The first case was the last excision I made, on december the 21st…   74 years old. Coming every 6 months, bearing a CDKN2A mutation. Only one melanoma in her past history. Her brother had a pancreas carcinoma…  A pink lesion on her neck, unseen before                                                 Case 2 50 years old. This case is a bit older, last may, but I think I did not publish it              Referred for a suspicious ..read more

Hi Everyone,   I have a surgical case today on the posterior ear. 78M presented for a routine skin check on the background of multiple previous SCCs and BCCs. This lesion was found on the back of his R post ear. It was biopsied and confirmed nodular BCC.  Biopsy Path: POSTERIOR EAR: BASAL CELL CARCINOMA, NODULAR. Histopath – punch bx – post ear ?BCC   MACROSCOPIC Post ear- The specimen consists of a cylindrical piece of skin, measuring 3mm in diameter and to a depth of 2mm. Specimen embedded whole in one block. Three levels sectioned. MICROSCOPIC Within the dermis, throughout ..read more

Case 1 Lesion in the scalp not present at birth in a 2 years old girl. What do you think it is and what would you do about it?         This man is 55 and has had 2 invasive melanomas in the past. He has numerous atypical nevi. This was one on his abdominal wall that I photographed and then when filing the photos I thought I had better excise it! Was I justified by the subsequent histology report?         Case 3 A lesion on the temple in a 75 years old male. No recent changes. Nice vessels. What is it? The post Tuesday Trio April appeared firs ..read more

yes bloggers and lurkers here is  a couple of    of pigmented lesions that  had me concerned          and  lastly  a  sobering example of  what immunosuppression  and CLL   can do to  you  in  a  UV   plentiful area   case 1    this fellow  has a melanoma  in situ removed by  me  4  years or so ago        , he is  77 now  the initial  melanoma in situ   so  that was the original  4 yea ..read more

One of those cautionary tales. I thought a good illustration of the capabilities of lentigo maligna and surgical margins. This is though in the setting of some immunosuppression. Bit of a saga sorry but this 67 yr old man, who is now a retired builder, first presented back in 2015 with a pigmented lesion on the left temple. Complicating features were his history of psoriatic arthritis on methotrexate and humira. Diagnostic excision undertaken and reported as lentigo maligna with a positive margin at 12 o’clock. Wider excision undertaken by myself, I don’t have a photo of that but in my op no ..read more

This 80yr old gent  with a history of NMSC presented with this growing painful nodule on the superior helical rim over several months.  It was extremely tender to touch making  examination of the lesion difficult.  Clinical features and dermoscopy which showed keratin structures ,ulceration ,white circles  and dot vessels  favoured  a diagnosis of SCC.  The distance of excision with 4mm clinical margins  was around  25 mm. How would you manage from here ? You can send your surgical plan to me : cd.pappas.con@gmail.com As usual I will put up m ..read more

Comorbidities, advanced age and history of the lesion all bear upon the decision whether to recommend to your patient that a lesion be excised.  For cases 1 and 2 it’s not necessarily a straightforward decision whether to biopsy or excise, or when.  Case 3 is a surgical closure challenge.  1. A 76 year old woman who was commencing radiotherapy and chemotherapy in 2 weeks. This lesion had been growing for 5 months, treated initially with antifungals by her GP in December and it’s grown so now it’s a bit of a worry. She had a left hip prosthesis in July 2023 and bilateral TKRs in ..read more

  Hi all, today an entity that I came across several times, once again, while being overseas: BAP-1 inactivated melanocytic tumors or BAPomas (one of multiple given names!)   A nice introduction on this topic was posted a couple of months ago by Dr Ian Katz. See it here:https://www.skincancercollege.org/dermoscopathology-case-1-2024/   BAP1 inactivated melanocytic tumors (BIMT), also referred to as Wiesner nevi or informally Bapomas, are melanocytic tumors with unique genetic profiles. (Wiesner et al., 2011) The occurrence of multiple BIMT has been associated with familial canc ..read more

Hi all. I found this pigmented lesion on the upper back of 71 year old woman during a skin check.   What do you think?       The post Dermoscopy Monday appeared first on Skin Cancer College Australasia ..read more

Broadcasting from Bali today !   Case 1   An 80-year-old gentleman with a history of multiple NMSC. Recently he had an SCC removed from the L ear mid helix; hence, the piece missing. He asked me to look in his L concha as it had bled several times. His L ear surviving helix “has a big scab on it”;  he was worried the SCC had returned. Has it? His other concern was a recurrent scabbing area on his nasal tip that had been present for a few months. I examined his skin and found a pink patch on R outer canthus/cheek. What are your diagnoses? Ear Ear Polarised Helix Helix ..read more