Skin-melanocytic tumor
Nevi
Cockarde nevus

Author: Christopher Hale, M.D. (see Authors page)

Revised: 31 January 2017, last major update November 2014

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PubMed Search: Cockarde nevus
Cite this page: Cockarde nevus. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/skintumormelanocyticcockardenevus.html. Accessed December 14th, 2017.
Definition / general
  • Rare (< 3% in recent study, Br J Dermatol 2011;165:137)
  • Speckled nevus with targetoid appearance
  • Named for resemblance to a “cockarde” also called “cockade” - a rosette / knot of ribbons used for decoration (Am J Dermatopathol 2012;34:607)
  • May be related to eclipse nevus
Diagrams / tables

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Cockade / cockarde ribbon

Terminology
  • Also called cockade nevus, kokardennaevus or naevus en cocarde / cockarde
Epidemiology
  • Usually children
  • Postulated that cockade nevi and eclipse nevi may represent UV-induced immune attack on developing melanocytes (Clin Exp Dermatol 2006;31:596)
Sites
  • Trunk is most common location
Clinical features
  • Concentric (targetoid) pattern of pigmentation with central papule (pink to brown / black) surrounded by clear zone, then outer stippled pigment
  • Zonation may be due to failure of melanin synthesis (Acta Derm Venereol 1980;60:360)
Case reports
Treatment
  • Biopsy of childhood scalp lesions not necessary, but presence may indicate higher overall lifetime risk of melanoma (Arch Dermatol 2009;145:1334)
Dermoscopy
  • Darker central globular pattern, lighter homogenous inner ring and peripheral darker reticular ring (Br J Dermatol 2011;165:137)
Clinical images

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Figure 4: dermoscopy of scalp lesion

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Common clinical patterns of scalp nevi

Microscopic (histologic) description
  • Central lesion is junctional or compound nevus, intermediate zone is unremarkable and outer zone has multiple junctional melanocytic nests
Positive stains
  • HMB45, S100, MelanA
  • Melanin stains may only highlight periphery of lesions