CASE
A 47-year-old woman was referred to dermatology on an urgent basis for evaluation of a lesion on her foot. The markedly overweight patient had never seen the lesion. It was brought to her attention by her daughter, whose best friend had died of melanoma months before.
Given the circumstances, the patient could not say whether the lesion had changed or how long it had been present. Other than being obese, the patient was reasonably healthy. She had tolerated what little sun exposure she had had in her life, seldom experiencing sunburn. Her only prescription medication was for mild hypertension.
On examination, the lesion proved to be a 3.2-mm, uniformly pigmented and bordered, dark brown macule located on the dorsal aspect of the interdigital web space between the first and second toes of the right foot (Figure 1). Seizing the opportunity to conduct a thorough examination, we found the rest of the patient's skin to be free of significant sun damage or any lesions of note. Her overall coloring was a relatively dark skin phototype III/IV.
Dermatoscopic examination of the interdigital lesion was performed at 10× magnification, revealing a benign reticular pattern.
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