2012.4-27.Eponyms nevi

DOI: 10.7241/ourd.20124.89                                                                     article in PDF
Our Dermatol Online. 2012; 3(4): 374-376
Date of submission: 13.06.2012 / acceptance: 08.07.2012
Conflicts of interest: None



Khalid Al Aboud

Pathology Department, Wake Forest University, Winston-Salem, NC, USA

Corresponding author: Dr. Khalid Al Aboud    e-mail: amoa65@hotmail.com


There are many types of terms used in the nomenclature of skin conditions [1]. One of these types is naming these conditions after the scientists who first described or made a great contribution to those conditions [2].These type of terms, otherwise known as eponyms are commonly used in dermatology literature [1]. In a tabulation view, I listed in Table I [3-25], selected eponyms who are linked to melanocytic nevi. Some of these eponyms are still in use and some are being replaced by other terms. One reason for the changing trend in the naming of moles is the emerging new concepts in the understanding of these skin lesions. For example a new classification based on the histological pattern („silhouette”) of melanocytic nevi was suggested to be used preferably over the old classification of nevi of „junctional,” „compound,” and „dermal” nevi [4-5]. There is still no uniform nomenclature in some types of melanocytic nevi and it is clear that some consolidation of the nomenclature is needed in this area [3]. However, the continuous improvement in our understanding of nevi and new insights into the molecular heterogeneity of nevi, e.g., BRAF- and NRAS-mutational status, will allow more precise molecular-morphological correlations in the near future [5].
Eponymous melanocytic nevi

