Tuesday, December 20, 2016

New Pigmented Lesion

Thiss 56 year-old man was brought into the office by his wife who has noticed a new pigmentedlesion on his mid-back for around a year.  He did not see the point in coming in, but she made the appointment and came in with him.

The exam showed a 1.1 cm pigmented nodule with a play of color and irregular borders.  The dermatoscopic exam shows whitish areas, black areas, and pigment dots (among other things).

Clinically, I thought this was a superficially spreading melanoma.  I could not be 100% sure it was not a seborrheic keratosis.

An excisional biopsy was done.  Pathology will be added in a few days.
Pathology:  Superficial spreading melanoma, at greatest, 0.68 mm thick.
I will recommend a WLE.  Not further studies.

Note:  Often, a wife will make the appointment for her husband who is reluctant to see the physician.  This patient insisted on going to work as a pipe-fitter after the excision.  When a wife finds a lesion on her skin and asks her husband to take a look; he often says to her, "If your worried, see a doctor."

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 djelpern@gmail.com. Thank you.