Acta Dermato-Venereologica 97-10CompleteContent | Page 35

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A Large Skin-colored Nodule on the Plantar Foot: A Quiz
Nathan W. ROJEK, Veselina KORCHEVA and Sancy A. LEACHMAN
Department of Dermatology, Oregon Health and Science University, 3303 SW Bond Ave CH 16D, Portland, OR 97239, USA. E-mail: rojek@
ohsu.edu
A man in his early 50s presented to our department for a skin
cancer screening examination. He was generally healthy
with no personal history of skin or other cancers. His family
history was notable for the fact that his mother died from
metastatic ocular melanoma. He had no particular concerns
on his skin. Physical examination revealed a 2.5 cm soft,
skin-colored nodule on the right plantar foot. (Fig. 1a) He
reported this nodule had been present since childhood and
was biopsied in the distant past, with the results showing a
benign nevus. An excisional biopsy was performed for his-
topathologic evaluation (Fig. 1b). By immunohistochemical
analysis, there was negative staining for nuclear expression
of BRCA1 associated protein-1 (BAP1) (Fig. 1c). Genetic
testing revealed a heterozygous, pathogenic, truncating,
germline BAP1 variant.
What is your diagnosis? See next page for answer.
Fig. 1. (a) A large, soft, skin-colored nodule on the right plantar foot. (b) Histopathology: asymmetric, predominantly intradermal, melanocytic proliferation
composed of nests and sheets of epithelioid melanocytes with large, pleomorphic nuclei and light eosinophilic cytoplasm (hematoxylin and eosin (H&E),
original magnification × 2.5). (c) Negative immunohistochemical stain for BRCA1 associated protein-1 (BAP1) (original magnification ×20).
QUIZ SECTION
This is an open access article under the CC BY-NC license. www.medicaljournals.se/acta
Journal Compilation © 2017 Acta Dermato-Venereologica.
doi: 10.2340/00015555-2726
Acta Derm Venereol 2017; 97: 1265–1266