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Abstract Background Giant congenital melanocytic nevi (GCMN) are usually defined as nevi that exceed 20 cm in maximal diameter or 15% of the total body surface area. There have been reports of life-long malignant change risks arising from GCMN, leading to surgical excision of GCMN. This study aims to evaluate the thickness of melanocytes based on clinical factors in order to provide objective information for the complete resection of the lesion. Methods Overall, 75 patients diagnosed with GCMN between 2000 and 2021 were included, and their clinical records were collected retrospectively. 117 pathologic slides obtained during excision were reviewed to measure nevus thickness. Clinical factors were assessed with a generalized estimated equation model for association with nevus thickness. Results The thickness of nevus was significantly associated with the location and size. Nevus thickness was more superficial in the distal extremity than in the head and trunk (P = 0.003 [head]; P

Introduction: The umbilicus is a unique physiologic scar of human body. Its absence leads to an unnatural abdominal appearance and can cause psychological and social complexes. Objective: To present a case of neoumbilicoplasty with vertical island pedicle flap for a large pigmented umbilical nevus. Clinical case: A healthy 50-year-old female patient with a history of a pigmentated nevus on the umbilicus since childhood that complains of changes in size and color of it. She also referred notice a lump in the upper umbilical region which was an umbilical hernia. The patient underwent an omphalectomy with oncological margins, an umbilical hernia repair and a neoumbilicoplasty with vertical island pedicle flap. Seroma was the only postoperative complication. Aesthetic results were acceptable and satisfied the patient. Conclusions: This is a rare case not only because the umbilical skin lesions are uncommon but the neoumbilicoplasty technique is rarely used.

ObjectiveThis study aimed to investigate the microscopic structure and characteristics of nevi on the conjunctiva of the lacrimal caruncle by in vivo confocal microscopy.MethodsIn total, four patients with nevi growing on the lacrimal caruncle conjunctiva were recruited. The morphological characteristics of the nevi were evaluated by in vivo confocal microscopy before excision surgery; the results were compared with histopathological analyses of the surgical specimens.ResultsThe nevi of the four patients were all located at the conjunctiva of the lacrimal caruncle, with a slightly nodular surface, mixed black and brown color, and clear boundary. The nevi were round and highly protruded on the surface of the lacrimal caruncle, with an average diameter of 4.5 ± 1.29 mm. Under in vivo confocal microscopy, the pigmented nevus cells on the conjunctiva of the lacrimal caruncle were observed to be clustered in nests with irregular boundaries. The cells were round or irregular, with clear cell boundaries, hyper-reflective at the periphery, with low reflectivity in the center. Vascular crawling was observed in some regions. Histopathological analysis showed that nevus cells were roughly equal in size and distributed in a nodular pattern. Melanin granules were observed in the cytoplasm. No atypia or mitotic figures of the cells were found.ConclusionThis study revealed that the microstructure of nevi growing on the conjunctiva of the lacrimal caruncle can be identified by in vivo confocal microscopy.

Congenital melanocytic nevus of the eyelid, also known as the "panda nevus of the eyelid," is a rare presentation of a congenital nevus. It presents as a divided lesion over the upper and lower eyelids. We describe a case of a 25-yearold female who presented to us with this lesion over the right upper and lower eyelids who underwent surgical excision with a full-thickness graft for the residual defect. [ABSTRACT FROM AUTHOR]

Copyright of Der Hautarzt is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Tissue expansion is an important reconstruction method to solve defects such as burns and giant nevi or breast reconstruction. This article aims to report the experience of the Plastic Surgery Service of the Hospital de Clínicas of the Federal University of Paraná (UFPR) with the use of expanders. Methods: This is a retrospective, descriptive, and analytical study of patients who underwent tissue expansion for reconstructive surgery at the Hospital de Clínicas da UFPR, from January 2010 to December 2016. Results: 61 patients and 80 surgeries were analyzed, including re-expansion procedures. Age ranged from 2 to 73 years (mean 31). The majority of patients were female (83.6%), aged over 40 years, undergoing breast reconstruction treatment after radical mastectomy (36%). The complications observed in these patients were: signs of infection (14.7%), suture dehiscence (3.2%), seroma (3.2%), defect in the expander (3.2%), exposure of the expander (3, 2%), necrosis (1.6%) and signs of hypoperfusion (1.6%). Patients undergoing breast reconstruction had the highest number of complications (40.1%). Reexpansion was necessary for 37.7% of patients. Conclusion: The skin expansion technique is indicated for several pathologies' treatment. The tissue expansion procedure has high complication rates. Knowing the patient's profile, the main types of complications, and the factors associated with these complications can help prevent them.

