Case discussion: How would you treat this patient? [7 February]

This week’s case discussion, submitted by Dr Terry Harvey, is a highly engaging five-part feature, with an update each day this week. A 35-year-old male patient with no personal or family history of skin cancer presents for his first skin check. Multiple moles are noted.

case discussion

How do you manage these patients?

Update #1:

This image is of a lesion that was noted to be particularly suspicious. How do you evaluate this?

 case discussion


Update #2:

Here is the pathology report. What next?




Update #3:

Here is the wide local excision report. What next?

case discussion

Update #4:

Here is the final report.

case dicsussion

– Prof David Wilkinson

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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13 comments on “Case discussion: How would you treat this patient? [7 February]

  1. There is a pink ulcerated lesion in the mid central of his back; which i would like to have a closer look at on dermoscopy
    Dermoscopy of the moles to see his signature naevus pattern. Biopsy odd ones out.
    Serial clinical photographs to look for changes of his moles

  2. The dermoscopic image appears to be the lesion in the dead centre of the clinical photo. It appears to be an ‘ugly duckling’, looking more pink than the other lesions. On dermoscopy, there is a hint of regression in the 3 – 5 o’clock region of the lesion, and there is a fair amount of ‘pinkness’ throughout the lesion, though to be honest, it doesn’t outright scream out as a melanoma.

    1. Just wondering… regarding the 3-5 o’clock area, is it still regression if it is not whiter than the surrounding skin. I’m not sure myself. Can anyone advise please. Cheers

  3. One of those “uncertain” lesions. Some asymmetry, Slight flares of redness – When in doubt cut it out !– excision biopsy and review with patient with Annual skin check and mole mapping.