MELANOTIC FRECKLE (HUTCHINSON), MÉLANOSE CIRCONSCRITE PRÉCANCÉREUSE (DUBREUILH)

Abstract

IT HAS been stated that diagnosis of cutaneous malignant melanoma is comparable to writing the death certificate of the patient. An exception to this gloomy prognosis is the malignant melanoma arising from the pigmented lesion that Hutchinson^* first described as senile freckle or infective melanotic freckle, later termed by Darier and by Dubreuilh lentigo malin des vieillards and still later by Dubreuilh³mélanose circonscrite précancéreuse. We believe this disease is too briefly discussed in the usual textbooks of dermatology to afford comprehensive understanding of the pathologic process and differentiation from the more serious malignant melanoma arising from the pigmented dermoepidermal nevus (junction type nevus). Such differentiation is of importance from the standpoint of prognosis and of treatment. Discussion of these features is the object of this report. Since Hutchinson's^* brief description of the disease relatively few comprehensive reports have been published. Notable exceptions