Melanocytic tumors with intraepidermal melanophages: a report of five cases with review of 231 archived cutaneous melanocytic tumors

J Cutan Pathol. 2015 Jun;42(6):394-9. doi: 10.1111/cup.12479. Epub 2015 Mar 27.


Dermal melanophages are frequently encountered in both benign melanocytic nevi and malignant melanoma. In contrast, intraepidermal melanophages (IEM) are under-recognized in melanocytic lesions and their biologic significance is not understood. Herein, we report the clinical and histopathologic features of five melanocytic lesions featuring IEM encountered prospectively in our dermatopathology practice at the University of Chicago. Two hundred and thirty-one (231) archived skin primary melanocytic proliferations were also investigated retrospectively in a de-identified, archival teaching set collection. Nineteen of 231 of the archived cases were positive for IEM. Among the total 24 IEM-positive cases (5 prospective and 19 archived cases), 13 were categorized as Spitz nevi (p < 0.0001) and 3 as atypical Spitz tumors (p = 0.0152). Fourteen of 24 cases with IEM also exhibited intracorneal melanocytes (p < 0.0001). IEM are evidently not rare, especially in spitzoid melanocytic neoplasms. IEM in our series were significantly correlated with intracorneal melanocytosis, possibly indicating an association between IEM and suprabasal melanocytosis and/or transepidermal elimination of melanocytes.

Keywords: Spitz nevus; intraepidermal melanophage; macrophage; melanoma; transepidermal elimination.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Child
  • Cornea / pathology
  • Epidermis / pathology
  • Female
  • Humans
  • Immunohistochemistry
  • In Situ Hybridization, Fluorescence / methods
  • Macrophages / pathology
  • Male
  • Melanins / metabolism
  • Melanocytes / pathology*
  • Melanoma / pathology*
  • Melanoma, Cutaneous Malignant
  • Nevus, Epithelioid and Spindle Cell / pathology
  • Phagocytosis / physiology
  • Prospective Studies
  • Retrospective Studies
  • Skin Neoplasms / pathology*


  • Melanins