The survival times of patients who had an elective regional lymph node dissection was compared with that of those who did not undergo the procedure in a database of 72 patients with clinical Stage I melanoma of intermediate thickness (1.51–3.99 mm). All of the patients had been followed for 5 years or longer or until death. No significant differences were found in other reported prognostic factors, suggesting that the two groups were comparable. By multivariate analysis, a low mitotic rate, intermediate patient age, and the presence of an infiltrative lymphocytic response were found to be associated with favorable survival. There did not appear to be any association of elective regional lymph node dissection with survival; and it was concluded that such therapy should not be regarded as "standard" for clinical Stage I melanoma of intermediate thickness.

The occurrence of uveal and cutaneous malignant melanoma and the dysplastic nevus syndrome in the same individual suggests an etiologic relationship among these diseases. Thus, the dysplastic nevus syndrome could be viewed as marking an increased risk of both cutaneous and ocular melanoma. We postulated that if such a relationship exists, patients with both forms of melanoma should have a high prevalence of dysplastic nevi. We examined 44 patients (31 women and 13 men ranging in age from 20 to 80 years) with uveal melanoma for evidence of cutaneous melanoma and dysplastic nevi. We also examined photographs of 46 patients (24 men and 22 women ranging in age from 19 to 67 years) with nonfamilial cutaneous melanoma to determine the prevalence of dysplastic nevi. We found a 4.5% prevalence of dysplastic nevi in patients with uveal melanoma, significantly lower than the 41% prevalence in patients with cutaneous melanoma (two of 44 patients vs 19 of 46 patients). This study indicates that uveal and cutaneous melanoma are not etiologically linked through dysplastic nevi and suggests that patients with uveal melanoma are no more likely to have cutaneous dysplastic nevi than the general population.

In two cases of target blue nevi of the foot, both lesions displayed a distinctive concentric pigmentary variation. This correlated histologically with a peripheral alteration of dermal collagen accompanied by a focal regression or differentiation of blue nevus cells. The resulting distinctive target blue nevus can be clinically differentiated from a malignant melanoma.

• An 84-year-old man was examined for progressive pain, edema, and infiltrating skin lesions on his lower extremities. A skin biopsy specimen confirmed the suspected diagnosis of angioendotheliomatosis proliferans. The clinical course and histologic changes suggested the malignant form of this disease. Treatment with intravenous doxorubicin hydrochloride caused a complete clinical remission. (Arch Dermatol1982;118:512-514)

Asymptomatic nodules, suspected of being nodular melanomas, were subjected to 30 s of direct pressure. All the biopsy-proven nodular melanomas remained unchanged by this procedure. The nodules later proven by biopsy to be angiomas were found to collapse slowly in response to pressure. This test can be used to identify angiomas. It should be employed in the routine clinical examination of lesions suspected of being nodular melanomas.

Tn 1971, Altman and Meharegan1and Kaidbey and Kurban2established inflammatory linear verrucose epidermal nevus (ILVEN) as a distinct clinical entity. Since that time, ILVEN has become recognized as a frequent cause of linear psoriasiform eruption. It has been suggested that previous cases that were reported as linear psoriasis and as psoriasis overlying an epidermal nevus were, in fact, misinterpreted cases of ILVEN. This case illustrates the potential complexity of diagnosing a linear psoriasiform eruption and it establishes psoriasis superimposed on an epidermal nevus as a distinct clinical entity. Report of a Case A 1-year-old infant had an inflammatory linear skin eruption on the right upper portion of his back and extending down the right arm (Fig 1). A light brown plaque had been noted in the axilla at birth. This lesion remained unchanged until the age of 6 months, when a psoriasiform scaling plaque developed over the