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Cutaneous Melanoacanthoma Clinical Presentation

  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
 
Updated: Jun 10, 2016
 

History

Cutaneous melanoacanthomas are painless and slow growing. The slow but persistent growth and related cosmetic problems with melanoacanthomas may prompt an affected individual to consult a physician.

Patients are generally asymptomatic; however, trauma or manipulation of the melanoacanthoma may lead to bleeding or inflammation. Patients may live with cutaneous melanoacanthoma for decades before they seek treatment.

Oral melanoacanthoma is rare, first noted with the sudden appearance and rapid growth of a brown-black macule.[15] Gingival melanoacanthomas may be evident as solitary or multiple.[16] Oral melanoacanthoma may be bilateral.[17] It may rarely appear on the gingiva.[18]

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Physical

Melanoacanthomas are most often solitary. Multiple melanoacanthomas have been described. In one case, a 40-year-old man had multiple, minute, discrete or confluent shiny papules limited to his left upper eyelid.[19] They may rarely appear as multiple, asymptomatic, slowly growing, raised pigmented nodules and tumors scattered all over the body.[20] An ulcerating tumor has been described in one of the lesions.

Cutaneous melanoacanthomas are found mainly on the trunk or head, often on the lip or eyelid. They have also been observed on the penile shaft[13] and in the genital regions as a large, solitary, slowly enlarging, hyperpigmented verrucous tumor with a cerebriform surface.[21]

Cutaneous melanoacanthomas may be hyperpigmented or verrucous and round or oval. The lesion may be a papule, plaque, cutaneous horn, or nodule. Lesional diameters range from a few millimeters to 10 cm. Note the image below.

Large cutaneous melanoacanthoma in a 45-year-old m Large cutaneous melanoacanthoma in a 45-year-old man that obstructs his vision.

The authors have observed a darkly pigmented cutaneous horn that extended from the left upper eyelid to below the lower eyelid in a 45-year-old man; the lesion had histologic findings consistent with melanoacanthoma (see image below).

Melanoacanthomas can occur on the oral mucosa,[22] but oral lesions are distinct from cutaneous melanoacanthomas.[8, 23]  Dermatoscopic features have been described.[24]

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Causes

The cause of melanoacanthoma is unknown, but most instances appear to represent a benign neoplasm. Irritation or trauma to the skin may cause some cutaneous melanoacanthomas, especially on the lips. Trauma and irritation of the oral mucosa are believed to cause oral melanoacanthoma.

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Contributor Information and Disclosures
Author

Robert A Schwartz, MD, MPH Professor and Head of Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, Rutgers New Jersey Medical School; Visiting Professor, Rutgers University School of Public Affairs and Administration

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, New York Academy of Medicine, American Academy of Dermatology, American College of Physicians, Sigma Xi

Disclosure: Nothing to disclose.

Coauthor(s)

W Clark Lambert, MD, PhD Professor and Head, Dermatopathology, Departments of Pathology and Dermatology, Rutgers New Jersey Medical School

W Clark Lambert, MD, PhD is a member of the following medical societies: American Academy of Dermatology, American College of Physicians, American Society of Dermatopathology, International Academy of Pathology, Medical Society of New Jersey, Sigma Xi, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

George G Kihiczak, MD Clinical Instructor, The Ronald O Perelman Department of Dermatology, NYU Langone Medical Center

George G Kihiczak, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, Sigma Xi

Disclosure: Nothing to disclose.

Specialty Editor Board

David F Butler, MD Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

David F Butler, MD is a member of the following medical societies: American Medical Association, Alpha Omega Alpha, Association of Military Dermatologists, American Academy of Dermatology, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Phi Beta Kappa

Disclosure: Nothing to disclose.

Christen M Mowad, MD Professor, Department of Dermatology, Geisinger Medical Center

Christen M Mowad, MD is a member of the following medical societies: Alpha Omega Alpha, Noah Worcester Dermatological Society, Pennsylvania Academy of Dermatology, American Academy of Dermatology, Phi Beta Kappa

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References
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Large cutaneous melanoacanthoma in a 45-year-old man that obstructs his vision.
Photomicrograph of cutaneous melanoacanthoma. Large polydendritic melanocytes are seen at all levels of the epidermis. Acanthosis, hyperkeratosis, and slight papillomatosis are also present (hematoxylin and eosin stain, original magnification X139).
 
 
 
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