Case discussion: How would you treat this patient? [13 September]
This week’s case discussion, submitted by Dr David Stewart, features a 51-year-old male patient who presents for his routine skin check. This pigmented skin lesion is noted.
- 51-year-old male
- Pigmented lesion
What is your evaluation and what would you do next?
Here is the pathology report. What is your structured approach to assessing lesions such as this?
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6 comments on “Case discussion: How would you treat this patient? [13 September]”
Chaos present in structure, colour and border. Eccentric perifollicular pigmentation right upper. Radial streaming upper pole. Possible Lentigo Maligna. Excisonal biopsy with 2mm margin.
Excisional biopsy with 2 mm margins.
Three point checklist :
Atypical network – present
Blue white structures – present.
Excision with 2 mm margin due to blue grey structure at 2 o’clock . Pigmented solar lentigo/ keratosis with possible transition to lentigo maligna
it is better to remove this lesion by biopsy
# point check list is Zero but this white and brown globular lesion with bleeding blood vessels can not be considered as benign . It is a nevi that is becoming malignant . I am not on the side of actinic keratosis as the skin is intact around the lesion . We have to do a large and deep biopsy for diagnostic and after we will remove eventual malignant cells and refer if necessary . A follow up will be set up to control good or bad progress .