Case 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?

Case discussion     Case discussion


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

Case discussion

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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6 comments on “Case discussion: How would you treat this patient? [5 March]

  1. 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.

  2. 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

  3. Clinically a pigmented macule over back 5-6mm
    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.

  4. 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?

  5. Ring the pathologist and ask if they might have another look. Possibly provide the clinical and dermoscopic images