Volume 1, Issue 2, Pages (March 2015)

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Volume 1, Issue 2, Pages 74-76 (March 2015) Eruptive melanocytic nevi heralding the diagnosis of metastatic malignant melanoma: A case report Nour Kibbi, BA, Stephan Ariyan, MD, Frederick Slogoff, MD, Rossitza Lazova, MD, Jennifer Nam Choi, MD JAAD Case Reports Volume 1, Issue 2, Pages 74-76 (March 2015) DOI: 10.1016/j.jdcr.2015.01.002 Copyright © 2015 American Academy of Dermatology, Inc. Terms and Conditions

Fig 1 Histopathologic examination of the melanoma on the nose. There is irregular proliferation of melanocytes in the epidermis and in the dermis. The melanocytes are arranged in nests, which vary in size and shape. Single melanocytes are seen at the dermal epidermal junction and down a hair follicle. The melanocytes are pleomorphic. Some melanocytes display hyperchromatic nuclei, prominent nucleoli, and melanin pigment in their cytoplasm. A mitotic figure (arrow) is shown. JAAD Case Reports 2015 1, 74-76DOI: (10.1016/j.jdcr.2015.01.002) Copyright © 2015 American Academy of Dermatology, Inc. Terms and Conditions

Fig 2 Eruptive nevi. At a follow-up visit 11 months after the initial diagnosis of melanoma, numerous monomorphic, 1- to 2-mm dark brown to black macules were noted scattered on the patient's back and posterior shoulders consistent with eruptive melanocytic nevi. On dermoscopic examination, these macules showed darker irregular centers. Because their appearance was concerning, histologic examination was indicated. JAAD Case Reports 2015 1, 74-76DOI: (10.1016/j.jdcr.2015.01.002) Copyright © 2015 American Academy of Dermatology, Inc. Terms and Conditions

Fig 3 Histologic examination of an eruptive nevus. There is a compound melanocytic nevus composed of mostly single, small, and monomorphous melanocytes in the epidermis and in the papillary dermis. The melanocytes exhibit heavily pigmented cytoplasm. Numerous melanophages are seen in the papillary dermis at the base of the lesion. JAAD Case Reports 2015 1, 74-76DOI: (10.1016/j.jdcr.2015.01.002) Copyright © 2015 American Academy of Dermatology, Inc. Terms and Conditions

Fig 4 Development of ITM. More than 1 year after the initial diagnosis, the patient presented with five 5-mm firm nodules arranged in a linear pattern on the left parietal, left postauricular, and left mastoid scalp. Histologic examination found in-transit melanoma metastases. JAAD Case Reports 2015 1, 74-76DOI: (10.1016/j.jdcr.2015.01.002) Copyright © 2015 American Academy of Dermatology, Inc. Terms and Conditions