Focal XXXX (mucocutaneous junction): a report of a unique case with a review of the literature.

@entity1 @entity11930 @entity66 @entity4482 @entity3059
PURPOSE: To describe the first isolated and focal @entity4482 . METHODS: Review of clinical, histopathologic, and immunohistochemical characteristics and relevant literature. RESULTS: A 93-year-old Caucasian @entity1 with a flat, irregular, and deeply pigmented black growth of the left upper eyelid margin of unknown duration underwent a full-thickness eyelid excisional biopsy. Microscopically, a population of loosely aggregated, mitotically inactive, heavily pigmented oval-to-elongated spindle dermal cells that paralleled the epithelium was seen. @entity3059 and HMB-45 immunostaining of premelanosomes could not distinguish between melanocytes and melanophages. The more specific microphthalmia-associated transcription factor stained the nuclei of the subepithelial melanocytes before and after bleaching of the cytoplasmic melanin. The @entity1 did not have @entity11930 . No residual pigmentation or lesional recurrence has been noted during 6 months of follow up. CONCLUSIONS: A blue nevus of the preorbicularis eyelid skin is extremely rare, and still more uncommon is such a lesion of the eyelid margin. Careful microscopic and immunohistochemical evaluation is necessary to establish the proper diagnosis. Wide local excision should be performed due to concern about a more common and serious melanomatous nodule. A differential diagnosis of other @entity66 in this location is offered.