Background: Skin cancer is one of the most common forms of cancer in the world and melanoma is the deadliest type of skin cancer. Both melanoma and melanocytic nevi begin in melanocytes (cells that produce melanin). However, melanocytic nevi are benign whereas melanoma is malignant. This work proposes a deep learning model for classification of these two lesions. Methods: In this analytic study, the database of HAM10000 (human against machine with 10000 training images) dermoscopy images, 1000 melanocytic nevi and 1000 melanoma images were employed, where in each category 900 images were selected randomly and were designated as the training set. The remaining 100 images in each category were considered as the test set. A deep learning convolutional neural network (CNN) was deployed with AlexNet (Krizhevsky et al., 2012) as a pretrained model. The network was trained with 1800 dermoscope images and subsequently was validated with 200 test images. The proposed method removes the need for cumbersome tasks of lesion segmentation and feature extraction. Instead, the CNN can automatically learn and extract useful features from the raw images. Therefore, no image preprocessing is required. Study was conducted at Shahid Beheshti University of Medical Sciences, Tehran, Iran from January to February, 2020. Results: The proposed model achieved an area under the receiver operating characteristic (ROC) curve of 0.98. Using a confidence score threshold of 0.5, a classification accuracy of 93%, sensitivity of 94%, and specificity of 92% was attained. The user can adjust the threshold to change the model performance according to preference. For example, if sensitivity is the main concern; i.e. false negative is to be avoided, then the threshold must be reduced to improve sensitivity at the cost of specificity. The ROC curve shows that to achieve sensitivity of 100%, specificity is decreased to 83%. Conclusion: The results show the strength of convolutional neural networks in melanoma detection in dermoscopy images. The proposed method can be deployed to help dermatologists in identifying melanoma. It can also be implemented for self diagnosis of photographs taken from skin lesions. This may facilitate early detection of melanoma, and hence substantially reduce the mortality chance of this dangerous malignancy.

The divided nevi occur in contiguous areas of the skin that are mostly benign lesions. We report six cases of nevus divided on the penis and its dermoscopic patterns. Clinical follow-up was the best therapeutic option for this group of patients, considering the location of these lesions.

Kissing nevi or split nevi are congenital melanocytic nevi on adjoining areas of the body formed as a result of separation during embryogenesis. Most kissing nevi are seen over the eyelids and only a handful of them have been reported over the penis. Becker’s melanosis is a common androgen dependent hamartoma with epidermal, melanocytic or smooth muscle origin. Herein, we describe the case of a 20-year-old male who presented with kissing nevi over the glans penis and prepuce. The patient also had a large Becker’s melanosis over the left side extending from the lower back to left lumbar area, the lateral aspect of left buttock and thigh till the knee. Our case is the first instance where a kissing melanocytic nevus is associated with Becker’s melanosis. [ABSTRACT FROM AUTHOR]

ABSTRACT Pigmented vulvar lesions are uncommon; they occur in about 10%-12% of women and include benign and malignant processes, as well as post-inflammatory changes and hyperchromatic lesions due to melanin increase. Among the benign processes, there are vulvar nevi, present in 2% of adult women. There is a small subgroup classified as atypical melanocytic nevi that account for 5% of vulvar nevi and is associated with younger women. Despite the importance of early diagnosis, the clinical history and time of evolution of the lesion are not well explored, as patients rarely examine the region, as do dermatologists. We report a case of an melanocytic nevus in the small lip in a 43-year-old woman.

