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1800 867 1390Case discussion: How would you treat this patient? [21 December]
Our case discussion this week features another case from Dr Terry Harvey.
- Barely visible lesion (as marked)
- Lesion on left posterior leg
What do you make of the clinical and dermoscopic images presented? Benign or suspicious? What is your differential diagnosis? If suspicious, how would you biopsy?
Update:
Here are the results. Thoughts? What next? What are the treatment options?
We encourage you to participate in the case discussions and submit your own clinical images and questions, so we can all learn together.
Learn more about skin cancer medicine in primary care at the next Skin Cancer Certificate Courses:
1300 856 695
+44 203 514 0688
1800 867 1390
Lesion with serpentine blood vessels
Shave /punch biopsy to confirm basal cell carcinoma
If confirmed,complete excision of the lesion
Arborising vessels tiny clod of pigment ?bcc. 4-5mm punch biopsy
Suspicious, basal cell carcinoma, excisional biopsy.
arborizing vessels – punch biopsy at least 3mm to exclude BCC
Looks like a BCC with well focussed arborising vessels; I would excise with 3mm margins
Early superficial BCC with very characteristic aborising blood vessels.
Punch biopsy and excise.
branching vessels would imply a BCC….
Suspicious
D Dx BCC, amelanotic melanoma
Ex’s Iona like biopsy with 2mm margin
superficial BCC with arborisation, use cryo to freeze at 2 weekly cycles. no need for biopsy as the diagnosis is clear
Increased vascularity noted, pale, non pigmented, translucent, suspect BCC.
Biopsy suggested.
Any of following methods to obtain tissue sample may be acceptable; in order of increasing accuracy.
Vigorous curretage; small punch; large punch; excision.
If physician is 100% confident in a diagnosis of a small BCC, destructive methods may be acceptable such as heavy cryo or electrocautery.
Suspect pigmented BCC although arborizing blood vessels can be seen in Melanoma. Excisional Biopsy