Clark's nevus
It is an atypical nevomelanocytic lesion. Dysplastic (atypical, Clark's) nevi are clinically distinctive nevi with characteristic histology and an increased risk of melanoma change [3- 5]. Clark's nevus shows the architectural atypia. The atypical architectural features include asymmetry, irregular peripheral border of the lesion, shoulder phenomenon (extension of the junctional component of a compound nevus beyond its dermal component), lentiginous growth of solitary melanocytes along and focally in between elongated rete ridges, and bridging of junctional melanocytic nests. The term dysplastic (atypical) nevus syndrome, (OMIM155600) refers to the familial or sporadic occurrence of multiple dysplastic (atypical) nevi in an individual. Familial cases of this syndrome were originally called the B-K mole syndrome (based on the surnames of two of the probands) and the FAMMM syndrome (familial atypical mole/ malignant melanoma syndrome) [3]. Contraversy surrounding the use of the term 'dysplastic' in the title has led to the suggestion that the term 'atypical mole syndrome' is more appropriate. The use of the term 'Clark's nevus' as a synonymous term ignores its origin; the term was used by Ackerman for a nevus with architectural atypia in the form of a junctional shoulder extending beyond the dermal one [3]. A small minority of dermatologist and dermatopathologists in the USA use the term Clark's nevus. It is probably even smaller in other countries. Clinically these are usually larger than ordinary nevi (more than 5mm in diameter), and often show a mixture of tan, dark brown, and pink areas [3]. While Clark nevus overlaps with dysplastic nevus, the terms are not interchangeable. The diagnosis of dysplastic nevus indicates both architectural and cytologic atypia. Clark nevus, while showing architectural atypia, is composed of cytologically unremarkable melanocytes. Clark nevi have been eponymically named after Wallace H. Clark, Jr., who, in 1978, first drew attention to this particular type of nevus by studying numerous melanocytic nevi in patients with concomitant melanomas.
Jadassohn-Tieche nevus
This term was once used for a blue nevus. Blue nevus is a dermal melanocytic lesion which present as a blue-black macule or papule found most commonly on the extremities. It is almost invariably acquired after infancy [3,6]. It is named after Max Tièche(1878-1938), a Swiss physician and Joseph (Josef) Jadassohn (1863-1936), a German dermatologist [7]. It has been suggested that, the epithelioid combined nevi (ECN) fell into three phenotypes with morphologies that most closely paralleled those pictured by Carney and Ferreiro in the Carney complex: the classic or Carney complex pattern (ECN-CC), those that showed overlap with deep penetrating nevus (ECN-DPN), and those that have many dermal Spitz's nevus features, (Blue + Spitz’s nevus; (ECN-BLITZ). The latter (blitz nevus is simply a combination of epithelioid blue and Spitz features in the one lesion [8].
Masson neuronevus
It is more commonly, known as neural nevus, or neurotized melanocytic nevus. In this nevus, the nevus cells may assume a neuroid appearance with spindle shaped cells and structures resembling Meissner's tactile body [9,10]. It is named after, Claude L. Pierre Masson (1880-1959), a French--born Canadian pathologist [10].
Meyerson's nevus
It is a junctional, compound, or intradermal nevus surrounded by an eczematous halo which may be pruritic [11,12]. Halo dermatitis around a melanocytic nevus was first described in 1971: by Meyerson [12]. Meyerson's nevus is also referred to as halo dermatitis, halo eczema and Meyerson's phenomenon. Halo-like changes around pigmented melanocytic lesions can take a number of forms. Halo nevus or Sutton's nevus, is an example of a regressing benign nevus with a depigmented zone around the nevus [13]. A ring of deeperpigmentation around benign nevi with an intervening narrow non-pigmented zone giving a target-like appearance has been termed the Cockarde (also spelled as Cocarde and Cockade) nevus [3]. There are also other types of nevi which are characterized by variation in the color. Eclipse nevus is a lesion characterized by a tan center and an irregular darker brown peripheral rim that is occasionally discontinuous [3]. Melanocytic nevi with eccentric foci of hyperpigmentation ("Bolognia sign") can be considered as a melanoma-simulating type of acquired melanocytic nevus [14].
Miescher's nevus
It is a subtype of ordinary, or common, melanocytic nevus [3-5,15]. They are benign melanocytic proliferations which most commonly occur on the face and present as firm, tan to brown dome-shaped papules. In this ''endophytic'' nevus, nevus cells extend to the deep reticular dermis; the terms "endophytic" describe the histological arrangement of the melanocytic cell aggregates rather than the clinical appearance. This nevus is named after Alfred Guido Miescher (1887-1961), an Italian-born Swiss dermatologist.
Nevus of Ito
A dermal melanocytic condition affecting the shoulder area [3]. Initially described by Minor Ito in 1954 [16].
Nevus of Nanta
A nevus of Nanta is characterized by the presence of cutaneous ossification (osteoma cutis) in an existing melanocytic nevus [3]. It is named after a french dermatologist, André Nanta (1883-1963) [17].
Nevus of Ota
It is a dermal melanocytic lesion. It is a diffuse, although sometimes slightly speckled, macular area of blue to dark-brown pigmentation of skin in the region of ophthalmic and maxillary divisions of the trigeminal nerve. There is often conjunctival involvement as well [3]. Two a acquired dermal melanocytoses that appear in adult life, often in the distribution of the nevus of Ota have been described.Hori's nevus refers to bilateral nevus of Ota-like macules, usually on the malar regions, while sun's nevus is acquired unilateral nevus of Ota [3]. Ota (also spelled Ohta) was a Japanese author, dramaturge, poet, art historian, and literary critic, as well as a licensed doctor specializing in dermatology during the Taisho and early Showa periods in Japan [17]. Ota’s pen name was Mokutaro? Kinoshita or Kinoshita Mokutaro?. Ota served at several universities in Japan as professor of dermatology and a noted leprosy researcher [17].
