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Year : 2016  |  Volume : 17  |  Issue : 1  |  Page : 78-79

Lipomatous hairy bathing trunk nevus with multiple satellite nevi


Department of Dermatology, Government Medical College, Srinagar, Jammu and Kashmir, India

Date of Web Publication4-Jan-2016

Correspondence Address:
Shagufta Rather
Department of Dermatology, Government Medical College, Srinagar, Jammu and Kashmir
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2319-7250.172474

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How to cite this article:
Rather S, Yaseen A, Hassan I. Lipomatous hairy bathing trunk nevus with multiple satellite nevi. Indian J Paediatr Dermatol 2016;17:78-9

How to cite this URL:
Rather S, Yaseen A, Hassan I. Lipomatous hairy bathing trunk nevus with multiple satellite nevi. Indian J Paediatr Dermatol [serial online] 2016 [cited 2020 Jul 2];17:78-9. Available from: http://www.ijpd.in/text.asp?2016/17/1/78/172474

Sir,

Giant congenital melanocytic nevi also called garment or bathing trunk nevi are rare, occurring in one of every 200,000–500,000 births.[1] Their importance lies in the cosmetic variation, their cause, and in their possible malignant transformation or in their association with nevi in the central nervous system as a distinctive syndrome. There is a significant association between bathing trunk nevus and lipomatosis.[2],[3],[4] Here, we present a patient with a combination of bathing trunk nevus with outstanding lipomatosis located on the same area and multiple satellite nevi. An 11-year-old girl, born of a first degree consanguineous marriage, presented to us with a large blackish skin lesion, covered with thick and black hairs over the trunk and arms, since birth. Also, the girl presented with similar but smaller lesions distributed over the buttocks, upper legs, and arms. As she grew, older multiple swellings appeared in the lesion over the back. The skin lesions and swellings gradually increased in size with age in proportion to the body growth. There was no other significant or family history of similar lesions. Her general and systemic examination was unremarkable. Cutaneous examination revealed a large, blackish, and thick plaque extending over the entire back, chest, neck, upper half of abdomen, and left arm and the right arm in its upper one-third [Figure 1] and [Figure 2]. Multiple macular lesions of similar morphology, ranging in size from few mm to 3 cm were noted over the buttocks, proximal legs, and arms. However, there was no evidence of hairs over these satellite lesions. The large plaque over the trunk and arms was covered with thick, black hairs which were more prominent over the back. There were multiple nodules of varying sizes and shapes on this giant nevus on the back. All were mobile, nontender, nonpulsatile, and soft in consistency with well-defined margins, with the largest over the left infrascapular region measuring 14 cm × 6 cm [Figure 1]. Ophthalmological examination was normal. Her routine hematological, biochemical investigations and computerized tomography scan of the brain were within normal limits. Biopsies were taken from the nevoid area and the swelling, which on histopathological examination revealed compound melanocytic nevus and lipoma, respectively [Figure 3]a and [Figure 3]b.
Figure 1: Bathing trunk nevus over the back with numerous lipomatous swellings. Multiple satellite nevi can also be seen

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Figure 2: Giant congenital nevus extending over the neck, chest, part of abdomen, and upper limbs

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Figure 3: Histopathology showing features of (a) compound melanocytic nevus (arrows show melanocytes). and (b) lipoma

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A clinical diagnosis of congenital bathing trunk nevus with multiple satellite nevi and lipomatosis was made.

Giant congenital nevi have been reported by many authors, but the rarity of our case lies in the coexistence of a giant congenital melanocytic nevus, multiple satellite nevi and lipomatosis. This constellation of findings may be probably due to a defect in neural crest, which is the origin not only of melanoblasts but also of Schwann cells, sensory ganglia, bone, fat, muscle, and blood vessels. This may account for the association of bathing trunk nevus with abnormalities such as neurofibromatosis, spina bifida occulta, meningocele, club foot, and hypertrophy or atrophy of deeper structures of a limb.[4],[5],[6] However, the primary etiology remains debatable.

 
  References Top

1.
Cabrera H, Gómez ML, García S. Lipomatous melanocytic nevomatosis. J Eur Acad Dermatol Venereol 2002;16:377-9.  Back to cited text no. 1
    
2.
Chung C, Forte AJ, Narayan D, Persing J. Giant nevi: A review. J Craniofac Surg 2006;17:1210-5.  Back to cited text no. 2
    
3.
Gulati R, Jain D, Mehrania K, Kuldeep CM, Mathur D. Giant congenital nevomelanocytic nevus with satellite lesions, vitiligo and lipoma: A rare association. Indian J Dermatol Venereol Leprol 2000;66:316-7.  Back to cited text no. 3
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4.
Bhagwat PV, Tophakhane RS, Shashikumar BM, Noronha TM, Naidu V. Giant congenital melanocytic nevus (bathing trunk nevus) associated with lipoma and neurofibroma: Report of two cases. Indian J Dermatol Venereol Leprol 2009;75:495-8.  Back to cited text no. 4
[PUBMED]  Medknow Journal  
5.
Le Dourarin NM. The neural crest in the neck and other parts of the body. Birth Defects 1975;11:19.  Back to cited text no. 5
    
6.
Le Lièvre CS, Le Douarin NM. Mesenchymal derivatives of the neural crest: Analysis of chimaeric quail and chick embryos. J Embryol Exp Morphol 1975;34:125-54.  Back to cited text no. 6
    


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  [Figure 1], [Figure 2], [Figure 3]



 

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