Asymptomatic Heterogeneously Black-Pigmented Plaque In A 58-Year-Old Man: An Unusual Presentation Of A Melanoma Mimicker

A 58-year-old man with a history of nodular basal cell carcinoma presented with an asymptomatic black-pigmented lesion on his left shoulder, without variation in size over time, which had been present for years. Physical examination revealed an irregular black-bluish-pigmented plaque with a maximum diameter of 8 mm. The dimple sign was negative (Figure 1). Dermoscopy showed a pseudo-pigmentary network and comedo-like openings at its center, asymmetrical peripheral streak-like structures, areas of brown-bluish pigmentation, fingerprint-like structures, and eccentric milialike cysts (Figure 2). The lesion was excised and histological examination was performed (Figure 3).