 1 | 1 |
| 2018 July | 1 | 2 | 3 |
| 2018 June | 0 | 3 | 3 |
| 2018 May | 0 | 2 | 2 |
| 2018 April | 0 | 1 | 1 |
| 2018 March | 5 | 6 | 11 |
| 2018 February | 82 | 4 | 86 |
| 2018 January | 118 | 7 | 125 |
| 2017 December | 106 | 7 | 113 |
| 2017 November | 100 | 8 | 108 |
| 2017 October | 81 | 4 | 85 |
| 2017 September | 105 | 4 | 109 |
| 2017 August | 106 | 7 | 113 |
| 2017 July | 89 | 2 | 91 |
| 2017 June | 110 | 10 | 120 |
| 2017 May | 92 | 2 | 94 |
| 2017 April | 90 | 4 | 94 |
| 2017 March | 89 | 13 | 102 |
| 2017 February | 143 | 7 | 150 |
| 2017 January | 74 | 7 | 81 |
| 2016 December | 95 | 7 | 102 |
| 2016 November | 127 | 12 | 139 |
| 2016 October | 126 | 13 | 139 |
| 2016 September | 121 | 17 | 138 |
| 2016 August | 86 | 9 | 95 |
| 2016 July | 87 | 7 | 94 |
| 2016 June | 12 | 6 | 18 |
| 2016 May | 6 | 10 | 16 |
| 2016 April | 4 | 8 | 12 |
| 2016 March | 7 | 1 | 8 |
| 2016 February | 5 | 1 | 6 |
| 2016 January | 15 | 16 | 31 |
| 2015 December | 9 | 7 | 16 |
| 2015 November | 9 | 11 | 20 |
| 2015 October | 15 | 2 | 17 |
| 2015 September | 9 | 8 | 17 |
| 2015 August | 12 | 1 | 13 |
| 2015 July | 67 | 8 | 75 |
| 2015 June | 64 | 5 | 69 |
| 2015 May | 68 | 17 | 85 |
| 2015 April | 54 | 7 | 61 |
| 2015 March | 36 | 9 | 45 |
| 2015 February | 39 | 10 | 49 |
| 2015 January | 52 | 11 | 63 |
| 2014 December | 50 | 20 | 70 |
| 2014 November | 31 | 7 | 38 |
| 2014 October | 72 | 8 | 80 |
| 2014 September | 43 | 10 | 53 |
| 2014 August | 36 | 15 | 51 |
| 2014 July | 70 | 16 | 86 |
| 2014 June | 52 | 10 | 62 |
| 2014 May | 71 | 19 | 90 |
| 2014 April | 63 | 10 | 73 |
| 2014 March | 59 | 24 | 83 |
| 2014 February | 47 | 29 | 76 |
| 2014 January | 58 | 23 | 81 |
| 2013 December | 62 | 23 | 85 |
| 2013 November | 44 | 24 | 68 |
| 2013 October | 51 | 24 | 75 |
| 2013 September | 42 | 14 | 56 |
| 2013 August | 10 | 28 | 38 |
| 2013 July | 6 | 20 | 26 |
| 2013 June | 7 | 16 | 23 |
| 2013 May | 10 | 9 | 19 |
| 2013 April | 12 | 20 | 32 |
| 2013 March | 10 | 8 | 18 |
| 2013 February | 24 | 5 | 29 |
| 2013 January | 14 | 4 | 18 |
| 2012 December | 13 | 4 | 17 |
| 2012 November | 1 | 1 | 2 |
| 2012 October | 1 | 1 | 2 |
| 2012 September | 1 | 0 | 1 |
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