<p>A 34 year old lady presented with a relatively long-standing lesion on her buttocks that recently had changed colour becoming black. There had been no history of trauma. How would you manage this patient? </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 there were black structureless areas, some black clods and a hint of network.</p>
<p>I have seen many very dark brown soft, ''wobbly'', benign melanocytic dermal naevi, some of which have black areas (probably as a result of trauma), however, I have seldom seen one this dark especially with a history of change. Even though I believed this was likely to be benign, I felt histology was needed, however, rather than undertaking what would have been a very significant excision, I felt it appropriate to do a deep shave excision/biopsy. The result showed a benign melanocytic naevus.</p>
<p>It is uncommon for benign melanocytic dermal naevi to become malignant. In the two cases where I have seen transformation the patient developed <strong>irregular pigment spreading out from the base</strong> (a little bit of regular pigmentation at the base is not uncommon), one of these cases is illustrated below.</p>
<p>Going back to the original case, would I manage a similar presentation in the same way in the future ..... probably. </p>
<p>Images copied with kind permission from South Tees Hospitals NHS Foundation Trust.</p>