Objective:It has been attempted to find out that Homine Placents and Soyeom mixed Pharmacopuncture (HSP) procedure is effective for the removal of melanocytic nevus of considerable size which cannot be applied to general acupuncture.Methods:Hominis placenta (0.5ml) and Soyeom (0.5ml) mixed pharmacopuncture (1.0ml) was subcutaneously injected in several places of melanocytic nevus. The treatment was performed about 20 times, once a week. Layer analysis of pigmentation was carried out using ECOSKIN.Results:One year after the HSP procedure, the pigmentation of the melanocytic nevus was slightly reduced and completely removed after 2 years of procedure.Conclusion:The HSP could be effective for removing hyperpigmentation in the melanocytic nevus.

The value of dermoscopy in the detection of skin cancer is well established. Less is published on the utility of dermoscopy in the evaluation of pediatric skin disease. Our review (in two parts) aims to serve as an update on pediatric dermoscopy and to provide readers with a practical application for the use of dermoscopy in pediatric dermatology clinics. In part I, we propose a dermoscopy algorithm for pediatric skin disease and melanocytic growths, and in part II, we address vascular growths, common skin infections, and inflammatory conditions for which dermoscopy is valuable. [ABSTRACT FROM AUTHOR]

Objective: To investigate the application and challenge of reflectance confocal microscopy (RCM) in the diagnosis of pigmented nevus. Method: A total of 997 patients with clinical diagnosis of pigmented nevus were included in the study, and RCM imaging was performed on the lesion of each patient. A biopsy was performed in 78 of these patients for histological diagnosis. We retrospectively analyzed the results of RCM diagnosis and histological diagnosis and then found the RCM characteristics of the histologically confirmed lesion. Results: According to the RCM images, 823 of the 997 (82.55%) patients were diagnosed with pigmented nevus, while 113 (11.33%) were not diagnosed by dermatologists using RCM. Of the 78 biopsy lesions, 36 of the 46 (78.26%) cases diagnosed with pigmented nevus were consistent with histological diagnosis, while three were rediagnosed with dermatofibromas, four were seborrheic keratosis, one was malignant melanoma in situ, and two were lentigo. Conclusion: RCM exhibits a high diagnostic accuracy for patients with clinical diagnosis of pigmented nevus. However, due to the limitation of RCM scanning depth and the commonality of the microscopic characteristics of related diseases, RCM still faces certain challenges in the diagnosis of pigmented nevus. [ABSTRACT FROM AUTHOR]

Background: Skin cancer is one of the most common forms of cancer in the world and melanoma is the deadliest type of skin cancer. Both melanoma and melanocytic nevi begin in melanocytes (cells that produce melanin). However, melanocytic nevi are benign whereas melanoma is malignant. This work proposes a deep learning model for classification of these two lesions. Methods: In this analytic study, the database of HAM10000 (human against machine with 10000 training images) dermoscopy images, 1000 melanocytic nevi and 1000 melanoma images were employed, where in each category 900 images were selected randomly and were designated as the training set. The remaining 100 images in each category were considered as the test set. A deep learning convolutional neural network (CNN) was deployed with AlexNet (Krizhevsky et al., 2012) as a pretrained model. The network was trained with 1800 dermoscope images and subsequently was validated with 200 test images. The proposed method removes the need for cumbersome tasks of lesion segmentation and feature extraction. Instead, the CNN can automatically learn and extract useful features from the raw images. Therefore, no image preprocessing is required. Study was conducted at Shahid Beheshti University of Medical Sciences, Tehran, Iran from January to February, 2020. Results: The proposed model achieved an area under the receiver operating characteristic (ROC) curve of 0.98. Using a confidence score threshold of 0.5, a classification accuracy of 93%, sensitivity of 94%, and specificity of 92% was attained. The user can adjust the threshold to change the model performance according to preference. For example, if sensitivity is the main concern; i.e. false negative is to be avoided, then the threshold must be reduced to improve sensitivity at the cost of specificity. The ROC curve shows that to achieve sensitivity of 100%, specificity is decreased to 83%. Conclusion: The results show the strength of convolutional neural networks in melanoma detection in dermoscopy images. The proposed method can be deployed to help dermatologists in identifying melanoma. It can also be implemented for self diagnosis of photographs taken from skin lesions. This may facilitate early detection of melanoma, and hence substantially reduce the mortality chance of this dangerous malignancy. [ABSTRACT FROM AUTHOR]

