<p>A 76 year old lady was referred with a BCC on the face. As part of a general examination I came across this brown-black lesion on the scalp. How are you going to manage this?</p>
<p>Clinically the lesion was smooth.</p>
<p>Dermoscopically there was asymmetry and large areas were structureless. The main question was what was causing the appearance of the brown-black network (descriptive only)?</p>
<p>I have seen many seborrhoeic keratoses on the scalp take on a rather atypical appearance, however, with this case I could not rule out a melanocytic lesion from clinical grounds alone so histology was required.</p>
<p>Histology showed a seborrhoeic keratosis, however, this could have been something more serious so gaining histology was appropriate.</p>
<p>Image copied with kind permission from South Tees Hospitals NHS Foundation Trust.<span></span></p>
