Case discussion: How would you treat this patient? [23 March]

In this week’s case from Dr Tim Aung, a patient presented for a skin check:

  • 50 year-old male
  • Ugly duckling identified

What is your assessment of the clinical and dermoscopic images, and what would you do next? Why?

Case discussion      Case discussion      Case discussion

Update:

Here are the results. What next?

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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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14 comments on “Case discussion: How would you treat this patient? [23 March]

  1. I would like to know whether this patient was aware of this/ was this lesion present before hand and for how long.
    The sinister features are the age, and if the patient indicates that he was not aware of it.
    In terms of the lesion I did not see any feature to redflag this lesion. and if i do not know the demographics i will consider it benign

  2. General thickened network with an eccentric area of dense pigmentation. Melanoma possible. Requires excision

  3. Reticular network on scalp so nevus unlikely. Thick lines fading to periphery in a uniform fashion. Uniform with no asymmetry except for structure top right. Solar keratosis becoming seb keratosis. Can observe

  4. Atypical pigment network.
    white scar like area ? Asymmetry of structure? … melanoma or dysplastic naevus.
    Needs excision biopsy.

  5. Atypical pigment network, asymmetry.
    Clinically ugly duckling sign.
    Excisional biopsy DDX: Dyspalstic nevus vs Melanoma

  6. I suspect this in on the front of his hairy chest? If so, I`d leave it alone – symmetrical compound naevus. History of change possibly could make me change my mind. Short term f/u after 3 months could be an option.

    ?The image might also suggest a scalp location ?? – if so, cut it out, suspected melanoma.

  7. I don’t have much to add here. For me the dermoscopy was tricky – I scored it 1 for asymmetry, so called it benign.