Neurofibromatosis type 1 (NF1) is a genodermatosis caused by heterozygous germ line variations in the NF1 gene. A second‐hit NF1 aberration results in the formation of café‐au‐lait macules, cutaneous neurofibroma and plexiform neurofibroma (PNF). Mosaic NF1 (mNF1), caused by a postzygotic NF1 mutation, is characterized by localized or generalized NF1‐related manifestations. Although NF1 and mNF1 are associated with pigmentary skin lesions, clinically recognizable melanocytic nevi that developed over PNF have not been reported. Here, we report the first case of multiple melanocytic nevi that developed on a giant café‐au‐lait macule and PNF. The PNF had biallelic NF1 deletions, a whole deletion of NF1 and a novel intragenic deletion involving exons 25–30. The deletions were not detected in the blood, which resulted in the diagnosis of mNF1. Furthermore, the nevus cells had not only biallelic NF1 deletions but also NRAS Q61R, a common mutation found in congenital melanocytic nevi. These analyses revealed the coexistence of the two different mosaic diseases, mNF1 and congenital melanocytic nevi. For a diagnosis of cases with atypical NF1‐like symptoms, genetic analyses using blood and lesional tissues are useful and aid in genetic counseling. [ABSTRACT FROM AUTHOR]

Abstract: Although giant congenital melanocytic nevus is a rare lesion, it causes significant deformity and carries a risk of malignant degeneration. Different surgical techniques for the lesion removal are described, including serial resection, resection with skin grafting, and resection and coverage with expanded skin flap (skin expanders). The aim of this study is to report the author's 40 years of experience with cases requiring at least 4 serial excisions to complete the treatment. Serial resection is an effective, safe, and simple technique that requires a lot of patience. Treatment often results in a single linear scar, requires no donor sites, nor large flaps. It is not subject to potencial complications of expanders and avoid aesthetic deformities depending on the location.

Background: Long‐pulsed (LP) lasers at pulse durations of 1‐300 ms have been used to destroy nests of nevi cells by selectively targeting pigment chromophores. Objective: To evaluate dual‐wavelength LP laser‐induced tissue reactions. Methods: The patterns of LP 755‐nm alexandrite (Alex) and/or 1064‐nm neodymium (Nd):yttrium‐aluminum‐garnet (YAG) laser‐induced tissue reactions were macroscopically evaluated using a tattoo‐embedded phantom. Additionally, a pilot in vivo human study was performed for common acquired melanocytic nevus, of which dermoscopic images and high‐speed cinematographs were obtained. Results: Combinations of Nd:YAG and Alex laser treatments at interpulse intervals of 10 or 20 ms generated round to oval zones of photothermal and photoacoustic injury in two distinctive areas containing disintegrated tattoo particles. Treatment at interpulse intervals of 10 or 20 ms between Alex and Nd:YAG pulses elicited lesser degrees of thermal damage to surrounding tissues, compared to treatment at 100 or 200 ms. Immediately after combined LP laser treatment of human nevus lesions in vivo, Nd:YAG‐Alex treatment at a 20‐ms interpulse interval exhibited more remarkable crusting and erosive appearances than Alex‐Nd:YAG treatment. Conclusion: For treating pigmented disorders, sequential delivery of LP Nd:YAG and Alex pulses at short interpulse intervals of 10‐20 ms can effectively destroy nests of pigment chromophores. [ABSTRACT FROM AUTHOR]

