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Sunday, September 24, 2006
30 year old woman with changing mole
This 30 yo woman has noticed an enlarging pigmented lesion in her right axilla for almost a year. Her mother, a registered nurse, asked her to see a dermatologist. Her husband did not notice it.
The patient has Type II skin. The general cutaneous exam was unremarkable save for a 1.2 cm in diameter barely elevated plaque. There is a play of pigment and outline is irregular.
An excisional biopsy was performed.
Pathology: Malignant melanoma in situ , superficial spreading type. (Read by H. Byers of BU Skin Path who took photomicrographs) "The specimen exhibits a marked nested and lentiginous melanocytic proliferation with large severely atypical epithelioid cells. There is irregular nesting, focal confluent lentiginous melanocytic proliferation and cellular dyshesion."
She is scheduled for a wider excision, 0.5 cm on either side. No further work-up other than regular follow-up visits.
Your thoughts are appreciated.
Wednesday, September 20, 2006
Positive Band Aid Sign
Most dermatologists know about the "positive band aid sign." To me, it means a skin cancer has been lurking there for a while.
This 82 yo man came in with a one year history of a "sore" on his back. The drainage stained his shirt. When the band aid was removed, there was a one cm in diameter clean friable tumor, most likely a basal cell.
The lesion was shave biopsied and desicated and curetted. I'll affix a copy of the biopsy report when I get it.
How many of you use the term "Positive band Aid Sign?"
This 82 yo man came in with a one year history of a "sore" on his back. The drainage stained his shirt. When the band aid was removed, there was a one cm in diameter clean friable tumor, most likely a basal cell.
The lesion was shave biopsied and desicated and curetted. I'll affix a copy of the biopsy report when I get it.
How many of you use the term "Positive band Aid Sign?"