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Case discussion: How would you treat this patient? [3 May]
Posted on by Abbie Shortt
We feature another great case discussion from Dr Terry Harvey this week, regarding a 50-year-old male patient who came in for a routine skin check with no lesions of concern.
- 50-year-old male
- Routine skin check
What is your assessment of the clinical and dermoscopy images? What would you do?
Update
Here are the results. How would you treat?
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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12 comments on “Case discussion: How would you treat this patient? [3 May]”
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An asymmetric pigmented lesion, multiple colours, in dermoscopy atypical pigment networks, globules and peppering. Provisional dx: SSM, atypical nevus
Mx: excisional biopsy with 2mm margin and following up with the pathology report
Basal cell cancer. Asymmetrical pigmented non melanocytic skin lesion with leaf like pattern and brown nodules and globules.
Pigmented BCC
Chaos present; no visible grey but possible eccentric hypopigmented areas, dark clods, a variety of blood vessels
? Melanoma Ddx. BCC
Excise with 2 mm borders
I would excise. It appears to be an ugly duckling. Dermoscopy features are brown clods, structureless areas. polymorphic vessels. ? melanoma
Various clods size with some blood vessels. It could and looks to me merely atypical Nevus but I would just excise to rule out sinister things.
Also I forgot to add bcc. It can show this features.
Pigmented BCC-complete excision removal with 3mm margin + biopsy
ASYMMETRICAL GLOBULES
PEPPRING
??BLUE GRAY OVOID NEST
AREAS OF NEOVASCULRIZATION
?? BASAL CELL CARCINOMA
Asymmetric globules,peppering and hairpin vessels at the 4 o clock position.
Suspicious.I would excise with a 2 mm margin
asymmetry shape and pigmentation
arborizing vessels
negative network
? BCC
excision bx with 2mm margin
If you know your dermoscopy, this lesion just “looks like a BCC” – especially the “background of the tumour”. The vessels are quite atypical. I would have done a punch biopsy here – 3 or 4mm. and gone from there.