Copyright of Jornal Brasileiro de Patologia e Medicina Laboratorial is the property of Sociedade Brasileira de Patologia Clinica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: the Giant Congenital Melanocytic Nevus (GCMN) is a pigmented lesion of great size, usually presented since the birth, although some lesions could appear in the first months of life. It is an atypical benign proliferation of melanocytes in the skin that could have curious morphologies. It is associated in some cases to extracutaneous manifestations and melanoma development. It is characterized by a hyperpigmented lesion in different tones of brown and could affect since the brain until the lower limbs. The most frequent location is the posterior trunk, the face, scalp and extremities. Case report: the case of a young female patient with GCMN «in garment» with several satellite lesions is presented in order to carry out a thematic review and to indicate the importance of the control period and following. Conclusion: the GCMN is a benign cutaneous alteration that implies serious esthetic disorders when it increases its size. The treatment difficulties and the medico-social implications must be kept in mind. Rev.cienc.biomed. 2015;6(1):155-159 KEYWORDS Nevus, Pigmented nevus; Melanoma; Melanocytes.

This learning exercise challenges clinicians and dermatopathologists to consider the differential diagnosis of an unevenly colored solitary papule over the upper back of an adolescent female.

Congenital melanocytic nevus consists of congregations of nevomelanocytes. It is found in approximately 1% of new born infants. Congenital melanocytic nevus needs to be excised before it transforms into a malignant lesion. Many strategies have been attempted for the removal and reconstruction of the nevus. Serial excision enables wound closure to be accomplished with a shorter scar than if the original lesion was elliptically excised in a single stage and reorientation of the scar closer to the relaxed skin lines. The routine utilization of an elliptical serial excision as a standard method of closure often leads to the formation of elongated scars and waste of skin. The "Cogwheel pattern" serial excision is a new technique for reducing the size of the nevus efficiently. Reducing the final scar length, distributing the tension over many directions, and having the chance of decrease in operation numbers are ultimately achieved with the use of the "Cogwheel pattern" serial excision.

We describe a case of plantar interdigital cutaneous melanoma in a 22-year-old woman who reported changes in a pigmented lesion during pregnancy. Diagnosis was late and evolution unfavourable. The purpose of this report is to draw the attention of dermatologists to the need for careful regular examination of melanocytic lesions in pregnant women, not ignoring possible changes as always physiological.

O nevo de Becker se manifesta como uma mácula hipercrômica, localizada predominantemente no tronco anterior ou região escapular, e frequentemente associada à hipertricose. A coexistência do nevo de Becker e anormalidades cutâneas, músculo-esqueléticas ou maxilo-faciais corresponde à síndrome do nevo de Becker. Relata-se o caso de uma paciente de 16 anos, portadora desde os sete anos de mácula hipercrômica, localizada no tronco ântero-lateral direito, estendendo-se até a face medial da coxa direita, acompanhada de hipoplasia mamária ipsilateral. O exame anatomopatológico confirmou a hipótese clínica de nevo de Becker.Becker's nevus is a hyperpigmented macula that is predominantly located on the anterior trunk or on the scapular region, frequently associated with hypertrichosis. The association of Becker's nevus with other cutaneous, musculoskeletal or maxillofacial anomalies has been called Becker's nevus syndrome. We report a case of a 16-year-old girl with a hyperpigmented macula which spread from her right anterolateral trunk to the inner part of her right thigh accompanied by ipsilateral mammary hypoplasia. The skin lesion started when the patient was seven years old when it was also noticed ipsilateral mammary hypoplasia. The histological exam confirmed the clinical hypothesis of Becker's nevus.

Objective: This study aimed to investigate the microscopic structure and characteristics of nevi on the conjunctiva of the lacrimal caruncle by in vivo confocal microscopy., Methods: In total, four patients with nevi growing on the lacrimal caruncle conjunctiva were recruited. The morphological characteristics of the nevi were evaluated by in vivo confocal microscopy before excision surgery; the results were compared with histopathological analyses of the surgical specimens., Results: The nevi of the four patients were all located at the conjunctiva of the lacrimal caruncle, with a slightly nodular surface, mixed black and brown color, and clear boundary. The nevi were round and highly protruded on the surface of the lacrimal caruncle, with an average diameter of 4.5 ± 1.29 mm. Under in vivo confocal microscopy, the pigmented nevus cells on the conjunctiva of the lacrimal caruncle were observed to be clustered in nests with irregular boundaries. The cells were round or irregular, with clear cell boundaries, hyper-reflective at the periphery, with low reflectivity in the center. Vascular crawling was observed in some regions. Histopathological analysis showed that nevus cells were roughly equal in size and distributed in a nodular pattern. Melanin granules were observed in the cytoplasm. No atypia or mitotic figures of the cells were found., Conclusion: This study revealed that the microstructure of nevi growing on the conjunctiva of the lacrimal caruncle can be identified by in vivo confocal microscopy., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Cai, Xu, Ng and Li.)

