CORRELATION BETWEEN THE HISTOPATHOLOGY AND THE EPILUMINESCENCE MICROSCOPY FEATURES OF MALIGNANT BLUE NEVUS

BACKGROUND. The validation of epiluminescence microscopy (ELM) for the diagnosis of pigmented skin lesions is conditional on the demonstrati on of consistent histologic correlates of the ELM patterns. The ELM ch aracteristics of malignant blue nevus (MBN) have never been reported p reviously. OBJECTIVE. To evaluate the histologic counterparts of the E LM features of a case of MBN. METHODS. Comparison between the histolog ic characteristics observed in step-sections of the lesion and the str uctures observed in a digital ELM image. RESULTS. On ELM, the lesion s howed a diffuse whitish-blue veil, round black blotches, a collection of dark colored punctate spots, and fragmented bluish reticular-like f ormations in the periphery. At histologic examination, the black blotc hes and the spots appeared to correlate with areas of intense focal ne crosis in the papillary and reticular dermis, and the reticular-like s tructures were demonstrated to correspond to the presence of free mela nin and melanophages in the papillary dermis. CONCLUSION. In this case of MEN, blotches and spots seen on ELM correlated with intense necros is in the papillary and reticular dermis, and reticular-like formation s were the counterparts of free melanin and melanophages in the papill ary dermis. (C) 1996 by the American Society for Dermatologic Surgery, Inc.