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July 1990

Should the Excisional Biopsy of Clinically Probable Melanomas Include a Margin That Might Also Serve as Adequate for Treatment?

Author Affiliations

Northwestern University Medical School, Chicago, Ill

Arch Dermatol. 1990;126(7):877-878. doi:10.1001/archderm.1990.01670310037005

REPORT OF A CASE  An 84-year-old white woman was seen in consultation by the Dermatology Service, Northwestern Memorial Hospital, Chicago, Ill, for evaluation of an asymptomatic pigmented papule located in the left inguinal region. The patient had been hospitalized for treatment of bloody diarrhea, abdominal pain, and dehydration due to infectious colitis. The lesion was discovered during physical examination, although it had been present for at least 5 years. Recent clinical changes were not known.Laboratory studies included a complete blood cell count with differential, clotting parameters, electrolyte levels, and measurements of hepatic function and enzyme levels. A mild metabolic acidosis and leukocytosis were present. A chest roentgenogram revealed changes consistent with chronic obstructive pulmonary disease, but did not reveal infiltrates and adenopathy.The lesion consisted of a 3 × 5-mm dark-brown papule with a slightly bluish hue. Irregular macular hyperpigmentation comprised its lateral border. On moistening the lesion, a

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