Skin melanocytic tumor
Topics to be merged
Dermal nevus

Topic Completed: 1 August 2014

Minor changes: 21 September 2020

Copyright: 2003-2021,, Inc.

PubMed Search: dermal nevus [title]

Christopher S. Hale, M.D.
Page views in 2020: 9,959
Page views in 2021 to date: 4,102
Cite this page: Hale CS. Dermal nevus. website. Accessed March 4th, 2021.
Definition / general
  • Nevus with all melanocytes within the dermis
  • Also called intradermal nevus
  • Most common adult nevus
  • Represents final stage in progression from junctional to compound to dermal nevus
  • Seen mainly after adolescence
Clinical features
  • Flat, pedunculated or papillary, often hairy
  • Flesh colored or lightly pigmented (usually becomes lighter over time)
  • Pigmentation may be in flecks up to 1 cm
  • Melanomas only rarely arise from intradermal nevi (Dermatology 1998;196:425)
  • Rarely has cerebriform appearance (Cutis 2004;73:254) - these nevi may be congenital
Dermoscopy description
  • Nonpigmented lesions: brown pigment (78%), white areas (53%), comma shaped vessels (50%), hair (47%), hairpin vessels (22%), comedolike openings (22%) and dotted vessels (19%, Dermatol Surg 2007;33:1120)
Case reports
Clinical images

Contributed by Mark R. Wick, M.D.
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Polypoid, breast skin

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Mole on the cheek below ear

Microscopic (histologic) description
  • Small nests of melanocytes in upper dermis, often around pilosebaceous units, with variable pigmentation and cellularity
  • May have multinucleated melanocytes; deeper portion is usually less pigmented and less cellular and may have Wagner-Meissner corpuscles (representing neural portion of nevus)
  • Mucin in 3% of stroma and within nests of nevus cells (Am J Dermatopathol 2008;30:236)
  • Rarely nevus giant cells, balloon cells, infiltration by fat cells or osseous metaplasia
  • No junctional component
  • Can also be classified as Unna’s pattern (purely adventitial lesion confined to expanded papillary dermis and often to perifollicular dermis, usually neck, trunk or limbs) or Miescher’s pattern (melanocytes diffusely infiltrate adventitial and reticular dermis in wedge shaped pattern, usually on face, Am J Dermatopathol 2007;29:141)
  • Slit-like "pseudovascular" spaces may be seen through artifact of processing (Ultrastruct Pathol 1980;1:361) and biopsy procedure (Am J Dermatopathol 1984;6 Suppl:25)
Microscopic (histologic) images

Contributed by Yuri Tachibana, M.D.

Nests of melanocytes

Contributed by Angel Fernandez-Flores, M.D., Ph.D.
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Unna pattern

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Intradermal nevus with osseous metaplasia

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