Is there A malignant freckle?

The malignant freckle diagnosis is best suited to the clinical pattern of an indolent facial pigmented lesion of the elderly. The histopathology of such tumors is variable and not diagnostic. The use of the histopathologic diagnosis of malignant freckle is not advised, especially in extrafacial lesions, where its unjustifiable implied good prognosis is misleading. These conclusions are based on a review of 23 cases of so-called malignant freckle diagnosed pathologically at Presbyterian Hospital. Of the 18 extrafacial lesions studied 17 proved on “second look” to be invasive malignant melanoma. The 5 facial lesions, despite their clinical similarities, demonstrated variable pathology.