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.

Cases associated with this book:

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

Conference: DermatopathologyConsultations.com Teaching Collection

Atypical acral nevus
Author: Artur Zembowicz M.D. Ph.D.

Conference: Dr. Z's Consultations