Nevus Anemicus

Author: Loretta Davis, MD; Chief Editor: William D James, MD more...

Updated: Jan 19, 2012

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Background
Pathophysiology
Epidemiology
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Background

Nevus anemicus is a congenital vascular anomaly that presents clinically as a hypopigmented macule or patch, as shown below. The lesional pallor is due to a localized hypersensitivity to catecholamines with resultant vasoconstriction. Nevus anemicus is an uncommon disorder and was first described by Vorner in 1906.

Ill-defined, asymptomatic hypopigmented patch of nevus anemicus on the lateral leg.

Pathophysiology

Intralesional injection of bradykinin, acetylcholine, serotonin, nicotine, 5-hydroxytryptamine, and histamine fails to induce the anticipated vasodilatation or erythema in the affected area. However, erythema does follow an axillary sympathetic block or intradermal injection of the alpha-adrenergic blocking agent, pilocarpine. These findings suggest that nevus anemicus is best termed a pharmacologic nevus resulting from increased vascular sensitivity to catecholamines.^[1]This conclusion is further supported by autograft exchange transplantation studies that show donor site dominance. It also has been proposed that an abnormality in endothelial adhesion molecule induction (E selectin expression) may be involved, suggesting several pharmacologic anomalies are involved and further supporting the idea that nevus anemicus may best be termed a pharmacologic nevus.

Frequency

United States

The prevalence of nevus anemicus is not known, but it is not rare.

Mortality/Morbidity

Lesions of nevus anemicus usually persist unchanged throughout life. They are asymptomatic.

Race

No racial predilection has been noted in the literature for nevus anemicus.

Sex

Nevus anemicus appears more frequently in females.

Age

Nevus anemicus may be present at birth or first appreciated in early childhood.

Proceed to Clinical Presentation

Contributor Information and Disclosures

Author

Loretta Davis, MD Professor, Department of Internal Medicine, Division of Dermatology, Medical College of Georgia

Loretta Davis, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

Carrie L Kovarik, MD Assistant Professor of Dermatology, Dermatopathology, and Infectious Diseases, University of Pennsylvania School of Medicine

Carrie L Kovarik, MD is a member of the following medical societies: Alpha Omega Alpha

Disclosure: Nothing to disclose.

David F Butler, MD Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic

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

Disclosure: Nothing to disclose.

Jeffrey J Miller, MD Associate Professor of Dermatology, Pennsylvania State University College of Medicine; Staff Dermatologist, Pennsylvania State Milton S Hershey Medical Center

Jeffrey J Miller, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Association of Professors of Dermatology, North American Hair Research Society, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Catherine M Quirk, MD Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology and Society for Investigative Dermatology

Disclosure: Elsevier Royalty Other

Additional Contributors

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author, Theresa G. Knoepp, MD, to the development and writing of this article.

References

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