a) Clinical image
In a 68-year old patient a sharp circumscribed nearly homogeneous pigmentation (6x10mm) was visible at his left cheek. No change was noticed neither from the patient nor from his wife in the last three months. Since his retirement the patient was more in the outdoor area in the last eight years, before this time seldom.

b) Dermoscopy
Dermoscopically a typical skin of the male face is presented with partially visible follicles of hair after shaving. In the centre of the asymmetric skin lesion hair follicles clearly walled by pigmentation are visible, but not destroyed yet. In the left part beside the centre a possible beginning of destruction of one follicle is detectable. Towards the periphery the irregular and different partial pronounced lamellar pigmentation is reduced.

At the rim some chaotic arranged striae and pseudopods like structures (from 12 to 3 o'clock) are presented. In some areas the skin tumour seems to blur into the healthy skin (9 o'clock). The colours range from light brown to grey-blue to black. Concerning the differential structures no regularity is presented.

Histological diagnose
Lentigo-Maligna, no hint on a Lentigo-Maligna-Melanoma

Content and Copyright
Prof. Dr. A. Blum
Seestrasse 3a
78464 Konstanz
Germany

a.blum[at]derma.de
www.hautarzt-konstanz.de