Saturday, 20 February 2016

A whitish lesion




A 48-year-old woman consulted for a whitish scar-like lesion on her back.  


Clinical picture: whitish scar-like lesion with a pigmented border. Patient has a background of former heavy sun exposure.


At dermoscopy:
  • no signs in favor of a melanocytic lesion
  • a structureless  scar-like white pattern
  • pinkish areas without any vascular structures
  • a peripheral pigmentation (red square) in favor of leaf-like areas
Pathology revealed a superficial basal cell carcinoma



Thursday, 18 February 2016

HÜD DERMOSCOPE

I often receive emails from patients from all over the world asking me to make diagnosis on mole via clinical pictures.

Clinical pictures are not enough sufficient to allow an accurate diagnosis. Dermoscopy is now the standard for detection of early melanomas.
HÜD is a dermoscope that attaches to any smartphone camera, allowing you to take crystal-clear images of the moles on your skin. The accompanying First Derm app will teach you the skin cancer warning signs, remind you to track your spots over time and enable you to share your HÜD images with a dermatologist for evaluation.


You can order it online it at 80$:
HÜD DERMOSCOPE

You will be able to transfer images to your dermatologist or to get a remote diagnosis by connecting to FIRSTDERM
Service is available in:
  • English
  • French
  • Spanish
  • Italian
  • Swedish



Friday, 12 February 2016

A temporal lesion



A 60-year-old woman consulted for this temporal  pigmented lesion


 Dermoscopy revealed:

  • blue-gray dots / globules
  • leaf-like areas



Pathology was in favor of a basal cell carcinoma

Brachial melanoma




A 54-year-old man had a rapidly growing lesion on his right back for 6 months.



Dermoscopy revealed:
  • a vascular pattern with some polymorphous and atypical vessels
  • peripheral pigmentation
  • irregular globules
  • eccentric blotches


Pathology revealed a superficial spreading melanoma with Breslow index at 1.53 mm

A pigmented lesion on a shoulder



A 48-year-old man consulted for this pigmented lesion on his right shoulder.





Dermoscopy revealed:

  • an atypical reticular pattern
  • structureless areas with regression
  • a retiform depigmentation (negative pigment network)



Pathology was in favor of a melanoma in situ.

Saturday, 16 January 2016

Small, beware !


A 42-year-old man consulted for this small (4mm) pigmented lesion on his left calf.




Dermoscoy revealed:

  • asymmetry of colors and structures
  • some irregular blotches
  • an atypical pigment network
  • a radial streaming


Lesion was excised and pathology was in favor or a melanoma in situ.

Tuesday, 12 January 2016

A pigmented lesion

A 32-year-old man had his moles checked up.




Dermoscopy revealed:
  • whitish globules  / white cobblestone pattern
  • Light-brown peripheral network

 In favor of an accessory nipple


Central white cobblestone pattern





 Reference:

Dermoscopy of accessory nipples in authors’ own study 
G. Kamińska-Winciorek, J. Szymszal, W. Silny
Postep Derm Alergol 2014; XXXI, 3: 127–133



Sunday, 10 January 2016

A pigmented labial lesion

A 24-year-old woman consulted for a pigmented labial lesion.







Dermoscopy revealed multiple curves of semicircle, U or V mimicking the scales of a fish.
This fish scale-like pattern was in favor of a mucosal melanotic macule.


Fish scale-like pattern


Fish scale-like pattern is a new pattern described in mucosal melanotic macules.

Reference: 
Dermoscopy of pigmented lesion on mucocutaneous junction and mucous membrane.
Lin J, Koga H, Takata M, Saida T. 
BJD 161 (6); 1255-61

A yellowish lesion


A 70-year-old woman consulted for this small lesion on her right upper lid.




Dermoscopy revealed:

  • a yellow clod pattern
  • vessels arranged in a radial arrangement 
typical of a sebaceous hyperplasia

Saturday, 9 January 2016

Red lesions



A 62-year-old woman consulted for an acquired red tumor on her left ankle.



Dermoscopy revealed:

  • regular red dots
  • in a stringlike  distribution
in favor of a clear cell acanthoma

Saturday, 28 November 2015

Black lesion.


A 25-year-old woman consulted for a dark pigmented lesion on her abdomen


Dermoscopy revealed:

  • asymmetry of form
  • a central blotch
  • regular pseudopods
Pathology was in favor of melanocytic Spitz nevus

Cheek lesion.




A 55-year-old man consulted for a pigmented lesion on his left cheek

Dermoscopy revealed:

  • an irregular broadened network
  • rhomboidal structures
Pathology was in favor of a lentigo maligna melanoma in situ.

A small pigmented lesion on a leg





A 29-year-old woman consulted for  a small pigmented lesion on her right leg.


Dermoscopy revealed

  • spoke wheel areas
Pathology revealed a superficial basal cell carcinoma 


Regression.


A 21-year-man consulted for this lesion on his arm


Dermoscopy revealed:

  • a whitish - pinkish structureless area
  • with gray dots
in favor of a regressive lesion.

Pathology was in favor of a fully regressive melanocytic lesion. A fully regressive melanoma cannot be ruled out. 

Pigmented lesion on neck.


A 57 year-old-woman consulted for a pigmented lesion on her neck.


Dermoscopy revealed:
  • no melanocytic structures
  • a structureless pattern
  • irregular blue gray dots/globules 



Pathology was in favor of a Bowen's disease.

Friday, 27 November 2015

Another back lesion.


A 34-year-old man consulted for a changing pigmented lesion on his back.


Dermoscopy revealed:

  • asymmetry
  • an atypical reticular pattern
  • a regression area
Pathology revealed a melanoma in situ.


Back lesion



A 65-year-old man with many pigmented lesions on his back. One of this lesion was atypical.


Dermoscopy revealed:
  • multiple colors
  • an atypical reticular network
  • regression
  • a reticular depigmentation  (rectangle)


Pathology revealed a melanoma in situ.

Nodular lesion


A 57-year-old woman consulted for this nodular lesion on her right chest.


Dermoscopy revealed:

  • a non pigmented lesion
  • remnant of pigmentation (red circles)
  • a pink veil
  • atypical and polymorphous vessels

Pathology revealed a nodular melanoma (Breslow index 1.6mm)

Thoracic pigmented lesion


Man 52 years old; Acquired pigmented lesion on chest.



Dermoscopy revealed:

  • multiple colors
  • asymmetry of form and structures
  • an atypical network
  • a blue white veil
  • irregular dots and globules
Pathology revealed a melanoma in situ.

Saturday, 8 November 2014

Starburst pattern



A 43-year-old man consulted for this acquired pigmented lesion on his left leg.




Dermoscopy revealed:
  • a central blotch
  • a regular starburst pattern



 Two diagnoses were evoked: Reed nevus or melanoma. Regular blotch and symmetrical starburst pattern favored Reed nevus.

Lesion was excised and pathology revealed a superficial spreading melanoma with a Breslow index at 0.28mm.

Saturday, 4 October 2014

An ugly duckling


A 26-year-old woman consulted for many moles. One of them was considered "an ugly duckling".


Dermoscopy revealed:
  • an irregular blotch
  • asymmetry of form
  • chrysalis-like structures
Pathology revealed a superficial spreading melanoma (SSM) with a Breslow index at 0,6mm