Nevus anemicus: Difference between revisions
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The hypopigmentation is due to increased sensitivity of the blood vessels within the area to the body’s normal vasoconstricting chemicals, such as [[catecholamines]].<ref name="aocd">{{cite web |url=http://www.aocd.org/skin/dermatologic_diseases/nevus_anemicus.html|title=Dermatologic Disease Database |accessdate=25 October 2011}}</ref> | The hypopigmentation is due to increased sensitivity of the blood vessels within the area to the body’s normal vasoconstricting chemicals, such as [[catecholamines]].<ref name="aocd">{{cite web |url=http://www.aocd.org/skin/dermatologic_diseases/nevus_anemicus.html|title=Dermatologic Disease Database |accessdate=25 October 2011}}</ref> | ||
== | ==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. | |||
* If there is doubt about the diagnosis, rubbing the area causes the skin around the lesion to become red while the lesion itself does not change in color.<ref name="aocd"/> | * If there is doubt about the diagnosis, rubbing the area causes the skin around the lesion to become red while the lesion itself does not change in color.<ref name="aocd"/> | ||
* 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.<ref>{{cite web |url=http://www.globalskinatlas.com/imagedetail.cfm?TopLevelid=682&ImageID=1775&did=182|title=Global Skin Atlas |accessdate=25 October 2011}}</ref> | * 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.<ref>{{cite web |url=http://www.globalskinatlas.com/imagedetail.cfm?TopLevelid=682&ImageID=1775&did=182|title=Global Skin Atlas |accessdate=25 October 2011}}</ref> | ||
* | * \\ | ||
* Although the cutaneous [[Circulatory system|vasculature]] appears normal [[histologically]], the blood vessels within the nevus do not respond to injection of [[vasodilators]]. It has been postulated that the persistent pallor may represent a sustained localized adrenergic [[vasoconstriction]].<ref name="Nelson">Nelson Textbook of Pediatrics 19th. (10th ed.). W.B. Saunders Company. Page 640. ISBN 1-4377-0755-6.</ref> | * Although the cutaneous [[Circulatory system|vasculature]] appears normal [[histologically]], the blood vessels within the nevus do not respond to injection of [[vasodilators]]. It has been postulated that the persistent pallor may represent a sustained localized adrenergic [[vasoconstriction]].<ref name="Nelson">Nelson Textbook of Pediatrics 19th. (10th ed.). W.B. Saunders Company. Page 640. ISBN 1-4377-0755-6.</ref> | ||
* [[Diascopy]] is used to differentiate from other hypopigmented skin lesions, such as [[vitiligo]]. | * [[Diascopy]] is used to differentiate from other hypopigmented skin lesions, such as [[vitiligo]]. |
Revision as of 16:59, 26 June 2014
Nevus anemicus | |
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]
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.
- If there is doubt about the diagnosis, rubbing the area causes the skin around the lesion to become red while the lesion itself does not change in color.[3]
- 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.[4]
- \\
- Although the cutaneous vasculature appears normal histologically, the blood vessels within the nevus do not respond to injection of vasodilators. It has been postulated that the persistent pallor may represent a sustained localized adrenergic vasoconstriction.[5]
- Diascopy is used to differentiate from other hypopigmented skin lesions, such as vitiligo.
- Results of a skin biopsy would be interpreted as normal and only physiological testing can reveal the nevus in contrast to normal skin. Stroking the patch elicits no red flare. Only the normal skin would react with a characteristic erythematous response.
- Examination under a Wood lamp can also reveal the nevus anemicus patch will not emphasize as a patch of vitiligo would.[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]
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.
- ↑ "Global Skin Atlas". Retrieved 25 October 2011.
- ↑ Nelson Textbook of Pediatrics 19th. (10th ed.). W.B. Saunders Company. Page 640. ISBN 1-4377-0755-6.
- ↑ Barber Kirk (2010). Consultant For Pediatricians '. Page 9:233, 237.
- ↑ 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.