Nevus Pigmentosus

Definition: pigmentosus nevus is a benign tumor composed of nevus cells. Skin disorders are accompanied by pigmentation is a problem that is found in the clinic, one of which is a nevus pigmentosus. Almost everyone has nevus, nevus while undergoing changes, has 400 times higher risk to become malignant. Synonyms: nevus cell nevus, nevus nevoseluler

Etiology: skin nevus cells derived from the neural crest, these cells form small nests in the basal cell layer of the epidermis and the dermoepidermal junction zone. These cells divide and into the dermis and form a nest nests in the dermis.

Clinical manifestations: pigmentosus nevus can occur in all parts of the skin of the body, including the mucous membranes near the surface of the body. Lesions can be flat, papuler, or papilomatosa, usually measuring 24 mm, but can vary from as big as a pin to the size of the palm of the hand. Pigmentation also vary from color to blackish brown.

  Congenital Nevus pigmentosus, a nevus present at birth or occur several months after birth. According to its size can be divided into 3 groups: (small lesions) if nevus diameter smaller than 1.5 cm to 20 cm, and extensive lesions (giant) when the diameter of more than 20 cm.

      Sebaceous nevus of Jadassohn (NSJ) is hamartomatosa demarcated lesions, mostly composed of sebaceous glands and usually occur on the face and scalp. Nevus is rarely associated with an assortment of ectodermal and mesodermal defects.

      Other names are sebaceous nevus, nevus sebaceous linearis, congenital sebaceous gland hyperplasia, hamartoma of sebaceous glands, sebaceous adenoma sirkumskripta, syringo pilo sebaceous nevi, nevus and nevus organois

epiteliomatosus sebaceous capitis.

         NSJ is a rare growth. Obtained at approximately 0.3% of all neonates with the same incidence in men and women. Not obtained racial factor / ethnic, familial or inherited factors. NSJ said to be derived from germ cells from embryonic epidermal basal layer that has the potential to differentiate into various types of epithelial tumors.

         NSJ clinical picture is usually a solitary lesion, or multiple, shaped plaque demarcated, brownish yellow, orange, or red, shiny, verukosus with a diameter of several millimeters to several centimeters. Lesions are most commonly found on the head can also be on the face, neck and torso. Nevus is usually appear at birth or some time later. In childhood until just before puberty lesions are usually flat, but will grow into verukosus and thicker, lifelong and cause alopecia. NSJ extensive lesions and linear nevus sebaceous syndrome known, indicate systemic disorders such as epilepsy, mental retardation, skeletal abnormalities abnormalities of the nervous system, eye and kidney abnormalities.

        Epidermal nevus syndrome (SNE) or also called nevus organois phakomatosis, Schimmelpenning, Feuerstein syndrome and Mim and solomon's syndrome is a congenital syndrome obtained in an autosomal dominant inherited. The disease is characterized by skin abnormalities such as epidermal nevus associated with a variety of abnormalities in other organ systems, namely the central nervous system, skletal, Cadiomuscular, eye and urogenital.

       SNE's Causes are not known with certainty, but allegedly because of an error migration and development of embryonic tissue or the occurrence of errors in the process of neural tube ektoderin separation.

      This disease is often accompanied by abnormalities skletal, nerves and eyes. Skeletal abnormalities are found in 15-70% of patients, neurologic abnormalities are found in 15-50% of patients and eye abnormalities are found in 9-30% of patients. Sidrom epidermal nevus is a rare case, the number of events only l6% of all cases of epidermal nevus. This disease can be found from birth until the age of 40 years with the same ratio between men and women.

          Histopathologically known junctional nevus, compound nevus and dermal nevus. A quarter to a third of cases of malignant melanoma is said to originate from pigmentosus nevus. Type nevus is important to know to determine the prognosis. Of the three types of nevus, junctional nevus more notarized that has the potential to become malignant.

          Histopathological examination in addition to requiring time, also not all patients agreed to be biopsied. In circumstances biopsy can not be done, we need a better way to approach the histopathological diagnosis based on that then developed a tool called surface microscopy using a microscope techniques epileuminesen. This non-invasive technique that allows to see the in vivo images histomorfologi skin and gives hope for the clinical to make a diagnosis of skin pigmentation disorders more accurately. If the clinical picture can be sharpened with a nevus epiluminesenm techniques, the many benefits to be gained.

       Diiferential diagnosis: Melanoma maligma, blue nevus, nevus cells or epithelioid and spindle nevus, pigmented BCC, Histiositoma, pigmented seborrheic keratosis. Treatment: In general no treatment is required. But if the cause cosmetic problems, or frequent irritation due to friction of clothing, can be surgical excision. If there is suspicion toward malignancy can excision with histopathology.

Prognosis: In general good. But at the junctional nevus and nevus compound should receive attention because there is a possibility to change into

malignant.