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August 1991

Fatal Melanoma Arising in a Zosteriform Speckled Lentiginous Nevus

Author Affiliations

Department of Dermatology Yale University School of Medicine 333 Cedar St New Haven, CT 06510

Arch Dermatol. 1991;127(8):1240-1241. doi:10.1001/archderm.1991.01680070142027

To the Editor.—  The development of a cutaneous melanoma within a nevus spilus, or speckled lentiginous nevus, was recently reported in the Archives.1 A unique feature in that case was the presence histologically of intraepidermal melanocytic dysplasia within the "speckled" or hyperpigmented areas. The possibility that the melanocytic dysplasia was a predisposing factor for the development of the melanoma was considered. In the following case report, a melanoma developed within a zosteriform speckled lentiginous nevus that had histologic features that were similar to those described by Rhodes and Mihm.1 However, in contrast to previously reported cases,1-5 this patient subsequently developed metastatic disease that proved to be fatal.

Report of a Case.—  The patient was a 43-year-old white man with a history of a stage I cutaneous melanoma (Clark level III; Breslow depth, 1.6 mm) of the left posterior aspect of the neck diagnosed in 1986. His medical

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