Kosin Med J.  2023 Sep;38(3):215-218. 10.7180/kmj.22.119.

Dermoscopic features of an unusual case of targetoid hemosiderotic nevus

• Jeong SM
• Jung JH
• Kwon DI
• Seong SH
• Jang JY
• Park JB
• Jang MS

• KMID: 2546157
• DOI: http://doi.org/10.7180/kmj.22.119

Abstract

Targetoid hemosiderotic nevus (THN) is a rare variant of melanocytic nevus, characterized by a sudden development of a targetoid ecchymotic halo around a pre-existing nevus. THN clinically raises concern for malignant transformation due to its abrupt change in color and size. THN should be distinguished from other diseases showing a peripheral halo, including targetoid hemosiderotic hemangioma, halo nevus, and Meyerson nevus. Dermoscopy can help clinicians to differentiate THN from these diseases. The typical dermoscopic features of THN are known to be divided into two distinctive areas: the central melanocytic area and the peripheral ecchymotic area. In our case, dermoscopy revealed a novel bull’s eye pattern composed of a central area with characteristic features of benign melanocytic nevus, an intermediated white circular ring, and a peripheral milky red area. When a sudden change occurs in a pre-existing nodule showing targetoid features, dermoscopy should be considered before conducting a biopsy or surgical intervention.

Keyword

Case reports; Dermoscopy; Targetoid hemosiderotic nevus; Traumatized nevus

Figure

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  Fig. 1. (A, B) Blackish nodule on the abdomen surrounded by an ecchymotic targetoid halo.

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  Fig. 2. Dermoscopy revealed brownish globules (black arrows) and violaceus globules (white arrows) intermingled with a structureless jet-black area (white asterisk) on the center. On the periphery, homogeneous milky red areas (black arrowhead) with an intermediate whitish circular ring (black asterisk) surrounding the central nodule were seen (×10).

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  Fig. 3. Histological findings. (A) Dome-shaped architecture was seen along with the extravasation of red blood cells throughout the lesion (hematoxylin-eosin [H&E] stain, ×20). (B) Well-circumscribed proliferation of dermal melanocytes arranged in a nest and vessel dilatation were noted (H&E stain, ×200). (C) On the periphery, only extravasation of red blood cells was seen (H&E stain, ×400).

Reference

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