Increased Melanocytic Nevi in Patients with Inherited Ichthyoses: Report of a Previously Undescribed Association

Authors

  • Juliana Dumêt Fernandes M.D.,

    1. Department of Dermatology, Hospital das Clínicas, Medical School of the University of São Paulo, São Paulo, Brazil
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  • Maria Cecilia Rivitti Machado M.D.,

    1. Department of Dermatology, Hospital das Clínicas, Medical School of the University of São Paulo, São Paulo, Brazil
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  • Zilda Najjar P. Oliveira M.D., Ph.D.

    1. Department of Dermatology, Hospital das Clínicas, Medical School of the University of São Paulo, São Paulo, Brazil
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Address correspondence to Dr. Juliana Dumêt Fernandes, M.D., Av. Dr. Enéas de Carvalho Aguiar, 255, 3rd Floor, Room 3070, Cerqueira César, 05403 001, São Paulo, SP, Brazil, or e-mail: jdumet@gmail.com.

Abstract

Abstract:  Ichthyosis is a heterogeneous cornification disorder. Melanocytic lesions have not been previously described in association with ichthyosis. Their clinical importance lies in the fact that they may simulate melanoma clinically and dermoscopically, as seen in epidermolysis bullosa. The objective of this study was to evaluate the clinical, dermoscopic, and histopathologic features of nevi and lentigines in 16 patients with autosomal recessive congenital ichthyosis—lamellar ichthyosis and nonbullous ichthyosiform congenital erythroderma. Patients underwent general clinical examination dermoscopy. The more suspicious lesions were excised and to histopathologic examination. Most patients (n = 13) reported no personal or familial history of melanoma or atypical nevi. All of the patients had at least five atypical melanocytic lesions. Ten of the 16 patients had at least one atypical nevus or lentigo. This study suggests that increased atypical melanocytic nevi may be a feature of long-standing congenital ichthyoses. Whether this finding is disease-related or a coincidental observation is difficult to ascertain. As an unequivocal discrimination from malignant melanoma in vivo is not always possible, regular clinical follow-up of patients with ichthyosis and increased or unusual nevi is recommended.

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