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October 2009

Multiple Blue Macules and Papules on the Scalp—Quiz Case

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Copyright 2009 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2009

Arch Dermatol. 2009;145(10):1183-1188. doi:10.1001/archdermatol.2009.215-a

A 71-year-old Puerto Rican woman with a history of breast cancer was referred for dermatologic evaluation by her oncologist for reevaluation of pigmented lesions on the scalp, initially noted 8 years earlier. She had no personal or family history of melanoma. Physical examination revealed a 6-mm blue papule with 16 discreet 2- to 3-mm blue satellite macules within a normally pigmented 2-cm area of the left parietal scalp (Figure 1, shown after biopsy). Biopsy specimens of the largest papule (Figure 2 and Figure 3, hematoxylin-eosin, original magnification ×40 and ×200, respectively) and a satellite papule were taken.

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