Phacomatosis pigmentokeratotica (PPK) is characterized by the co-existence of epidermal nevi and large segmental speckled lentiginous nevi of the papulosa type. PPK, previously explained as 'twin spot' mosaicism due to the postzygotic crossing-over of two homozygous recessive mutations, has recently been shown to derive from one postzygotic activating RAS mutation. Epidermal nevi, including those in PPK, are known to give rise to neoplasms such as trichoblastoma and basal cell carcinoma. Within speckled lentiginous nevi, Spitz nevi and melanoma have been well documented. We report a case of PPK with a combined melanocytic and adnexal neoplasm presenting where the nevi conjoined. Using next-generation sequencing techniques, we were able to identify the same HRAS G13R mutation within both components of the tumor, and to show the absence of additional mutated modifier genes in a panel of 300 cancer-related genes. Given the genetic findings in this rare tumor-type, we suggest that this case may be used as a model for understanding the development of biphenotypic neoplasia or intratumoral heterogeneity in some cases. [ABSTRACT FROM AUTHOR]

Abstract This web-based clinical case module is part of a series of online modules being developed for the medical student curriculum in dermatology. This self-directed resource serves as a supplement to traditional lecture and clinical teaching. The purpose of this module is to help students develop a clinical approach to the evaluation and initial management of patients presenting with suspicious pigmented lesions that are concerning for malignant melanoma. In this case, a 40-year-old woman presents with a dark, suspicious mole. As users navigate through the module, they are presented with various decision branch points in the care of the patient. In this way, the module seeks to closely mimic a true clinical experience as students are able to see the consequences of their clinical decision-making. Users also learn how to appropriately counsel the patient on healthy sun protection habits and preventative skin surveillance. A comprehensive summary of key points on melanoma (including epidemiology, etiology, treatment, and prognosis) may be reviewed at the end of the module. The module requires PowerPoint 2007 or Microsoft Office 2007 compatibility. Computer-assisted instruction has been shown to be at least as effective as traditional lecture in teaching dermatology morphology to medical students. The effectiveness and significance of the present work are under study. We plan to use pre- and postassessments to evaluate the effectiveness of this module.

O objetivo deste estudo é relatar um caso de lesão verrucosa cujo diagnóstico foi de nevo melanocítico composto associado à hiperplasia siringofibroadenomatóide. O paciente foi submetido a exérese de lesão cutânea abdominal com diagnóstico clínico de nevo melanocítico de Miesher. A microscopia óptica revelou epiderme hiperplásica e derme com ninhos de células névicas intimamente associados com aglomerados de ductos écrinos e arranjados segundo um padrão siringomatóide. A concomitância de hiperplasia epidérmica e proliferação siringomatóide é definida como siringofibroadenomatose écrina e pode ser devida a fatores de crescimento secretadas pelo estroma alterado.The aim of this study was to report a case of a verrucous lesion diagnosed as a compound melanocytic nevus associated with syringofibroadenomatous hyperplasia. The patient was submitted to excision of the abdominal skin lesion and diagnosed as Miesher melanocytic nevus. Optical microscopy revealed epidermal hyperplasia and dermis with nests of nevus cells intimately associated with eccrine duct clusters arranged in a syringoid pattern. The coexistence of epidermal hyperplasia and syringomatoid proliferation is defined as eccrine syringofibroadenomatosis and may result from growth factors released by the impaired stroma.

