Melanotic freckle of Hutchinson

“Melanotic freckle of Hutchinson” is defined as an obligatory cutaneous precancerosis, analogous to keratosis, leukoplakia, and the premelanomatous stage of juvenile melanoma. Its clinical course, differential diagnosis, pathlogy, treatment, and prognosis are described. The evolution of this lesion to true malignant melanoma is slow and almost imperceptible. Clinical lesions, photomicrographs, and the cosmetic end results of surgical excision and plastic repair are illustrated.