Volume 4, Issue 10, Pages (November 2018)

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Volume 4, Issue 10, Pages 1000-1003 (November 2018) Reflectance confocal microscopy features of labial melanotic macule: Report of three cases Ana Carolina Porto, MD, Naiara Fraga-Braghiroli, MD, Tatiana Pinto Blumetti, MD, PhD, Mariana Petaccia de Macedo, MD, PhD, Harold Rabinovitz, MD, Alon Scope, MD, Juliana Casagrande Tavoloni Braga, MD, PhD JAAD Case Reports Volume 4, Issue 10, Pages 1000-1003 (November 2018) DOI: 10.1016/j.jdcr.2018.07.019 Copyright © 2018 American Academy of Dermatology, Inc. Terms and Conditions

Fig 1 Labial melanotic macule: case 1. A, Dermoscopic image with irregular lines. B, RCM individual image (0.5 × 0.5 mm) shows at the DEJ level dendritic cells in the interpapillary spaces. C, H&E histopathologic panoramic view. Discrete acanthosis and hyperpigmentation of the basal keratinocytes. D, Immunohistochemistry profile shows CD1a+, demonstrating that the dendritic cells seen under RCM are LCs. E, Melan-A immunostain shows a minimum increase in the melanocyte counts in the basal layer, with no atypia. JAAD Case Reports 2018 4, 1000-1003DOI: (10.1016/j.jdcr.2018.07.019) Copyright © 2018 American Academy of Dermatology, Inc. Terms and Conditions

Fig 2 Labial melanotic macule: case 2. A, Dermoscopic image shows irregular lines and brownish pigmentation. B, RCM individual image (0.5 × 0.5 mm) shows at DEJ level dendritic cells around and between dermal-papillae. C, H&E histopathologic panoramic view. Acanthosis, parakeratosis, and hyperpigmentation of the basal keratinocytes. D, Immunohistochemistry profile for CD1a shows numerous LCs. E, Immunohistochemistry profile for Melan-A immunostain negative for melanocytic proliferation. JAAD Case Reports 2018 4, 1000-1003DOI: (10.1016/j.jdcr.2018.07.019) Copyright © 2018 American Academy of Dermatology, Inc. Terms and Conditions

Fig 3 Labial melanotic macule: case 3. A, Dermoscopic image shows irregular gray and dark dots/granules. B, RCM individual image (0.5 × 0.5 mm) shows at DEJ level a sheet of dendritic cells around and between the dermal papillae. C, H&E histopathologic panoramic view. Epidermis with hypergranulosis, epidermal hyperplasia, and increased pigmentation of the basal keratinocytes of the third patient. D, Immunohistochemistry profile for CD1a immunostain is positive for numerous LCs cells into the squamous mucosa. JAAD Case Reports 2018 4, 1000-1003DOI: (10.1016/j.jdcr.2018.07.019) Copyright © 2018 American Academy of Dermatology, Inc. Terms and Conditions