Abstract
A 39-year-old male presented for evaluation of newly developed pigmented macules on his left upper arm. He was diagnosed with stage IIIA, BRAF-negative malignant melanoma 2 years prior and underwent multiple wide local excisions, skin grafting, radiation, and immunotherapy. Despite extensive treatment, he developed recurrent melanoma at the site of the scar three times and metastasis to his liver, spleen, and right hip. The patient then began pembrolizumab therapy during which a cluster of gray-black macules developed at the inferomedial aspect of the melanoma scar on his left upper arm (Fig 1).
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