Saturday, March 28, 2015

Darkness Visable: A Worrisome Image

Abstract: 75 yo man with an ominous lesion on his back

HPI: The patient is a 75 year-old man who rarely sees physicians.  His wife noticed a large number of lesions on his back.  His son had a melanoma of an upper eye-lid.  The patient has never had a skin cancer. His wife had some 5 fluorouracil cream that was over 10 years old and had applied it for a few weeks to the large lesion on his back.

O/E:  His back reminds one of Van Gogh's Starry Night."  Amidst the constellations of starry lesions, one lonely planet stands out.  It is 2.5 cm in diameter.

Clinical Photos: (all images taken by Dr. Yoon Cohen with an iPhone 6)


Dermatoscopic Images:

Diagnosis:  Probably Melanoma.  Presentation may have been modified by 5FU Cream.

The biopsy showed no evidence of malignancy.  Six weeks later, we saw the patient in follow-up.  The lesion looked a bit less worrisome,  A large incisional biopsy was taken. Findings will be reported when pathology is ready.


Plan: Waiting for reading of second biopsy.

We welcome any comments and diagnostic thoughts.


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