PMC3562615_01
Clinical appearance of a dark, irregular, and raised skin lesion measuring 8 x 11 cm located on the back.
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A 7-day-old Italian male child showed at birth a dark, irregular, and raised skin lesion measuring 8 x 11 cm located on the back (Figure 1).
Dermoscopic features. An irregular pigmentation (a-d), atypical pigment network (a-d), irregular dots and globules (a-d), irregular streaks (a-c), and a wide blue-whitish veil (a-c) are clearly visible.
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A careful dermoscopic examination was performed, which revealed irregular pigmentation, atypical pigment network, irregular dots and globules, irregular streaks, and a wide blue-whitish veil (Figure 2).
Histopathologic features. We can see (a-c) a dermic component characterized by a solid growth pattern with deep nodules showing a high hypercellularity with no significant atypia. These melanocytes are densely packed and uniform in nature exhibiting a small nucleus; some cells have fine nucleoli. Nuclear pleomorphism is not seen. Immunohistochemical stains. It is visible a strong positivity for S-100 protein (d) and ki67 (e) but a negativity for the HMB-45 (human black melanoma 45) (f). Abbreviations. H/E: hematoxylin and eosin.
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There was (Figures 3(a), 3(b), and 3(c)) a dermic component characterized by a solid growth pattern with deep melanocytic nodules showing a high hypercellularity with no significant atypia. The immunohistochemical stains showed a strong positivity for S-100 protein (Figure 3(d)) and ki67 (Figure 3(e)), while the HMB-45 (human black melanoma 45) staining was negative (Figure 3(f)).
Clinical appearance of the patient after a three-time plastic surgery operation. No skin-grafting or cutaneous expander was needed.
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The patient underwent a three-time plastic surgery operation in April, June, and September 2010 that resulted in a complete excision of the lesion (Figure 4).