Department of Plastic and Reconstructive Surgery, University Hospital of South Manchester NHS Foundation Trust, Wythenshawe Hospital, Southmoor Road, Wythenshawe, Manchester M23 9LT, UK.
We report the finding of a malignant blue naevus of 14.3 mm Breslow thickness in association with a keloid scar on the earlobe of an Afrocaribbean gentleman. Malignant blue naevus is extremely rare and to date it has not been reported in association with keloid scars. We recommend routine histopathological examination of all excised keloid scars. Where histopathological services are limited, examination should certainly be carried out for keloids with unusual characteristics. Excision should be complete, rather than intralesional, in order to avoid leaving behind areas of potential neoplasia.