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1800 867 1390Case discussion: How would you treat this patient? [30 July]
This week we have an interesting case. From the shown clinical and dermoscopy images, please evaluate, indicate your likely diagnosis, and method of biopsy.
Update:
These are the results from the pathology report. What is your conclusion and what are the next steps you would take to treat this patient?
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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1300 856 695
+44 203 514 0688
1800 867 1390
Ddx
1. melanoma metastases
2. nodular melanoma
need excision biopsy first before deciding further course of action
Chaos, black clods
Depending on the size, may be too large for an excisional biopsy being on the scalp.
Suggestive,of a melanoma
Would consider a shave biopsy.
no diagnosis possible with non contact dermoscopy. dermoscopic grey needs shave biopsy done irrespective of lesion appearance on scalp or face as it forms an exception
Looks awful clinically, suspect NM clinically; ideally excise 2mm margin, but may need to shave if unable to excise. Clark level 4, PNI – refer for to melanoma unit
Not much to add here – obviously suspicious clinically and needs excision biopsy, with nodular melanoma in the mix. Pathology confirms this, so wide excision required