Acta Dermato-Venereologica 99-1CompleteContent | Page 35
QUIZ SECTION
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Bizarre Pigmented Lesion on the Scalp: A Quiz
Giuseppe MICALI, Anna Elisa VERZÌ, Elisabetta D’AGATA and Francesco LACARRUBBA
Dermatology Clinic, University of Catania, Via S. Sofia 78, IT-95123 Catania, Italy. E-mail: [email protected]
A 7-year-old girl presented with a pigmented lesion on her
scalp. The lesion had been present for 2 years and, according
to her parents, had changed recently. Clinical examination
revealed the presence on the right temporal region of a
roundish, smooth, brown macule approximately 0.9×0.7 cm
with unusual tiny speckles (Fig. 1A). Dermatoscopy showed
a diffuse brown pigmentation and a regular network at the
periphery; moreover, several yellowish globules of various
shapes and dimensions were observed in the centre of the
lesion (Fig. 1B). Reflectance confocal microscopy (VivaS-
cope ® 3000, Lucid, MAVIG, Munich, Germany) revealed
a meshwork pattern at the dermal–epidermal junction and
several roundish clusters of moderately refractive large
cells with a hypo-refractive centre in the superficial dermis
(Fig. 2A). The lesion was excised and histopathological
examination (haematoxylin and eosin staining) revealed
the features of a compound melanocytic naevus characte-
rized by junctional nests of large cells with a pale and clear
cytoplasm (Fig. 2B).
Fig. 1. (A) Roundish, smooth, brown macule with unusual tiny speckles on
the scalp of a 7-year-old girl. (B) Dermatoscopy (×10) showing a diffuse
brown pigmentation, a regular network at the periphery, and several
yellowish globules of various shapes and dimensions in the centre.
What is your diagnosis? See next page for answer.
Fig. 2. (A) Reflectance confocal
microscopy revealing a meshwork
pattern at the dermal–epidermal
junction and several roundish
clusters of moderately refractive
large cells with a hyporefractive
centre in the superficial dermis.
(B) Histopathological examination
revealing junctional nests of
large cells with a pale and clear
cytoplasm (haematoxylin and
eosin; H&E).
This is an open access article under the CC BY-NC license. www.medicaljournals.se/acta
Journal Compilation © 2019 Acta Dermato-Venereologica.
doi: 10.2340/00015555-3039
Acta Derm Venereol 2019; 99: 119–120