|Year : 2013 | Volume
| Issue : 1 | Page : 39-40
Giant nevus anemicus: A rare case report
Anisha Sethi, Tejinder Kaur, K J P S Puri
Department of Dermatology, Venereology and Leprosy, GMC, Amritsar, Punjab, India
|Date of Web Publication||23-Aug-2013|
Department of Skin and S.T.D, GMC, Amritsar - 143 001, Punjab
Source of Support: None, Conflict of Interest: None
Nevus anemicus is an uncommon, localized, congenital vascular malformation. It occurs due to hyper sensitization of an area to the circulating catecholamines with normal histology. A giant nevus anemicus of this magnitude has not been reported until date and we report this unusual case of giant nevus anemicus in a 4-month-old male child.
Keywords: Catecholamines, diascopy, nevus anemicus, nevus depigmentosus, vitiligo
|How to cite this article:|
Sethi A, Kaur T, Puri K. Giant nevus anemicus: A rare case report. Indian J Paediatr Dermatol 2013;14:39-40
| Introduction|| |
Nevus anemicus is a congenital disorder characterized by macules of varying size and shape that are paler than the surrounding skin and cannot be made red by trauma, cold or heat. The paler area is due to the blood vessels within the area, which are more sensitive to the body's normal vasoconstricting chemicals.
| Case Report|| |
A 4-month-old male child presented with his parents to the dermatology clinic with a history of an asymptomatic white patch on the left side of his back since birth. At birth, the lesion was small in size present over left upper back, but since then it is increasing in size and has appeared over the left side of the chest and left upper limb. Milestones of the child were normal. On mucocutaneous examination, there was a well-defined hypopigmented patch with irregular margins over the left chest and abdomen, back and left upper limb [Figure 1]a & b and [Figure 2]. There was no erythematous reaction upon rubbing, heating or cooling the involved skin in our patient. When a glass slide was applied to the border of the lesion, the border became inapparent. A clinical diagnosis of nevus anemicus was made. Skin biopsy was performed and that came out to be normal.
|Figure 1: Left trunk showing a large hypopigmented patch on the (a) anterior aspect and (b) back|
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| Discussion|| |
Nevus anemicus is a congenital hypopigmentedpatch. It most commonly occurs as a single patch on the trunk. Several studies have shown that nevus anemicus is caused by a localized vascular hypersensitivity to catecholamines.  This catecholamine sensitivity produces increased vasoconstriction and skin pallor. When pressure is applied to the border of the patch with a clear glass slide (i.e., diascopy), the border between lesion and normal skin disappears because the normal skin becomes blanched. Since the histopathology of nevus anemicus is normal, nevus anemicus is a pharmacologic nevus and not an anatomic one. , No treatment is required.
The differential diagnosis of nevus anemicus includes Hansen's disease, nevus depigmentosus, tinea versicolor and vitiligo. They all were excluded one by one clinically and on the basis of histopathology. Counseling was performed as no treatment was required.
To the best of our knowledge, this is the first case of giant nevus anemicus to be reported.
| References|| |
|1.||McMillan JA, DeAngelis CD, Feigin RD, Warshaw JB. Oski's Pediatrics, Principles and Practice. 4 th ed. 2006. p. 458. |
|2.||Mountcastle EA, Diestelmeier MR, Lupton GP. Nevus anemicus. J Am Acad Dermatol 1986;14:628-32. |
|3.||Requena L, Sangueza OP. Cutaneous vascular anomalies. Part I. Hamartomas, malformations, and dilation of preexisting vessels. J Am Acad Dermatol 1997;37:523-49. |
[Figure 1], [Figure 2]