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If there is an air bubble, hold the syringe so the needle is pointing up

32 The background tan patch (caf au lait maculelike) of an SLN (which in larger lesions may have a linear or blocklike configuration with sharp midline demarcation) is usually noted at birth or soon thereafter, with spots appearing over time

Although the term PEM allows one to deal with diagnostically challenging pigmented melanocytic tumors, for which a reliable distinction between melanoma and an unusual pigmented nevus is difficult or impossible by light microscopic examination alone, we caution against labeling lesions as PEM, which previously would have been diagnosed as benign EBN or pigmented dermal spindle and epithelioid cell nevus

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