The American Society of Dermatopathology

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Interactive Case Study - February 2014

Speckled pigmented patch

Lindsay Eminger, MD; Tammie Ferringer, MD

Question 1:

A 62-year-old male presented with a 2.5 cm x 5 cm tan patch with speckled dark brown-black macules on his left shoulder (Figure 1). The lesion was asymptomatic and had been present since adolescence. The histopathology is shown below (Figure 2-9)

Figure 1. Clinical photo

Figure 2. H&E

Figure 3. H&E

Figure 4. H&E

Figure 5. H&E

Figure 6. S100

Figure 7. HMB-45

Figure 8. CD34

Figure 9. EMA

What is your diagnosis?