Malignant melanoma arising in a blue nevus with features of pilar neurocristic hamartoma.

A 65-year-old man presented with a history of a giant blue plaque of the parietal scalp since childhood. Biopsy revealed a cellular blue nevus. The blue nevus was observed for 10 years and thought to be unchanged until a new adjacent lesion was noted. Biopsy of the new lesion revealed metastatic malignant melanoma. A wide excision was performed of the original lesion which revealed malignant melanoma arising in a blue nevus. Areas within the blue nevus were consistent with a pilar neurocristic hamartoma, whereas other areas were consistent with a common blue nevus. Subsequent satellite metastases developed, with early metastases resembling blue nevi except for the absence of a stromal component and the presence of hyperchromatic nuclei. Later metastases were typical of metastatic melanoma. This case illustrates the uncommon evolution of malignant melanoma from a blue nevus. The histological features and relationship between melanoma, blue nevus, and pilar neurocristic hamartoma are reviewed.

Subcutaneous calcification in venous ulcers: report of a case.

We report on a 77-year-old woman with a recalcitrant leg ulcer that contained and extruded calcified material. Roentgenograms of the involved leg showed extensive subcutaneous calcification. The literature concerning subcutaneous calcification in venous insufficiency is reviewed. The patient responded to surgical debridement of the calcified tissue and subsequent skin grafting.