A 4-year-old boy undergoing maintenance chemotherapy for acute lymphoblastic leukemia presented with a new eruption of junctional nevi on the dorsum of both feet (Figure). The lesions were brought to the dermatologist’s attention by the patient’s parent during a follow-up for eczematous dermatitis. At the time of presentation, the patient’s chemotherapy regimen followed the Children's Oncology Group protocol AALL0932, comprising mercaptopurine, methotrexate, vincristine, dexamethasone, and trimethoprim-sulfamethoxazole prophylaxis for Pneumocystis jirovecii pneumonia. Differential diagnoses included eruptive nevi and genodermatoses associated with melanocytic nevi, including Noonan syndrome, Carney complex, and familial atypical multiple mole-melanoma syndrome.1 Physical examination revealed scant melanocytic nevi outside the new eruptions and was otherwise noncontributory. The patient had even skin pigmentation, normal facies, and age-appropriate cognition. Dermoscopy results revealed small, evenly pigmented globules typical of eruptive nevi. Due to the patient’s age and the benign appearance of the nevi using a dermatoscope, histologic examination was not conducted. Given the appearance of the lesions, the patient’s history of immunosuppression, and the lack of findings suggestive of an underlying genetic syndrome, this presentation was considered most in keeping with eruptive nevi.
Sign in to take quiz and track your certificates
JN Learning™ is the home for CME and MOC from the JAMA Network. Search by specialty or US state and earn AMA PRA Category 1 Credit(s)™ from articles, audio, Clinical Challenges and more. Learn more about CME/MOC
CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.
Corresponding Author: Catherine J. Stewart, MSc, Cumming School of Medicine, University of Calgary, 3330 Hospital Dr NW, Calgary, AB T2N 4N1, Canada (email@example.com).
Published Online: May 17, 2023. doi:10.1001/jamadermatol.2022.6543
Conflict of Interest Disclosures: None reported.
Additional Contributions: We thank the patient’s mother for granting permission to publish this information.
Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:
It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.
You currently have no searches saved.
You currently have no courses saved.