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New insights into oculodermal nevogenesis and proposal for a new iris nevus classification
  1. Christoph Schwab1,
  2. Iris Zalaudek2,
  3. Christoph Mayer1,
  4. Regina Riedl3,
  5. Werner Wackernagel1,
  6. Herbert Juch4,
  7. Birgit Aigner2,
  8. Alexandra Maria Brunasso2,
  9. Gerald Langmann1,
  10. Erika Richtig2
  1. 1Clinic of Ophthalmology, Medical University of Graz, Graz, Austria
  2. 2Department of Dermatology, Medical University of Graz, Graz, Austria
  3. 3Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
  4. 4Institute of Cell Biology, Histology and Embryology, Medical University of Graz, Graz, Austria
  1. Correspondence to Dr Erika Richtig, Department of Dermatology, Medical University of Graz, Auenbruggerplatz 8, 8036 Graz, Austria; erika.richtig{at}medunigraz.at

Abstract

Background/aims To gain more knowledge about presence and dermatological associations of iris nevi as well as possible pathways involved in the formation of iris nevi.

Methods We conducted a prospective, interdisciplinary observational study. Presence, morphology, topography of iris and cutaneous nevi as well as factors indicating sun-exposure were noted.

Results A total of 632 participants including 360 (57%) women were examined. Of those, 26 subjects revealed 27 iris nevi. According to the current classification, all iris nevi were judged as solitary with the majority of them (n=20; 74%) located in the lower quadrants. In six (22.2%) cases we noted a peculiar 'incomplete sectoral pattern'; these nevi were located close to the pupil, were larger and had a more elongated, triangular shape compared with those located distant from the pupil, which appeared smaller and more roundish. Notably, five of these six peculiar (incomplete sectoral) iris nevi were located on the upper half of the iris.

Conclusions Based on our findings we propose classifying iris nevi into sectoral, incomplete sectoral and solitary subtypes. Additionally, we set up a hypothetic concept of oculodermal nevogenesis suggesting a time-dependent embryogenic alteration affecting the normal melanocyte location, migration and maturation along peripheral nerve sheets. Our new concept explains well the morphology and extension of benign melanocytic proliferations in the ocular region as well as their relation to uveal melanoma.

  • Embryology and development
  • Epidemiology
  • Neoplasia

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