Nevus anemicus
| Nevus anemicus | |
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| Left leg with nevus anemicus patches. |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Nevus anemicus is a congenital disorder characterized by hypopigmented macules of varying size and shape.[1][2]
Pathophysiology
The hypopigmentation is due to increased sensitivity of the blood vessels within the area to the body’s normal vasoconstricting chemicals, such as catecholamines.[3] The involved area is lighter than the normal skin, not because of a loss of pigment occurs, but because blood vessels are constricted, producing a permanent blanching of the area. This blanching is a functional rather than a structual abnormality, presumed to be caused by local increased sensitivity to catecholamines.[4] Although the cutaneous vasculature appears normal histologically, the blood vessels within the nevus do not respond to injection of vasodilators.
Differential Diagnosis
- Nevus anemicus must be differentiated from vitiligo and other diseases causing hypopigmentation.
- Rubbing the area causes the skin around the lesion to become red while the lesion itself does not change in color.[3]
- Diascopy is used to differentiate nevus anemicus from other hypopigmented skin lesions, such as vitiligo.
- Results of a skin biopsy are often interpreted as normal unlike other conditions.
- Physiological testing can exacerbate the appearance of the nevus in contrast to normal skin. Normally, when the skin is stroked, normal skin would react with a characteristic erythematous response. In nevus anemicus, stroking the patch elicits no red flare.
- Examination under a Wood lamp can also distinguish the patch form vitiligo. [5]
Natural History, Prognosis, and Complications
- The patch appears on the skin at birth or in early childhood and the lesion is benign.
Physical Examination
- In most people, the patches are under 10 cm in size.
- Often the patches are difficult to see against the background color of the patient’s skin, but if sunburn develops, then the white area stands out prominently.[6]
Treatment
Since the histopathology of nevus anemicus is normal, nevus anemicus is a pharmacologic nevus and not an anatomic one.[7][8] In most people a nevus anemicus is on a covered area and so light in appearance that no treatment is needed.[3]
Gallery
Image obtained from Dermatology Atlas[9]
See also
References
- ↑ James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. Page 582. ISBN 0-7216-2921-0.
- ↑ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 1-4160-2999-0.
- ↑ 3.0 3.1 3.2 "Dermatologic Disease Database". Retrieved 25 October 2011.
- ↑ McMillan , Julia A; DeAngelis, Catherine D.; Feigin, Ralph D.; Warshaw, Joseph B. (2006). Oski's Pediatrics, Principles & Practice. (4th ed.). Page 458. ISBN 978-0-7817-1618-5.
- ↑ Barber Kirk (2010). Consultant For Pediatricians '. Page 9:233, 237.
- ↑ "Global Skin Atlas". Retrieved 25 October 2011.
- ↑ Mountcastle EA, Diestelmeier MR, Lupton GP. Nevus anemicus. J Am Acad Dermatol 1986;14:628-32..
- ↑ Requena L, Sangueza OP. Cutaneous vascular anomalies. Part 1. Hamartomas, malformations and dilation of preexisting vessels. J Am Acad Dermatol 1997;37:523-49,quiz 549-52.
- ↑ {{cite web| title= Dermatology Atlas, created by Samuel Freire da Silva, M.D. | url=(http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=313)