PMC2929512_01
A solitary oval shaped brown-black macule of 8.7 x 11.1 mm with whitish scaly surface was seen on the right upper arm.
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fig1
On physical examination, solitary oval shaped brown-black macule of 8.7 x 11.1 mm with whitish scales was detected on the right upper arm (Figure 1).
Dermoscopic examination demonstrated irregular flossy streaks, irregular brown dots/globules, and blue-whitish regression structures with overlying whitish scaly areas.
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fig2
Dermoscopic examination demonstrated light to dark irregular pigmentation with milky red areas containing irregular blue-white structures suggesting partial regression and overlaying many linear and small reflecting whitish scaly areas (Figure 2).
Hematoxylin and eosin staining revealed marked acanthosis with hyperkeratosis and irregular melanin pigment distribution throughout the epidermis to papillary dermis. The papillary dermis showed a dense infiltrate of lymphocytes and numerous scattered melanophages.
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fig3
Histopathological examination of hematoxylin and eosin-stained specimen (Figure 3) revealed that the epidermis showed marked acanthosis with elongation and thickening of the rete ridges with hyperkeratosis, and marked atypia of keratinocytes.