case_images: PMC3938370_01
case_images: PMC3938370_02
case_images: Blackened plaque around the surgical ulcer in the third interdigital space of the
  right foot
case_images: abd-89-01-0157-g01.jpg
case_images: PMC3938370_02_abd-89-01-0157-g01.jpg
case_images: f01
case_images: At dermatological examination in our service, she presented a blackened plaque around the surgical ulceration (location of biopsy) in the third interdigital space of the right foot (Figures 1 and 2) and a painful palpable hardened mass on the root of right thigh measuring approximately 8 cm.
case_images: Another angle of the lesion in the third interdigital space of the right foot, which
  gives a better view of the blackened area
case_images: abd-89-01-0157-g02.jpg
case_images: PMC3938370_02_abd-89-01-0157-g02.jpg
case_images: f02
case_images: At dermatological examination in our service, she presented a blackened plaque around the surgical ulceration (location of biopsy) in the third interdigital space of the right foot (Figures 1 and 2) and a painful palpable hardened mass on the root of right thigh measuring approximately 8 cm.
case_images: Dermoscopy showing the destructured melanocytic lesion, irregular multifocal
  pigmentation with areas of light brown, dark brown, black, and grey, brown spots and
  globules with irregular distribution and an amorphous grey-blue area. The centre
  presents as an area of secondary scar tissue from a previous biopsy
case_images: abd-89-01-0157-g03.jpg
case_images: PMC3938370_02_abd-89-01-0157-g03.jpg
case_images: f03
case_images: The centre presented a secondary scar area from a previous biopsy (Figure 3).
case_images: Histology: superficial disseminative melanoma with a nodular component, noting in the
  epidermis adjacent to the nodule (to the right) epidermotropism until the granulosa
  layer. (HE 40x)
case_images: abd-89-01-0157-g04.jpg
case_images: PMC3938370_02_abd-89-01-0157-g04.jpg
case_images: f04
case_images: Review of the slide confirmed diagnosis of superficial spreading melanoma with a nodular component, Breslow index 6.3mm, Clark level IV, presence of ulceration with 5.5 mm extension, 13 mitoses in 10 high power fields, angiolymphatic invasion, absence of regression, and vertical growth phase (Figures 4 and 5).
case_images: Histology: at higher magnification, note the intense nuclear atypia and mitotic
  figures. (HE 400x)
case_images: abd-89-01-0157-g05.jpg
case_images: PMC3938370_02_abd-89-01-0157-g05.jpg
case_images: f05
case_images: Review of the slide confirmed diagnosis of superficial spreading melanoma with a nodular component, Breslow index 6.3mm, Clark level IV, presence of ulceration with 5.5 mm extension, 13 mitoses in 10 high power fields, angiolymphatic invasion, absence of regression, and vertical growth phase (Figures 4 and 5).