Case discussion: How would you treat this patient? [16 October]

This week we have an interesting case from Dr Slavko Doslo. A 40-year-old female presented for a skin check and a lesion was noticed on her back.

What is your assessment of the clinical and dermoscopic images? What would you do – if anything?

Case discussion Slavko     Case discussion Slavko

Update:

This is the pathology result. What is your conclusion and what are the next steps you would take to treat this patient?

Case discussion_Slavko Doslo

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7 comments on “Case discussion: How would you treat this patient? [16 October]

  1. I can’t see any specific patterns. Even vessels I can’t see. But as said pink and brown mandate excision to exclude malignancy.

  2. This lesion has chaos and the clue of an eccentric structure-less area. I would excise but it initially looked benign and similar to the other lesions on her back.

  3. do a comparative approach to check the other moles and see if there is a link between all of them. this looks like a sclerosing nevi, all sclerosing nevi should be excised for path confirmation as they feature a grey area to work on.

  4. Sorry for my late entry due to recent HealthCert course with MCQs exam.
    Dermoscopically: Chaos in term of structure (asymmetric) and colour (>2 colours)
    Clues: pale-pinkish structureless (eccentric and centric), v/s patterns (polymorph + subtle dotted v/s). Unable to see other clues.
    Based on the above (??Hypomelanotic MM), 2-3mm margin excisional biopsy and go from there.

    Now, the report indicated MiS with clear of margin. Nevertheless it is prudent to do a wider excision (5mm margin) as per guidelines if not done yet despite the report saying clear on initial excision.

  5. Tricky case – not really a lonely lesion clinically, and not much that is specific on dermoscopy. I suspect many of us – including me – might have missed this! Well done Slavko.