HISTOPATHOLOGICAL FEATURES OF ACRAL MELANOCYTIC NEVI IN CHILDREN - STUDY OF 21 CASES

Benign melanocytic lesions in children may give cause for some concern histologically. This is because they represent a specific entity or t hey reflect the state of evolution of the lesion or the anatomical loc ation. This latter phenomenon has been poorly documented in children. In this study, we address the problem of atypical features frequently seen in benign nevi from acral sires in a group of patients aged 18 ye ars or less. Twenty-one cases (12 female, 9 male) were identified from the Department of Pathology files during the years 1975-1988. All wer e Caucasian. Histological examination revealed that 6 cases were conge nital and 15 were aquired; of these, 19 cases (90%) had a junctional c omponent and all of these exhibited architecture atypia in the form of either lentiginous proliferation (84%) or confluence of junctional ne sts (84%). Forty-two percent (8/19) showed a mixture of both. Thirty-s even percent (7/19) exhibited transepidermal elimination of melanocyti c nests, with 13/19 (68%) showing single cell, infiltration of the epi dermis. Atypical size, shape, and location of the junctional nests wer e present in 10/19 cases (53%). Within this group there appears to be no relationship between the age of the patient and the degree of archi tectural atypia. Mild cytological atypia was common. This report stres ses the importance of anatomic subsite in the assessment of melanocyti c lesions in children as well as in adults.