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JAMA Dermatology Clinicopathological Challenge |

Diffuse Progressive Proliferation of Dark Papules in an Otherwise Healthy African American Woman QUIZ ONLINE FIRST

W. C. Cole Claiborne, MD, MPH1; Ashley E. Morgan, MD2; Andrea Tesvich Murina, MD1
[+] Author Affiliations
1Department of Dermatology, Tulane University School of Medicine, New Orleans, Louisiana
2Tulane University School of Medicine, New Orleans, Louisiana
JAMA Dermatol. Published online August 10, 2016. doi:10.1001/jamadermatol.2016.2744
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An African American woman in her 30s with no medical history presented with a 4-year history of diffuse progressive proliferation of dark papules with first onset several weeks after a sunburn. What is your diagnosis?

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A, Photograph of left thigh shows diffuse 1- to 2-mm dark brown-black macules and papules. B and C, Punch biopsy of right arm shows a circumscribed proliferation of pigmented epithelioid melanocytic nests, located primarily at tips of rete ridges. Moderate cytologic atypia is present. Superficial papillary dermis shows prominent pigment incontinence. No mitotic figures are seen. Kamino bodies were not visualized. D, Melan-A immunostain shows low pagetoid migration of melanocytes with a lack of melanocytic confluence at the dermal-epidermal junction.

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