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This lesion is characterised by a combination of
common
acquired naevus
or
Spitz naevus
with
blue naevus
or
congenital naevus.
Histologically
the two lesions are usually present in distinct areas or may be closely
intermingled.
Clinically,
combined naevi present as well circumscribed hyperpigmented spots
surrounded by less pigmented areas.
These lesions
may simulate melanoma by being asymmetrical and displaying markedly
irregular pigmentation.
Histopathology,
one variant reveals epithelioid and spindle cells of Spitz naevus
together with
dysplastic naevus.
In another variant there are small melanocytes with large balloon cells,
simulating balloon cell melanoma. It is not at all uncommon to see
a very small component of non-blue naevus in a
cellular blue naevus or
deep penetrating naevus.
Unlike melanoma,
there is no evidence pagetoid intraepidermal spread. Image
Link1 ;
Image Link
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