A recurrent melanocytic nevus phenomenon in the setting of Hailey–Hailey disease

Abstract

Atypical acquired melanocytic nevi in patients with epidermolysis bullosa (EB) have been referred to as EB nevi and are considered to be a type of recurrent nevus with atypical but distinctive histopathologic findings. Herein, we describe an atypical nevus in a patient with Hailey-Hailey disease with different histopathologic findings from EB nevi because of presumably different pathogenesis. It is important to be aware that the recurrent nevi phenomenon can be seen in acantholytic conditions as well as blistering disorders, given these lesions may clinically resemble melanoma.

Recurrent Nevus Phenomenon Developing within a Keloid

“…Similar occurrences of atypical, benign melanocytic lesions have been reported in other bullous disorders such as Hailey–Hailey disease [ 7 ]. Noor et al describe a case of a pigmented lesions developing within a difficult-to-treat area of Hailey–Hailey disease [ 7 ].…”

“…Similar occurrences of atypical, benign melanocytic lesions have been reported in other bullous disorders such as Hailey–Hailey disease [ 7 ]. Noor et al describe a case of a pigmented lesions developing within a difficult-to-treat area of Hailey–Hailey disease [ 7 ]. Histological examination of the lesion revealed characteristics of the recurrent nevus phenomenon including, irregular junctional proliferation of melanocytes in nests as well as poorly nested melanocytes with pagetoid spread.…”

“…Initially, the diagnosis of a recurrent nevus was overlooked in this case as there was a lack of clinical context describing Hailey–Hailey. Having learned that the patient had areas of recalcitrant Hailey–Hailey, a more appropriate diagnosis was given [ 7 ]. In the case of our patient, the knowledge of the previous piercing procedure and subsequent keloid formation allowed for an appropriate recognition and diagnosis of the recurrent nevus phenomenon arising above a keloid scar.…”

“…The recurrent nevus phenomenon is described as the reappearance or persistence of a nevus within the scar from a prior excision due to the benign proliferation of remaining melanocytes [ 1 , 2 , 3 ]. Any type of nevi (e.g., congenital, dysplastic, blue-type) may occur in this phenomenon following excision [ 4 , 5 , 6 , 7 ]. Recurrent melanocytic lesions appear to affect middle-aged females more commonly, are most frequently found on the back followed by the face and extremities, and usually develop within 6 months of the original biopsy [ 5 ].…”