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September 2001
Case submitted by Stephen Schleicher, MD
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CASE:
The patient is a 38-year-old man who has several dark lesions
on his upper back and shoulders that are of at least two years'
duration. All lesions are asymptomatic. He works as a laborer,
spending much time outdoors. Since early childhood, the patient
has experienced numerous episodes of sunburn. Past medical
history is negative for skin cancer. Examination of the affected
areas reveals multiple hyperpigmented macules, several of
which are strikingly black, with somewhat irregular borders.
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Junctional melanocytic nevi are benign lesions
characterized by pigment cells that arise at the dermal-epidermal
interphase. They are macular and may have a slightly irregular
border. Some are black and have a speckled appearance; these
have recently been termed "ink spot" nevi. Most commonly found
on sun-exposed areas, they may at times resemble malignant melanoma
and therefore necessitate biopsy. Fortunately, ink-spot nevi
have no malignant potential. |
Dr. Schleicher is director of the DermDx Centers for Dermatology
of Northeastern Pennsylvania and a clinical instructor of dermatology
at Graduate Hospital's City Line Campus in Philadelphia, Kings
College in Wilkes-Barre, and Beaver College in Glenside, Pennsylvania.
He is also a member of the EMERGENCY MEDICINE editorial board.
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