Copyright of Revista Odonto Ciencia is the property of EDIPUCRS - Editora Universitaria da PUCRS and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective　Through clinical observation and statistics，to get the best curative effect of surgical operation in treating pigment nevus method and provide clinical guidance. Methods　We reviewed of face and neck patients (1100 patients) with pigmented nevus in the department in the department of the dermatology，plastic surgery from January 2013 to October 2015，two different methods was designed on each parts and effect of the treatment, especially satisfaction degree was analyzed by statistical methods．Results　In 100 cases of patients, only 20 patients had mild scar hyperplasia at the neck incision and the rest of the patients were satisfactory. For special parts such as mouth，nose and eye around，along the direction of the muscle, arc and along the direction of dermatoglyph incision was designed respectively, patients obtained with higher postoperative satisfaction （P < 0.05）. Conclusion　In pigmented nevus of face and neck surgery treatment, surgical incision design requires dynamic and static combining method，incision design is important for the postoperative effect and patients' satisfaction. [ABSTRACT FROM AUTHOR]

Electrical bio-impedance can be used to assess skin cancers and other cutaneous lesions. The aim of this study was to distinguish skin cancer from benign nevi using multifrequency impedance spectra. Electrical impedance spectra of about 100 skin cancers and 511 benign nevi were measured. Impedance of reference skin was measured ipsi-laterally to the lesions. The impedance relation between lesion and reference skin was used to distinguish the cancers from the nevi. It was found that it is possible to separate malignant melanoma from benign nevi with 75% specificity at 100% sensitivity, and to distinguish nonmelanoma skin cancer from benign nevi with 87% specificity at 100% sensitivity. The power of skin cancer detection using electrical impedance is as good as, or better than, conventional visual screening made by general practitioners. [ABSTRACT FROM AUTHOR]

Background. Nevus density in children, a well-known risk factor for malignant melanoma, depends both on constitutional factors and on previous ultraviolet (UV) exposure. Secular trends of childhood UV exposure could thus be indirectly monitored by repeated standardized surveys assessing nevus density in children, such as the “childhood monitoring of nevus density (CMONDE-Study)”.Methods. Two complete surveys comprising all children at the time of school enrolment were performed in the city and county of Go¨ttingen, Germany, during the years 1999 and 2000. A total of 4252 children with a median age of 6.25 years were examined as part of the mandatory school enrolment health assessment, and complete data were available for 3881 children.Results. Median nevus density was 5.8/m2 in the entire study group. The subgroup-specific median increased from “Fitzpatrick skin type” IV to II, but the density was not increased for the type I subgroup. Similarly, nevus density rose with increasing lightness of hair color, but was very low in red-haired individuals. While the number of freckles was also strongly associated with nevus density, the association between iris color and skin reflectance, respectively, was weak. The duration of the additional examination for CMONDE was on average 3–5 min per child.Conclusion. We regard CMONDE as a highly feasible surveillance instrument, which should be implemented as an important addition to regular regional or national health reporting. [Copyright &y& Elsevier]

In daily practice, nail pigmentation can be a diagnostic challenge, especially if the dermoscopic findings are nonspecific. We present examples of cases, in which optical coherence tomography-a rapid, noninvasive imaging method-showed typical changes that were indicative for the diagnosis., (© 2021. Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

This learning exercise challenges clinicians and dermatopathologists to consider the differential diagnosis of an unevenly colored solitary papule over the upper back of an adolescent female. [ABSTRACT FROM AUTHOR]

Histochemical findings of primary and metastatic amelanotic melanomas were shown by the formaldehyde-induced fluorescence method (Falck and Hillarp). All or some of the amelanotic melanoma cells were discovered to emit green specific fluorescence. Results of the determination of 5-S-cysteinyldopa and DOPA in amelanotic melanoma tissues indicated that the specific fluorescence emitted by these cells is primarily due to the presence of 5-S-cysteinyldopa. The values of 5-S-cysteinyldopa in these tissues were lower than those in melanotic melanoma, but were approximately the same as those in pigmented nevus. When unpigmented tumors were histopathologically revealed to be malignant, amelanotic melanoma could be definitely diagnosed by the fluorescence method of Falck and Hillarp and the biochemical analysis of 5-S-cysteinyldopa in the tissues. [ABSTRACT FROM AUTHOR]

