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  Vol. 141 No. 1, January 2005 TABLE OF CONTENTS
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A Slightly Erythematous, Firm Papule on the Upper Arm—Diagnosis

Arch Dermatol. 2005;141:93-98.

Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Diagnosis: Amelanotic melanoma.

MICROSCOPIC FINDINGS AND CLINICAL COURSE

Histologic examination of the lesion revealed a superficial spreading melanoma invasive to Clark level IV, with a measured depth of 1.4 mm. Ulceration, regression, neurotropism, and vascular invasion were absent. No precursor lesion, tumor infiltrating lymphocytes, or microsatellites were identified. The mitotic rate was estimated at 1 mitosis per square millimeter.

On follow-up physical examination, the patient had no lymphadenopathy or hepatosplenomegaly. A chest radiograph demonstrated no abnormalities, and there was no evidence of metastases. A complete blood cell count was normal. The lesion was completely excised with a 2-cm margin of clinically normal skin. Sentinel lymph node mapping and a biopsy specimen from the right axilla did not show any evidence of metastatic melanoma (0 per 3 lymph nodes). The patient was without recurrence at the 6-month follow-up visit.

DISCUSSION

Early diagnosis and excision of melanoma are considered critical in enhancing survival. Typically, melanomas can be identified by features such . . . [Full Text of this Article]



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