Superficial dermal melanocytosis of the elderly: An exceptional occurrence?

Abstract

The development of flat pigmented lesions on chronically sun‐damaged (CSD) skin of the face may represent the clinical manifestation of a wide variety of hyperplastic/neoplastic melanocytic proliferations. We report the exceptional case of an acquired pigmented patch occurring on CSD skin, histopathologically characterized by diffuse hyperplasia of dendritic/spindled melanocytes in the superficial dermis within a widened band of actinic elastosis. This lesion was associated with a small focus of early invasive lentigo maligna melanoma (LMM). We show the melanocytic nature of the population of dermal pigmented cells by means of single and double immunohistochemical staining for melanocytic and histiocytic markers. The biologic significance of the focus of LMM within the hyperpigmented lesion (whether random collision phenomenon or causally related occurrence), as well as the pathogenesis of the whole dermal lesion are difficult to elucidate. Our case emphasizes the need for a better understanding of the pathophysiology of so‐called dermal melanocytes.

Considerations in geriatric dermatopathology

“…Given the normal changes that come with intrinsic and extrinsic aging, pigmented macules and patches on chronically sun‐damaged skin, especially on the head and neck, can be especially difficult to interpret, both clinically and histopathologically (Tables 4 and 5). 34 …”

“…Given the normal changes that come with intrinsic and extrinsic aging, pigmented macules and patches on chronically sundamaged skin, especially on the head and neck, can be especially difficult to interpret, both clinically and histopathologically (Tables 4 and 5). 34 Emerging literature regarding special cases Geriatric dermatopathology shares a multitude of clinical and histologic conditions with the general population. However, this population demonstrates unique characteristics that dermatologists and pathologists alike should be cognizant of.…”

A Case Series With Acquired Dermal Melanocytosis: A Retrospective Study From 2001 to 2018

“…9 A case of melanoma from nevus of Ota has also been reported. 10 A recent report described an 80-year-old man with chronically sun-damaged skin who later developed benign ADM, and a central focal area of lentigo malignant melanoma was found within the ADM. 11 It is not clear whether the lentigo malignant melanoma was associated with chronically sun damaged skin or DM. The precise pathogenesis is difficult to elucidate, but the emergence of a new subcutaneous nodule within dermal melanocytic lesions is rather alarming.…”