Pigmented Spindle Cell Naevus of Reed (PSCNOR)
Author: Dr Annie Price
Chief Editor: Dr Daniel Keith
A PSCNOR (also referred to as a Reed naevus) is a hyperpigmented melanocytic naevus with spindle-shaped melanocytes seen on histological evaluation. Typical Reed naevi are characterised by dark brown or black patches or papules.
Atypical PSCNOR may present as hypo or amelanotic papules and therefore present diagnostic uncertainty. They more commonly appear during childhood as benign Reed naevi. Though they can appear in adulthood this should normally warrant further inquiry and excision biopsy may be required to rule out Spindle Cell Melanoma.
Macroscopic Appearance
Figure 1.
A single, well-circumscribed dark brown Reed Naevus.
Dermoscopic Appearance
Reed naevi have three characteristic dermoscopic findings.
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Starburst pattern: See Figure 2. Prominent central pigmentation. Symmetrical radial lines/streaks at the periphery. These radiations correlate to areas of cell nest compression on histology.
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Globular pattern: See Figure 3. Hyperpigmented dots and globules are distributed throughout the lesion: so-called ‘coffee-beans’ appearance.
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Atypical pattern: Un-even distribution of colours and structures may resemble a blue-white veil appearance.
Figure 2:
Left (annotated) and right (unannotated).
Characteristic black/brown starburst pigmentation with radial lines (yellow arrows) surrounding the periphery. Dark and structureless in the centre.
Figure 3:
Annotated (right) and unannotated (left).
Globular pattern of PSCNOR. Black dots and globules (yellow arrows) more prominent peripherally on a less pigmented background.
