Volume 3, Issue 6, Pages (November 2017)

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Volume 3, Issue 6, Pages 524-528 (November 2017) Complete spontaneous regression of a metastatic acral melanoma with associated leukoderma Isobel R. Spring, MBBS BSc, Johann de Wet, MBChB, MMed, Henry Francois Jordaan, MBChB, MMed, MAAcadSA, Bianca Tod, MBBCh, MMed, FCDerm, Willem I. Visser, MBChB, MFamMed, MMed JAAD Case Reports Volume 3, Issue 6, Pages 524-528 (November 2017) DOI: 10.1016/j.jdcr.2017.07.001 Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions

Fig 1 A, Clinical presentation of a fungating, ulcerative mass on the right thigh with necrosis and tissue sloughing. B, Regressed primary acral melanoma on the sole of the right foot with a patch of leukoderma on the medial right ankle. Note that there is a follicular repigmentation pattern at both the periphery of the lesion and centrally. JAAD Case Reports 2017 3, 524-528DOI: (10.1016/j.jdcr.2017.07.001) Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions

Fig 2 A and B, Histology of a 5-mm punch biopsy specimen taken from the right heel lesion reveals numerous melanophages admixed with dermal fibrosis. B, Higher magnification of (A), highlighting the extensive dermal fibrosis. C and D, Histology of spindled atypical cells arranged in a fascicular and storiform growth pattern. JAAD Case Reports 2017 3, 524-528DOI: (10.1016/j.jdcr.2017.07.001) Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions

Fig 3 Immunohistochemical analysis of the biopsy specimen of the right thigh tumor showed the spindle cells to be both (A) HMB-45– and (B) Melan-A–positive. JAAD Case Reports 2017 3, 524-528DOI: (10.1016/j.jdcr.2017.07.001) Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions

Fig 4 Staging positron emission tomography–computed tomography (left column, transaxial; top row, coronal; bottom row, sagittal) reveals mild uptake of fluorodeoxyglucose in the right heel mass and intense heterogeneous uptake of fluorodeoxyglucose in the right thigh mass. Also note the moderate uptake in multiple pathological lymph nodes. JAAD Case Reports 2017 3, 524-528DOI: (10.1016/j.jdcr.2017.07.001) Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions