PMC5726670_01
Pigmented lesion on the lateral aspect of the left arm
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f1
A 15-year-old female patient presented to us with a pigmented lesion on the lateral aspect of the left arm for 1 year, slowly enlarging and itchy over the past 2 months (Figure 1).
Close up of pigmented lesion on the left arm with satellite lesions
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f2
Dermatological examination revealed a brown-blue irregular, well defined macule, with approximately 8 mm, with black-brown dots on the periphery (Figure 2).
Dermoscopy: blue-gray in a homogenous pattern, with peripheral streaks
and satellite lesions
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f3
On dermoscopy, there was a black-brown lesion, in a homogenous pattern, composed of structureless areas and with streaks in the periphery and satellite gray-blue lesions (Figure 3).
Central lesion showing strongly pigmented melanocytes amid dense fibrous
stroma and melanophages (Hematoxylin & eosin, X40)
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f4
Histopathology revealed spindle-shaped and dendritic, strongly pigmented melanocytes, amid dense fibrous stroma and melanophages, predominantly occupying upper and mid dermis (Figure 4).
Satellite lesions composed by melanocytes similar to the central lesion,
located close to the vessels in the dermis (black arrows) (Hematoxylin
& eosin, panoramic: X100; in set: X400)
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f5
Satellite lesions were seen in the adjacent skin, constituted by melanocytes similar to the central lesion, forming small aggregates located close to the dermal vessels (Figure 5).