Axillary lymphadenopathy: a complication of BCG immunotherapy for melanoma

We present a patient with a Clark level IV melanoma who received BCG immunotherapy by scarification for 12 months after wide excision. Six months after cessation of treatment, the patient developed regional lymphadenopathy that histology showed to be reactive epithelioid granuloma. Regional immunotherapy thus represents a potentially confusing factor in the post-operative assessment and management of the patient with melanoma.