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August 2007

Dermoscopy Patterns of Eczemalike Melanoma

Arch Dermatol. 2007;143(8):1073-1087. doi:10.1001/archderm.143.8.1081

A melanotic/hypomelanotic melanoma (AHM) may present uncommonly as a scaly and ill-defined reddish patch or plaque, simulating localized eczema or dermatitis.13 Such eczemalike AHM may not be suspected on clinical examination, potentially resulting in a delayed diagnosis and inappropriate treatment. Important clinical clues for AHM are a solitary, continuously enlarging lesion that is unresponsive to topical therapy. Furthermore, dermoscopy may enhance this suspicion by revealing atypical vascular structures, remnants of pigmentation, or nonspecific patterns that bar an accurate diagnosis.3,4 We report a case of AHM, clinically mimicking localized eczema, in which the correct diagnosis and management was facilitated by a suspect clinical history and by dermoscopy.

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