Case discussion: How would you treat this patient? [20 September]

This week’s case discussion, submitted by Dr Mazharul Islam, features a 65-year-old female patient with no significant history. This pink lesion is noted and photographed at a 3-month interval.

  • 65-year-old female patient
  • Pink lesion noted
  • 3-month interval

What is your evaluation? What next?

case discussion


Here is the pathology report.

case discussion

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16 comments on “Case discussion: How would you treat this patient? [20 September]

  1. i am not sure how long has had this lesion ,if new spot maybe do biopsy ,otherwise i will take picture and review in 2 months

  2. the lesion looks atypical with tan like structureless areas,non melanocytic with vessels that also look atypical.
    needs a biopsy.Punch vs excision?

  3. I can only see multiple clods/ dots. But taking into consideration the age and as a physical red spot. Perhaps to biopsy it just in case to rule out any nasty growth.

  4. Depending on time insitu, monitor or biopsy. Clinical image looks Seb K-ish, however microscopic images show structureless lesion with scattered red dots.

  5. structureless background with dot like vasculature scattered regularly and no pigment whatsoever. i think we should go ahead with follow up dermoscopic pictures

  6. White structureless ares and glomerular type dotted blood vessels suggestive of Bowens disease. I would punch biopsy.

  7. Looks like a BCC – there is evidence of interval change in the dermoscopic images – recc biopsy with 4mm margins .

  8. The lesion is a recent nevi ( + 3 months ) on a the 65 year old . it is new because it does not exist in her history . Dermoscopy show us lesion that grow . 1-2 cm increased in 3 months The structure of the lesion present globular structures , small vessels and other structures . The Age of the lady , structures of the image and the rapid grow lead me to say that it is a malignant nevi . We have to do a Excisional biopsy for diagnostic and excisional biopsy for treatment

  9. I think this lesion is a perfect candidate for a quick punch or shave – that is the guidance for pink lesions. It certainly needs a biopsy if it is solitary

  10. This one is obviously , unequivocal seb keratosis , unless pain to touch . If not -tender for that lesion , that is unequivocal seb K with well dermercated Border and yellow clod on Non polarised, no white line on polarised