Case discussion: How would you treat this patient? [13 February]

This week’s case discussion, submitted by Dr David Stewart, features a 73-year-old male patient with a lesion on his right ear detected during his routine skin cancer check.

The patient reports that the lesion has been present for many months and doesn’t bother him.

What are your thoughts on the clinical and dermoscopy photos? What would you do next?

case discussion


Here is the pathology result:

For further information on this topic, you may be interested to learn more about the HealthCert Professional Diploma program in Skin Cancer Medicine.

case discussion


Would you like to obtain advice or share your experience with your colleagues in the weekly blog case discussion?

 Participate with your cases so that we can learn together!

Submit your case here or send details to [email protected]






Leave a Reply

Your email address will not be published. Required fields are marked *

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

  1. Clinically a NMSC until proved otherwise. A non-pigmented lesion with a rolled edge and a vascular center.
    Dermatoscopically = in focused arborizing BVs = likely a Basal Cell Carcinoma: differential diagnosis a SCC, adnexal tu. or amelanotic melanoma less likely.
    PLAN = because the size and a higher risk site (R ear helical rim), a punch biopsy first, then management based on histology. Especially if it is one of the more aggressive BCC sub types, like morpheic, sclerosing or infiltrative = a bigger margin would then be needed.

  2. That single big arborising blood vessel bottom right may be giving it away.
    BCC likely, white-pink in colouration.
    Punch biopsy and then excise with wedge excision.

  3. I’d probably call a BCC
    Punch bx to confirm. Any component of Infiltrative BCC is concern for margins; thinking single flap vs H plasty

  4. Depressed non pigmented lesion with arborising vessels. No other distinctive features. Morphoeic BCC. Biopsy then Slow MOHS and ? FTSG vs Wedge resection. Not sure if H-Plasty will be possible. Diff Dx :Amelanotic melanoma