Acral skin nevus

    Article Contributors: 
    Sean Klepper M.D.
    Stephen Lyle, M.D., ...

    Also known as: melanocytic acral nevus with intraepidermal ascent of cells (MANIAC)

    Clinical Features:

    • Typically present as small, well-circumscribed brown macules

    Histologic Features:

    • Most often compound nevi
    • Lentiginous melanocytic proliferation and focal migration of nevus cells upward within the epidermis are common features of acral nevi.
    • Features of atypicality are similar to those of other melanocytic nevi: irregular nesting pattern, dyscohesion of nests, poor lateral demarcation, prominent pagetoid spread
    • The basal melanocytes in acral nevi often show some degree of enlargement and pleomorphism, potentially mimicking melanoma.  Features favoring a diagnosis of acral melanoma are continuity of melanocytes in the basal layers, nesting and more pronounced pagetoid spread and cytologic atypia.
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    Cases associated with this book:

  • Acral skin nevus
    Author: Stephen Lyle, M.D., Ph.D.

    Conference: Teaching Collection
  • Atypical acral nevus
    Author: Artur Zembowicz M.D. Ph.D.

    Conference: Dr. Z's Consultations