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Image Number #8467 (Melanoma)

Diagnosis: Melanoma

Description: Blue black papules cheek

Morphology: Papules,black

Site: Cheek

Sex: M

Age: 90

Type: Clinical

Submitted By: Ian McColl

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Differential Diagnosis
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History:

 This elderly gentleman had a long standing lentigo maligna on his cheek but developed a reactive clone of malignant melanocytes which invaded the local lymphatics to give this intransit spread. PET scans were negative for metastases elsewhere and he was treated with Keytruda a PD1 inhibitor drug with an excellent response.

See this reference for Side effects of Checkpoint Inhibitor Drugs

DermNetNZ   eMedicine   PubMed   Dermatology Online   Archives   JAAD for "Melanoma"

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