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April 2006

An Erythematous and Pigmented Lesion of the Abdomen—Quiz Case

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Arch Dermatol. 2006;142(4):515-520. doi:10.1001/archderm.142.4.515-e

A 79-year-old man with no specific complaints but with a history of multiple nonmelanoma skin cancers presented for a routine skin examination. He had no significant medical history and no personal or family history of melanoma.

On physical examination, a 1.5×1.5-cm irregularly shaped pigmented plaque was noted on the left lower abdominal area (Figure 1). The lesion was 2-toned, with 1 area that was macular and brown and 1 area that was slightly pink and elevated. No radial streaming, regression, or other features associated with melanoma were observed on dermatoscopy. There was no known history of a procedure associated with the lesion. Given the size of the lesion and the presence of 2 clinically distinct areas, the decision was made to obtain biopsy specimens from 2 sites. Two 3-mm punch biopsy specimens were obtained: 1 from the pink area (Figure 2) and 1 from the brown area (Figure 3).