<p>An enlarging lesion on the face but what is the white central area? </p>
Lmm2 De
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.
<p>This lady was referred with a rash on her trunk. During the consultation I noted the dark lesion on her right cheek. The patient had this biopsied (white central scar) a few months earlier and had been informed that the lesion was benign.</p>
<p>Clinically the lesion was suspicious and dermoscopically there were black structureless areas (white circles) and irregular black dots/clods (purple area). On the face black structureless areas usually equate to invasive melanoma. The lesion was excised and found to be a lentigo maligna melanoma of Breslow thickness 0.3mm.</p>
<p><strong>Nothing in science is 100% reliable</strong>, including histology, given the clinical appearance the initial histology should have been reviewed at the time. I have had a number of patients where the initial histology was benign, but on review of histology (as a result of clinical suspicion) the results were upgraded. Alternatively, in this case, the lesion could have had a more substantial biopsy or even excision in the first instance. </p>
<p>Copied with kind permission from South Tees Foundation Trust. </p>