Pointillist nevus
This term has been used for rare nevi with multiple, tiny, dark, brown to black dots on a skin-colored background [18]. These nevi with the varie- gated pigment, were called the pointillist nevi, in reference to the pointillist style of painting.
Reed's nevus
Reed's nevus, also known as, pigmented spindle cell nevus of Reed. It is now regarded as a distinct entity and not as a variant of the spindle-cell type of Spitz nevus, although the distinction between a Reed nevus and a pigmented Spitz nevus is not always easy [3,19,20]. It present as a well-circumscribed deeply pigmented papule, usually of recent onset, frequently located on the thighs of young adult females. It is named after, Richard J. Reed.
Spitz's nevus
Spitz nevus, also known as benign spindle and epithelioid cell nevus, is a variant of nevocellular nevus. This title recognizes the important contribution of Sophie Spitz (1910-1956), an American pathologist, who for the 1st time in 1948, published criteria for the diagnosis of specific lesion of childhood which despite some histological resemblance to malignant melanoma, was known to behave in a benign fashion [3,4,21]. Kamino bodies named after contemporary American dermatopathologist, Hideko Kamino, are dull pink areas of trapped basement membrane material within the epidermis seen in these nevi [22].
Sutton's nevus
Sutton's or halo nevus is characterized by presence of a depigmented halo up to several millimeters in width around a melanocytic nevus [3]. It is named after Richard Lightburn Sutton (1878-1952), an American dermatologist [13]. However, Happle [23] had reported that an accurate depiction of the halo nevus has been left by Matthias Grünewald in his painting "The Temptation of St. Anthony", which is part of the Isenheim altar piece (1512-1516), which is now exhibited in Colmar, Alsace. He added that, Sutton in 1916 only described a "leucoderma acquisitum centrifugum", leaving the nature of the central lesion in the dark. He concluded that, the term Sutton nevus appears less appropriate than the alternative eponymic designation "Grünewald naevus". The term is ''Grünewald-Sutton nevus'' also suggested for this nevus [24].
Unna's nevus
Unna's nevus is a subtype of ordinary, or common, melanocytic nevus [3-5]. They are benign melanocytic proliferations which most commonly present as soft papillomatous lesions of the trunk, neck and extremities. In these'' exophytic nevi'', the melanocytic cell aggregates are arranged in the papillary dermis. The term "exophytic" describe the histological arrangement of the melanocytic cell aggregates rather than the clinical appearance. It is named after Paul Gerson Unna (1850-1929), a German dermatologist [25].
Table I. Selected eponyms linked to melanocytic nevi
1. Al Aboud K, Al Hawsawi K, Ramesh V, Al Aboud D, Al Githami A: An appraisal of terms used in dermatology. Skinmed. 2003;2:151-3.
2. Al Aboud K, Al Hawsawi K, Ramesh V, Al Aboud D, Al Githami A: Eponyms in dermatology. Skinmed. 2004;3:11-2.
3. Weedon D: Lentigines, nevi, and melanomas.Chapter32, Lentigines, nevi, and melanomas. Weedon’s skin pathology. 3ed edn. 2010. Elsevier limited. P700-756.
4. Ackerman AB, Magana-Garcia M: Naming acquired melanocytic nevi. Unna’s, Miescher’s, Spitz’s Clark’s. Am J Dermatopathol. 1990;12:193-209.
5. Witt C, Krengel S: Clinical and epidemiological aspects of subtypes of melanocytic nevi (Flat nevi, Miescher nevi, Unna nevi). Dermatol Online J. 2010;16:1.
6. Buntin DM, Marley WM: Pathology quiz case 2. Blue nevus (Jadassohn-Tieche). Arch Dermatol. 1983;119:354-5, 357.
7. Al Aboud A, Al Aboud K: Josef Jadassohn (1863-1936), Felix Lewandowsky (1879-1921), and their syndrome. Clin Cosmet Investig Dermatol. 2011;4:179-82.
8. Groben PA, Harvell JD, White WL: Epithelioid blue nevus: neoplasm Sui generis or variation on a theme? Am J Dermatopathol. 2000;22:473-88.
9. Cramer HJ: [On the „blue neuro-nevus” (Masson)]. Hautarzt. 1966;17:16-21.
10. Steffen C: The man behind the eponym: C. L. Pierre Masson. Am J Dermatopathol. 2003;25:71-6.
11. Nicholls DS, Mason GH: Halo dermatitis around a melanocytic naevus: Meyerson’s naevus. Br J Dermatol. 1988;118:125-9.
12. Meyerson LB: A peculiar papulosquamous eruption involving pigmented naevi. Arch Dermatol. 1971;103:510-2.
13. Steffen C, Thomas D: The man behind the eponyms: Richard L Sutton: periadenitis mucosa necrotica recurrens (Sutton’s ulcer) and leukoderma acquisitum centrifugum-Sutton’s (halo) nevus. Am J Dermatopathol. 2003;25:349-54.
14. Pizzichetta MA, Massone C, Grandi G, Pelizzo G, Soyer HP: Morphologic changes of acquired melanocytic nevi with eccentric foci of hyperpigmentation („Bolognia sign”) assessed by dermoscopy. Arch Dermatol. 2006;142:479-83.
15. Yus ES, del Cerro M, Simón RS, Herrera M, Rueda M: Unna’s and Miescher’s nevi: two different types of intradermal nevus: hypothesis concerning their histogenesis. Am J Dermatopathol. 2007;29:141-51.
16. Al Aboud A, Al Aboud K: Eponyms in dermatology literature linked to Japan. Clin Cosmet Investig Dermatol. 2012;5:15-21.
17. Al Aboud K: André Nanta (1883-1963) and the nevus which bears his name. Our Dermatol Online. 2012;3:241-2.
18. Huynh PM, Glusac EJ, Bolognia JL: Pointillist nevi. J Am Acad Dermatol. 2001;45:397-400.
19. Grossin M: [Reed’s nevus]. Ann Dermatol Venereol. 1992;119:145.
20. Webber SA, Siller G, Soyer HP: Pigmented spindle cell naevus of Reed: a controversial diagnostic entity in Australia. Australas J Dermatol. 2011;52:104-8.
21. Shapiro PE: Who was Sophie Spitz? The woman behind the eponym. Am J Dermatopathol. 1992;14:442-6.
22. Al Aboud K: Hideko Kamino and the eponym linked to her name. Serb J Dermatol Venereol. 2011;3:122-4.
23. Happle R: [Grünewald nevus]. Hautarzt. 1994;45:882-3.
24. Borroni G, Vignati G: Should Sutton nevus really be called Grünewald-Sutton nevus? Am J Dermatopathol. 1993;15:506-8.
25. Romiti N: The pioneers of dermatology – Part 2 – The life and works of Paul Gerson Unna. An Bras Dermatol 2005;80. Available online at; h t t p : / / w w w. s c i e l o . b r / s c i e l o . p h p ? p i d = s 0 3 6 5 – 05962005000100013&script=sci_arttext&tlng=en



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