PMC3791969_01
The arrow points to a lesion of concern on the back of a 68 year old man. [Copyright:  2013 Inskip et al.]
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He was concerned about a skin lesion on his mid back which he reported having traumatised by scratching a week earlier (Figure 1).
Dermatoscopic image of the skin lesion indicated by the arrow in Figure 1. Three terminal hairs protrude from a structureless yellow lesion. Structureless red centrally is evidence of ulceration as is a single thread of adherent fibre (inferior central). A few small curved and dot vessels are seen inferior to the central structureless red area but are not considered sufficient to be a clue to the specific diagnosis. [Copyright:  2013 Inskip et al.]
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The lesion of concern on the patient's central back was 6mm in diameter (Figure 2).
Low power dermatopathologic view of the lesion shown in Figures 1 and 2. Beneath a crusted epidermis is a proliferation of nested cells with abundant clear cytoplasm. [Copyright:  2013 Inskip et al.]
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Histologic sections (Figures 3-11) showed a compound melanocytic proliferation with two components, the first consisting of bland nevus cells, which matured with descent and tracked down adnexal structures in a congenital pattern.
High power view of the boxed area in Figure 3. No intra-epidermal melanoma component is identified. [Copyright:  2013 Inskip et al.]
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Histologic sections (Figures 3-11) showed a compound melanocytic proliferation with two components, the first consisting of bland nevus cells, which matured with descent and tracked down adnexal structures in a congenital pattern.
Adjacent to the clear cell proliferation, clusters of cells without copious cytoplasm are arranged along a hair follicle. [Copyright:  2013 Inskip et al.]
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Histologic sections (Figures 3-11) showed a compound melanocytic proliferation with two components, the first consisting of bland nevus cells, which matured with descent and tracked down adnexal structures in a congenital pattern.
High power view of the boxed area in Figure 5 reveals bland benign nevus cells in clusters along the follicle. [Copyright:  2013 Inskip et al.]
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Histologic sections (Figures 3-11) showed a compound melanocytic proliferation with two components, the first consisting of bland nevus cells, which matured with descent and tracked down adnexal structures in a congenital pattern.
A high power view of the the balloon cells at the base of the lesion. No pigmentation is noted. Nuclear enlargment (arrow) and prominent nucleoli in cells at the base of the lesion indicate a lack of progressive maturation on descent in the dermis. [Copyright:  2013 Inskip et al.]
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Histologic sections (Figures 3-11) showed a compound melanocytic proliferation with two components, the first consisting of bland nevus cells, which matured with descent and tracked down adnexal structures in a congenital pattern.
Mitotic figures (four were counted) are easily identified in the balloon cells (arrow). [Copyright:  2013 Inskip et al.]
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Histologic sections (Figures 3-11) showed a compound melanocytic proliferation with two components, the first consisting of bland nevus cells, which matured with descent and tracked down adnexal structures in a congenital pattern.
Nuclear and cytoplasmic staining with S100. [Copyright:  2013 Inskip et al.]
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Histologic sections (Figures 3-11) showed a compound melanocytic proliferation with two components, the first consisting of bland nevus cells, which matured with descent and tracked down adnexal structures in a congenital pattern.
Faint cytoplasmic staining with HMB-45. [Copyright:  2013 Inskip et al.]
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Histologic sections (Figures 3-11) showed a compound melanocytic proliferation with two components, the first consisting of bland nevus cells, which matured with descent and tracked down adnexal structures in a congenital pattern.
A Melan-A stain highlights the cytoplasm of the balloon cells. [Copyright:  2013 Inskip et al.]
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Histologic sections (Figures 3-11) showed a compound melanocytic proliferation with two components, the first consisting of bland nevus cells, which matured with descent and tracked down adnexal structures in a congenital pattern.