Background: The main goal of excision of a pigmented nevus is to achieve an esthetically pleasing result. A single nevus can be removed by simple excision, whereas S-shaped suture can be used for the excision of 2 adjacent nevi. However, the choice of suturing method is based on the experience of the dermatologic surgeon, as there is no uniform standard for suture following the excision of 2 adjacent nevi. The aim of the present study was to determine whether S-shaped wound closure is appropriate for the excision of 2 adjacent nevi., Methods: The outcomes of 21 patients who underwent simultaneous resection of 2 adjacent nevi were retrospectively reviewed. Of these patients, 17 chose S-shaped suture and 4 chose direct suture. Patients were followed-up for more than 6 months to review their postoperative scars. Differences between the 2 methods were compared based on the patient and observer scar assessment scale. Diameters and the proportional relationship between the 2 nevi were analyzed., Results: Patients who underwent S-shaped wound closure surgery were more satisfied compared to those who had direct suturing (P<0.05); the nevus diameter-to-spacing diameter ratio was 0.68±0.35:1:0.99±0.56 in the S-shaped wound closure group., Conclusions: S-shaped wound closure following the excision of 2 adjacent nevi resulted in better patient satisfaction than the conventional direct suturing method., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/atm-20-7167). The authors have no conflicts of interest to declare., (2020 Annals of Translational Medicine. All rights reserved.)

Competing Interests: Competing interests: The authors have no conflicts of interest to disclose.

Congenital melanocytic nevi of the face are a frequent reason for consultation in paediatric plastic surgery. Usually of small size, they raise a complex problem of reconstruction when they are large and giant. The indication of excision is generally stated on aesthetic criteria whereas the risk of melanoma is especially important in the giant nevi. Simple suture, full thickness skin graft and expanded skin flaps are the techniques of choice. The treatment must be carried out precociously, follow a surgical planning, respect the aesthetic units of the face and the periorificial areas, adapt to the age of the child and bring psychological benefit to the child., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

Congenital melanocytic nevus consists of congregations of nevomelanocytes. It is found in approximately 1% of new born infants. Congenital melanocytic nevus needs to be excised before it transforms into a malignant lesion. Many strategies have been attempted for the removal and reconstruction of the nevus. Serial excision enables wound closure to be accomplished with a shorter scar than if the original lesion was elliptically excised in a single stage and reorientation of the scar closer to the relaxed skin lines. The routine utilization of an elliptical serial excision as a standard method of closure often leads to the formation of elongated scars and waste of skin. The "Cogwheel pattern" serial excision is a new technique for reducing the size of the nevus efficiently. Reducing the final scar length, distributing the tension over many directions, and having the chance of decrease in operation numbers are ultimately achieved with the use of the "Cogwheel pattern" serial excision.

Background: Pigment epithelium-derived factor (PEDF) was first isolated from the medium conditioned by human fetal retinal pigment epithelial cells and has been detected in a broad range of human fetal and adult tissues. Recent studies have indicated that PEDF activity is inhibitory to angiogenesis., Objective: To study the expression and distribution of pigment epithelium-derived factor (PEDF) in human melanocytes, malignant melanoma cells and tissues., Results: PEDF was expressed in human melanocytes. The expression of PEDF protein diminished in the following orders healthy skin, pigmented nevus and human malignant melanoma (p < 0.001). Both the expression of PEDF mRNA and protein was much lower or almost absent in the malignant melanoma cell line A375 than that in human melanocytes (p < 0.001)., Methods: The expression and distribution of PEDF in human healthy skin, pigmented nevus and malignant melanoma were studied. The expression of PEDF mRNA in human melanocytes and malignant melanoma cell line A375 was measured by reverse transcription polymerase chain reaction (RT-PCR) and PEDF protein was detected by immunohistochemical method and Western blotting analysis., Conclusion: The lack of PEDF expression may contribute to the pathogenesis of malignant melanoma.