Sean Klepper M.D.
Stephen Lyle, M.D., ...
Also known as: melanocytic acral nevus with intraepidermal ascent of cells (MANIAC)
- Typically present as small, well-circumscribed brown macules
- 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.