Postexcisional melanocytic regrowth extending beyond the initial scar: a novel clinical sign of melanoma

Abstract

This pattern of recurrence of a melanocytic lesion represents a little recognized and distinctive clinical presenting sign of melanoma.

Improving diagnostic accuracy for suspicious melanocytic skin lesions: New Australian melanoma clinical practice guidelines stress the importance of clinician/pathologist communication

“…4,18 Atypical features typically occur within six months of a previous injury, and the atypical pathological changes are usually confined to the area affected by the inciting agent, whereas recurrent melanoma generally grows into the surrounding tissue. 12,19 This may be a 'portion' of a naevus in the case of trauma/irritation/biopsy, but it may also be the entire lesion in the case of topical treatment (or even trauma/irritation). Since the histopathological changes of naevi or melanoma recurring after trauma may be very similar, it is essential that the previous biopsy and, if available, any relevant clinical and dermoscopic photographs be reviewed in conjunction with the clinician (Figure 2).…”

Melanoma arising in a persistent nevus: Melanoma where ‘pseudomelanoma’ is expected

“…Dermoscopic evidence of extension of melanocytic proliferation beyond a scar is a useful clue, which can help clinicians decide which lesions are at high risk. 17 Genomic testing can support a diagnosis for ambiguous lesions or help bring more certainty to an emotionally charged situation, such as in the case reported here. Although melanoma arising in association with a persistent nevus is rare, clinicians should be careful to recommend follow-up evaluation, especially if a lesion recurs, or if a persistent lesion changes.…”

Recurrence of a Cellular Blue Nevus with Satellitosis—A Diagnostic Pitfall with Clinical Consequences

“…The pathologic features of recurrent nevus and melanoma are often very similar. Kelly et al claimed that the most suspicious feature for melanoma in these cases is the growth of the lesion beyond the confines of the initial scar into the surrounding normal skin [ 12 ]. To differentiate recurrent nevus from melanoma, other diagnostic tools such as immunohistochemistry, dermoscopy, and confocal microscopy should be used in addition to standard (immuno)histologic work-up.…”

“…Recurrence of common melanocytic nevi has been fairly well characterized, clinically and histologically. In contrast, recurrence of blue nevi has been reported infrequently [ 11 , 12 ]. In a study by Harvell et al, no malignant transformation or satellitosis was detected in recurrent BN [ 11 ].…”