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1800 867 1390Case discussion: How would you treat this patient? [21 November]
In this week’s case discussion, submitted by Dr Magdy Malek, we look at a 5x5mm lesion discovered on the back of the neck of an 68-year-old male patient during his routine full skin examination.
What do you think, and what would you do?
Update
A shave biopsy was performed and the histopathology revealed lentigo maligna. The lesion was completely excised with wide excision 5mm margin.
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1300 856 695
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1800 867 1390
Asymmetry in colour and structures; atypical network; blue-grey structures = suspicious 3/3
Likely melanoma
Excision biopsy 2mm margins
suspicious lesion – pigmented BCC or melanoma
excision biopsy with 3mm margin
Chaos + structureless area .
In the middle it looks like regression / scar.
Can be a melanoma
I would remove this with 2 mm margin.
Although the edge from 12 to 3 o’clock resembles Seb K there is too much colour variability & asymmetry to ignore this. Excision all Biopsy required with suspicion of Melanoma in mind.
Red and brown with chaotic structure and different colours. Excise with 2 mm to rule out MM.
possible that its pigment incontinence
Iirgular borders,different shades of brown-melanoma
Wide excision biopsy
Probably BCC but is possibility of melanoma.
Definitely chaos of structure and colour of malignancy and requiring excision biopsy with 2 to 4mm margins as edges not distinct.
Ultimate management depends on histology.
Need for excision- possible MIS or melanoma–asymmetry, variation in colour and blue greyness,increased pigmentation/dark spots. Biopsy not representative.