Jennifer A. Sceppa

Four Views of Areolar Melanosis: Clinical Appearance, Dermoscopy, Confocal Microscopy, and Histopathology

Melanosis of the areola is a benign process characterized by hyperpigmentation of basal keratinocytes in the presence of normal to slightly increased numbers of melanocytes. It can simulate malignant melanoma clinically and it therefore, can present a diagnostic dilemma. We recently reported a case in which a pregnant patient presented with a growing, changing pigmented lesion on her right breast. Examination of the skin revealed a large, poorly demarcated and asymmetric hyperand hypopigmented patch spanning the left lower quadrant of the right areola and nipple without any associated induration or ulceration (Figure 1). Further evaluation of the lesion with dermoscopy, confocal microscopy, and histopathology ruled out malignancy and led to a diagnosis of areolar melanosis. In this report, we provide the first description of this entity under confocal microscopy and correlate its features across the various imaging modalities utilized.

Fine Wrinkling of the Thighs and Axillae—Quiz Case

Cary Chisholm, MD; Brook Brouha, MD, PhD; Phillip Lee, MD; Doyle Hansen, MD; Clay Cockerell, MD; Scott & White Memorial Hospital, Temple, Texas (Dr Chisholm); Texas A&M University Health Sciences Center, College Station (Dr Chisholm); University of California, San Diego (Drs Brouha, Lee, and Hansen); University of Texas Southwestern Medical Center, Dallas (Drs Brouha and Cockerell); and Dermpath Diagnostics, Dallas (Drs Brouha and Cockerell)