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.

No comments:

Post a Comment

We welcome your comments. We endeavor to serve your patients and you. If you want us to respond, please add your name and email address. Some people have trouble uploading comments. In that case, please send comments directly to Thank you.