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1800 867 1390Case discussion: How would you treat this patient? [5 March]
This week we have an interesting case from Dr Slavko Doslo. An 74-year-old female presented for a skin check and a lesion was noted on examination.
Please review and describe the clinical and dermoscopic image. What is your evaluation, and proposed next step/s?
Update:
This is the pathology result. What is your conclusion and what are the next steps you would take to treat this patient?
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1300 856 695
+44 203 514 0688
1800 867 1390
Peppering and regression, eccentric structureless area in what appears to have been originally a Clarke`s naevus, possibly even some polygons. Melanoma highly suspected. Excisional biopsy with 2mm margins, indicated.
Dermoscopic grey, regression with black dots happening in a preexistent nevus which is an orphan lesion in an elderly, most likely to be highly dysplastic nevus Vs SSM. Needs shave done
Clinically a pigmented macule over back 5-6mm
Dermoscopically:
Chaos in structure (asymmetric) and colour ( > 1 colour).
Clues: Dark dots and clods (peripherally as well), angulated thick lines that is potentially forming polygons.
Imp: LM/LMM or Dysplastic naevus.
2-3mm margin excisional biopsy is warranted.
Clearly we all agree that a 2mm excision biopsy is the best approach here – the lesion is clinically and dermoscopially suspicious. The result is a moderately dysplastic nevus – what does that mean? what would you do next?
Ring the pathologist and ask if they might have another look. Possibly provide the clinical and dermoscopic images
No further action needed if biopsy shows dysplastic nevus with complete excision