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JAMA Dermatology Clinicopathological Challenge
July 2014

New Blue-Black Nodule in a Patient With a History of Melanoma

Author Affiliations
  • 1medical student at University of Louisville School of Medicine, Louisville, Kentucky
  • 2Division of Dermatology, Department of Medicine, University of Louisville School of Medicine, Louisville, Kentucky
JAMA Dermatol. 2014;150(7):767-768. doi:10.1001/jamadermatol.2013.9405

A woman in her late 80s presented with a 5-month history of a new 2.8-cm blue-black nodule on her left lateral upper back (Figure, A). She reported that the lesion was mildly pruritic. The results of the physical examination were unremarkable and revealed no lymphadenopathy. A full review of systems was notable for unintentional weight loss, loss of appetite, diarrhea, and hair loss. Her history was significant for extensive sun damage, multiple nonmelanoma skin cancers, and a nonulcerated superficial spreading malignant melanoma (Breslow thickness, 0.56 mm) involving the right dorsal forearm in 2001. This lesion was reexcised, and histologic analysis showed no residual melanoma.

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