Cutaneous embolization of doxorubicin drug-eluting beads.

ridges and lesswithin the furrowsof thedermatoglyphs. Subsequent histopathologic analysis of those lesions demonstrated atypical melanocytes containing melanin granules within the crista profunda intermedia.6 Similarly, in their retrospective analysis of Japanese patients withmelanocytic lesions, Saida et al5 found the parallel ridge pattern more diagnostically accurateofmelanoma in situ than“irregular diffuse pigmentation.”5(p1235) Melanocyticnevi, subcornealhemorrhage, exogenouspigmentation, and lentiginosis and drug-induced hyperpigmentation candemonstrate a dermoscopic parallel ridge pattern.3 Benign dermoscopic attributes include a parallel furrow pattern,5 a lattice-like pattern,6 and/or the lack of disruption of the acrosyringia within the epidermal ridges.3 Our patient’s history suggested recent onset, an uncommon feature in ALM. Because we did not specifically inquire about exogenous pigment exposures, our initial evaluation failed to reveal information thatmay have allowed for earlier exclusion of ALM. Our case serves as a reminder to clinicians of the importanceof a thoroughhistory.Exogenous tissuedyeing should be considered in the differential diagnosis of acral pigmented lesions, particularly if the clinical history suggests the lesion is of recent onset.