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1800 867 1390Case discussion: How would you treat this patient? [10 May]
This week’s case discussion from Dr Thuy Au features a 71-year-old male with a lesion on his arm noted during a skin check.
- 71-year-old male
- Lesion on arm
Only the dermoscopy image is available. What is your assessment and what would you do next?
Update
Here is the pathology report. What next?
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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1300 856 695
+44 203 514 0688
1800 867 1390
asymmetry colour and shape
blue gray veil
negative network
? melanoma
P:
excision biopsy with 2mm clearance
Asymmetric multi-coloured pigmented lesion with pigment networks, globules, streaks crystal structures and scar like formation on sun damaged skin suspicious of Malignant Melanoma. A complete shave biopsy is recommended with 2mm margin and further follow up according to the pathology report.
Irreg outline, irreg networks and white patches. Excision biopsy with at least 5 mm margin .?MM
Chaos, asymmetry, blue grey, structureless areas/ regression, clods,
? Melanoma
Excision with 2 mm margin
Asymmetrical lesion with blue grey peripheral clods,eccentric structureless area
Plan : 2 mm excision biopsy
3 point check
+ve for asymmetry
+ve for white and blue colors
+ve abnormal network
DD : most probably melanoma
2 mm excision biopsy
Looks like a melanoma
irregular boarder
colorless areas
pink dark brown and black
pods seen
this is a melanoma
excision with 2 mm margin
structureless area with blue white veil, some peripheral network
Asymmetry in pattern and colour, white veil, areas of regression
B/G sundamaged skin
Suspected melanoma
For excisional biopsy with 2mm margins
ABC Score > 2
Asymmetry of Shape and Color
Grey Veil Noted
Excision Biopsy/ 3 mm punch Biopsy
PSL with irregular globules / clods. White grey structureless area and dark blotch. It’s worrying. Excise to exclude MM
Most have picked it which is good –irregularity/pigmentation /reticulation /small rhomboids and grey
Melanoma
Excision 5mm margin
Irregular margin , various colour , blue veil. Will do excision biopsy keeping 2 mm margin, further management based on histopathology.
ASYMMETRY IN COLOR AND SHAP
BLU GRAY GLOBULES
WHIT SCARE AREAS
SHINY WHIT STRANDS
FINGER PRINT APPEARNCE
?? BCC VERSUS MELANOMA
lesion is highly suspicious.
Atypical pigmentation.
Atypical network.
White structureless areas.
3 colors
Atypical network.
Excise with 2 mm margin
Suspicious 3/3 melanoma likely
Excision biopsy 2mm margin
collision lesion between a lentigo and melanoma, needs shave excision done
Melanoma
A great picture of what is likely a melanoma undergoing regression. Multiple colours, lots of grey. A nice deep shave or a formal 2mm excision biopsy is the way to go.