Volume 3, Issue 2, Pages (March 2017)

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Volume 3, Issue 2, Pages 135-137 (March 2017) Metastatic melanoma with features of blue nevus and tumoral melanosis identified during pembrolizumab therapy  Matthew F. Helm, MD, Michael J. Bax, MD, Paul N. Bogner, MD, Catherine G. Chung, MD  JAAD Case Reports  Volume 3, Issue 2, Pages 135-137 (March 2017) DOI: 10.1016/j.jdcr.2017.01.019 Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions

Fig 1 A new blue-gray papule was noted on the left side of the neck and was excised as outlined by gentian violet surgical marker. JAAD Case Reports 2017 3, 135-137DOI: (10.1016/j.jdcr.2017.01.019) Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions

Fig 2 Trephine biopsy result of the iliac crest shows atypical melanocytes and marked melanosis. (Hematoxylin-eosin stain; original magnification: ×200.) JAAD Case Reports 2017 3, 135-137DOI: (10.1016/j.jdcr.2017.01.019) Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions

Fig 3 Biopsy result of the left side of the neck shows large numbers of heavily pigmented melanophages along with spindle cells on markedly sun-damaged skin. (Hematoxylin-eosin stain; original magnification: ×200.) JAAD Case Reports 2017 3, 135-137DOI: (10.1016/j.jdcr.2017.01.019) Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions

Fig 4 Some spindle cells exhibit slight nuclear pleomorphism, are associated with eosinophilic stroma, and are surrounded by numerous melanophages. (Hematoxylin-eosin stain; original magnification: ×400.) JAAD Case Reports 2017 3, 135-137DOI: (10.1016/j.jdcr.2017.01.019) Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions