Case discussion: How would you treat this patient? [20 November]

This week, we have another wonderful case from Dr Slavko Doslo. A 65-year-old female presented for a skin check and a lesion was noticed as indicated.

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

Case discussion_Slavko Doslo      Case discussion_Slavko Doslo Case discussion_Slavko Doslo

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    Case Discussion_Slavko Doslo

We encourage you to participate in the case discussions and submit your own clinical images and questions so we can all learn together.

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7 comments on “Case discussion: How would you treat this patient? [20 November]

  1. Clinically/Macroscopically: a brown papule, ~ 8mm x 6mm.
    Dermoscopically:
    Chaos in term of structure and color.
    Clues: thick reticular (lower part), pale-white centric structureless, dotted v/s (if look into carefully by zooming) especially in the structureless area. Despite lack of strong clues, Fairly enough for 2-3mm margin excisional biopsy and go from there.
    Imp: LM or LMM /(MiS).

  2. no melanoma specific features other than central scar like depigmentation, appears more of a minimally dysplastic nevus or a sclerosing nevus. given that it is a loner lesion on an elderly patient, it warrants a shave biopsy

  3. The key for this case, in my view, is to take the clinical appearance seriously. It is so small and innocuous! many doctors would ignore this. The dermoscopy makes it easy – I agree 2/3 on 3-point leads to excision biopsy and then 5mm margin excision. Great pick up here – key is to be suspicious of lonely lesions