Case discussion: How would you treat this patient? [2 December]

This week we discuss an interesting case from Dr Colin Smith of a male patient with past history of NMSC.

What is your opinion on the clinical and dermoscopy images? What does dermoscopy show, how would you biopsy?

Case discussion     Case discussion

Update:

These are the results from the pathology report. What would you do next?

Case discussion Case discussion

 

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8 comments on “Case discussion: How would you treat this patient? [2 December]

  1. suspected melanoma versus basal
    dark brwon structure less area
    dark blue structure less area(atypical) may be noted as Blu gay ovoid nest
    shiny white streaks and areas
    dotted blood vessels or pinkish structure area on left half down
    excision biopsy with 2 mm margin

  2. This structureless lesion has a variety of colours, white lines and an ulceration. Differential’s include melanoma, BCC, and Merkel’s cell carcinoma. Also traumatized haemangioma. Excisional biopsy

  3. Chaotic lesion
    Surface ulceration
    Grey blue discolouration
    White lines
    Excision with 2mm margin initially and decide further care.

  4. Clinically- slight raised nodular with tiny ulcerated lesion on the scalp.
    Dermoscopically- Chaotic in term of colour and structure. Clues: Blue-grey and white structure with small ulceration. Polymorphic or dotted v/s were not obvious to me.
    Imp: (1) pBCC (2) MM.
    2mm margin excisional biopsy and go from there.

  5. A clearly suspicious lesion – pigmented, and so needs excision biopsy as we all agree. And then a most unusual diagnosis.

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