title: [Dermatoscopy and reflectance confocal microscopy aspects of a "nested melanoma of the elderly"].
abstract: BACKGROUND
  We report a case of a nested melanoma of the elderly, a recently described entity, and we describe its aspect under confocal reflectance microscopy.
  
  
  METHODS
  A 70-year-old woman presented a pigmented lesion of the left leg measuring 2 × 2.5 cm in diameter which was increasing in size. Dermatoscopic examination showed a predominantly globular pattern, with globules of irregular color and distribution. Reflectance confocal microscopy revealed the presence of dense nests at the dermo-epidermal junction with cytologic atypia and pagetoid cells. The histological appearance was overlapping and a diagnosis of nested melanoma of the elderly was made.
  
  
  CONCLUSIONS
  The presence in an older subject of a large pigmented lesion with an irregular globular pattern should be suspected of nested melanoma of the elderly. Reflectance confocal microscopy may be useful in the case of such difficult lesions to proceed with more confidence to surgical excision.
authors.affiliation: Service de dermatologie, université de Modène et Reggio Emilia, Via Università, 4, 41100 Modène, Italie.
authors.forename: A
authors.initials: A
authors.lastname: Casari
authors.affiliation: Service de dermatologie, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France; Groupe d'imagerie cutanée non invasive de la Société française de dermatologie, France. Electronic address: elisacinotti@gmail.com.
authors.forename: E
authors.initials: E
authors.lastname: Cinotti
authors.affiliation: Service d'anatomopathologie, université de Modène et Reggio Emilia, Via Università, 4, 41100 Modène, Italie.
authors.forename: A-M
authors.initials: AM
authors.lastname: Cesinaro
authors.affiliation: Service de dermatologie, université de Modène et Reggio Emilia, Via Università, 4, 41100 Modène, Italie.
authors.forename: G
authors.initials: G
authors.lastname: Pellacani
authors.affiliation: Unité de cancérologie cutanée, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Viale Umberto I, 50, 42123 Reggio Emilia, Italie.
authors.forename: C
authors.initials: C
authors.lastname: Longo
mesh_terms: D000368:Aged; D046169:Dermoscopy; D005260:Female; D006801:Humans; D008544:Melanocytes / Q000473:pathology; D008545:Melanoma / Q000175:diagnosis* / Q000473:pathology; D018613:Microscopy, Confocal; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000473:pathology
keywords: Elderly; Imagerie non invasive; In vivo reflectance confocal microscopy; Melanoma; Microscopie confocale par réflectance in vivo; Mélanome; Mélanome en grandes thèques des personnes âgées; Nest; Nested melanoma of the elderly; Non-invasive imaging; Personne âgée; Thèque