A 72 year old lady was referred with a lesion on the lower leg, the area bled and crusted from time to time. What are the diagnoses?
This is the lesion circled in purple. The predominant feature is that of many glomerular vessels, which in this case is in keeping with a patch of Bowen's disease.
Dermoscopy - Introduction, Terminology and Structures
A document to help you understand the dermoscopic descriptions used in this blog.
Dermoscopy Algorithm
To help you work through dermoscopic cases.
This is the lesion circled in green. The main dermoscopic feature is a central ulcer, given that this was non-healing with no history of trauma the differential includes malignancy (a BCC more likely than an SCC) or a benign entity. The diagnosis was that of a superficial BCC even though dermoscopically it lacks the typical vessels and so forth. Given the site then a non-surgical approach would be a good option, both lesions could be treated together with Imiquimod cream, Efudix cream or photodynamic therapy.
Images copied with kind permission from South Tees NHS Foundation Trust.
