Two cases of malignant melanoma arising in established stasis dermatit
is are described. One case was clinically thought to be melanocytic wh
ereas the other was not. Histologically, both showed similar features
with background varicose change of epidermal atrophy, sloughing of the
epidermis, intense proliferation of small thick walled blood vessels,
lymphocytic infiltrate and dermal fibrosis. In the superficial aspect
s of the biopsies there was little clue to the diagnosis of melanoma,
In the deeper aspects of case I, groups of melanocytes were present in
the reticular dermis which mimicked benign naevus cells, S-100 protei
n staining confirmed the melanocytic nature of these lesions, their ex
tent and the epidermal involvement, The latter features supported a ma
lignant diagnosis, These lesions can be overlooked clinically as well
as histologically.