A 53‐year‐old African American woman presented with a 10‐yea | Figure 1

A 53‐year‐old African American woman presented with a 10‐year history of enlarging nodular plaques on the right medial (a), left anterior and left medial thigh (b). Multiple wound cultures and special stains for microorganisms were all negative. There was no palpable lymphadenopathy. Histopathological examination of a skin biopsy is shown in (c). The cells were positive for S‐100 protein (d). What is the diagnosis?

Looks for some guidance/advice on this lesion.. 34 yo male with HX of htn, paroxysmal AFib, OSA w/CPAP, and depression. They noticed this dark spot on the ventral aspect of the L great toe ~2 months ago. They have been monitoring it thinking it was a bruise but has not changed. No known injuries/trauma. The first photo is a collage of the left image from around two months ago and the right side shows current. I have also attached a dermatoscopic image as well as a furrow ink test image. It is asymptomatic. He has no other known history with cancers. I am I wonder about an acral nevus but concerned about is being an acral melanoma with the pigment looking to run parallel along the ridges. Likely will have biopsied. Just wondering what the community thinks about the images. If it is melanoma and it's at least 2 months old (could be a bit older but didn't notice it), is there much risk for metastasis?

BRAF inhibitors induce different types and grades of cutaneous adverse events (AEs) that require prompt recognition and correct therapeutic management. Primary melanoma development, eventually related to paradoxical activation of the mitogen-activated protein kinase pathway, is one of the reported AEs. Here we describe the unusual case of a 70-year- old woman affected by metastatic BRAF-mutated melanoma who developed, after 3 weeks of BRAF inhibitors therapy, a new subungual, blackish-brown, triangular shaped, melanocytic lesion on the finger. The photographs were taken 4 weeks after the development of the lesion. Histology revealed an in situ melanoma. This is, to our knowledge, the first case of subungual second primary melanoma under BRAF inhibitor therapy.

A 67‐year‐old woman with no personal history of melanoma presented with a 4‐mm nonpalpable brownish lesion of unknown evolution located on volar skin of the right foot (a). Dermoscopy showed a previously undescribed transition pattern formed by a peripheral atypical pigment network with central blotch on nonglabrous skin and a parallel ridge on the glabrous side of the lesion (b). Histology revealed proliferation of atypical melanocytes arranged as single cells along the basal layer of the epidermis (c). Melan‐A stain was performed (d) and diagnosis of acral lentiginous in situ melanoma was confirmed. A transition pattern combining typical pigment network and volar benign pattern was previously described; the identification of this new transition pattern can be helpful in recognition of acral melanoma in clinically banal‐appearing lesions.

A lesion on the 72 year old patient’s left flank, non pruritic or tender. The patient noticed it two weeks ago. A lot of sun exposure. Seems like atypical melanocytic nevus. Multiple melanocytic nevi around the area.

A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis. He had a history of hypertension, long-term smoking, and a sedentary lifestyle. On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.

A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets. Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.

A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.

Patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this EKG that would warrant further work-up or is this just a pediatric EKG?