Intradermal Nevus

Diagnosis: Intradermal Nevus

Skin-coloured, papillomatous papule on on vermillion border of the lower lip. Submitted by Dr. Alaa Saad.

Clinical Presentation

Skin-coloured, papillomatous papule on on vermillion border of the lower lip. Submitted by Dr. Alaa Saad.

Clinical History

Flesh-colored to light brown, dome-shaped, soft papule. Usually on face or trunk. Stable over time. No changes suggesting melanoma.

Treatment

No treatment necessary. Excision for cosmetic reasons or if diagnostic uncertainty. Shave excision or punch excision.

Differential Diagnosis

• Basal cell carcinoma • Melanoma (amelanotic) • Dermatofibroma • Neurofibroma • Sebaceous hyperplasia • Cyst (epidermal inclusion)

Key Learnings

• Benign melanocytic nevus — nevus cells confined to the dermis (mature phase) • Typically flesh-colored to light brown, dome-shaped, soft papule • Part of the natural evolution: junctional → compound → intradermal (Unna-Abt maturation) • Dermoscopy: comma vessels, cobblestone pattern, or homogeneous tan structureless pattern • Benign — excision only for cosmetic reasons or diagnostic uncertainty • "Maturing" (maturation/neurotization) of nevus cells with depth is a sign of benign nature

Tags: dermatologist, dermatology, Intradermal Nevus, lip