Case discussion: How would you treat this patient? [22 April]

This week we have an engaging case. A 57-year-old woman who had noticed the depigmented lesion on her arm for some months. Patient thought she may have had a BCC three years before, but was unsure of site and size.

What do you make of the clinical and dermoscopic pictures? How would you biopsy this lesion?

Case discussion      Case discussion

Case discussion

Update:

Pathology report was of invasive melanoma. What are your thoughts and reactions?

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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4 comments on “Case discussion: How would you treat this patient? [22 April]

  1. non contact dermoscopy is pretty useless with DL4. cant comment at all. phenotypically looks like a sarcoid patch maybe?

  2. Very amazed to learn as invasive melanoma although nothing pointing clinically and dermoscopically- just slight elevated pinkish (erythema) patch with no network. But can happen any atypical in medical world. Is it Hypomelanotic or Amelanotic MM! WLE or referral depending upon BT.

    Any solitary EFG or NFG is requited to take seriously.

  3. A pink lesion with pigment in middle.The lesion seems to be slightly elevated. No network or blood vessels seen. The lesion seems large and would qualify for a partial biopsy. I would not suspected a MM as first choice. Her axillar lymphnodes should be examined. Needs more specific histology. if 0.75mm – 1.2mm: 2mm excision and referral to melanoma clinic. A SLNB would be offered in same procedure as the wide excision. Medical treatment can also be offered after wide excision depending on the stage.