Editorial |

Nested Melanoma, A Newly Defined Entity

Claus Garbe, MD1; Gisela Metzler, MD1
[+] Author Affiliations
1Department of Dermatology, Eberhard Karls University of Tübingen, Germany
JAMA Dermatol. 2013;149(8):905-906. doi:10.1001/jamadermatol.2013.4305.
Text Size: A A A
Published online


Three cases of nested melanoma have been documented in detail by Longo and colleagues.1 Clinically, we see flat, asymmetrically shaped lesions with irregular pigmentation, measuring 5 to 10 mm in diameter, on heavily sun-damaged skin, which are highly suggestive of melanoma. Dermoscopy reveals irregular dots and globules, a multicomponent overall structure, irregular blotches, and sometimes atypical pigment network, which are all indicative for melanoma. Confocal microscopy did not add much, revealing the presence of a “clod” pattern made of large compact nests with variable atypia. Taken all together, we would clinically diagnose superficial spreading melanoma in heavily sun-damaged skin.

Figures in this Article



Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview


Place holder to copy figure label and caption
Histopathologic Images (Original Magnification ×200 for All Panels)

A, Sharply circumscribed junctional nests of nevoid melanocytes within chronically sun-damaged skin; pagetoid spread of melanocytes is missing (hematoxylin-eosin). B, Melan A immunostaining shows nested melanocytes without pagetoid spread of cells in the epidermis. C, For comparison, a benign junctional melanocytic nevus in a newborn with distinct cell nests (hematoxylin-eosin).

Graphic Jump Location




Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Topics
PubMed Articles

Users' Guides to the Medical Literature

The Rational Clinical Examination
Make the Diagnosis: Melanoma