<p>A 43 year old woman presented with a new pink and brown irregular macule on the upper arm. What did histology reveal?</p>
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>Dermoscopically this is an asymmetrical lesion with an eccentric pink-brown structureless area along with dotted vessels (black circle). Working though the algorithm (link on right side of page) there are no obvious features of a melanocytic lesion (network, peripheral lines, grouped clods), equally there are no features of any other recognisable lesion, which takes us to the right hand side of the algorithm meaning that this could be a structureless melanocytic lesion. Given the presence of dotted vessels the differential included a hypomelanotic melanoma, and less likely an atypical spitz naevus.</p>
<p>Histology was not straightforward and a second expert opinion was requested, the conclusion of which was that the lesion represented an atypical spitz naevus, not meeting the criteria for melanoma. The case was discussed in the skin cancer MDT where it was decided that the patient should have a small wide local excision (up to 5mm) to be on the safe side.</p>
<p>Images copied with kind permission from South Tees Foundation Trust.</p>
