Case discussion: How would you treat this patient? [27 September]

This week’s case discussion, submitted by Dr Mazharul Islam, features a 60-year-old lady who presents with concern about a black spot on her right cheek which she believes is recent (approximately two weeks).

  • 60-year-old female
  • New black spot

What do you make of the images and what would you do next?

case discussion

Update

Here is the pathology result. What is your reaction?

case discussion

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11 comments on “Case discussion: How would you treat this patient? [27 September]

  1. Black in a lesion on the face is always suspicious so I’d remove (probably 3mm punch biopsy to remove the whole thing) and go from there

  2. This looks like a haemangioma to me, but since she is concerned and it is a new lesion I would do a 3mm punch biopsy

  3. Considering the age and the face with sun damage and a black spot I would excuse with 3mm margin and subject to histology.

  4. Darkness on magnification and shiny blackness with irregularity ,would excise ? possible MI –with 2mm margin biopsy may not be representative .

  5. A new blue nevi on and old person plead for a melanoma with atipic aspect to dermoscopy . Blood vessels concentrated there in the head of jellyfish argue too for a high level of cells activity. A delicate diagnostic and therapeutic and deep biopsy should be done on this part of the face and the referral for additional care is required.

  6. Eccentric hyperpigmented blotch with greyish outer pigmentation. In view of the new onset, I will consider early MM.
    With the histology report, I will discuss and share my dermoscopic findings with the histopathologist.