Cas du mois dermatoscopique
Vous retrouverez ici un nouveau cas intéressant tous les mois!
Follow-up of a severe dysplastic melanocytic nevus or a melanoma in-situ
At the left buttock of a 30-year-old female patient a distinct asymmetric tumour was visible with an asymmetry of the differential structures in the centre: irregular distribution of the homogenous, but different coloured pigmentation with different brownish shades and in the centre distinct greyish veil. Noticeable were the pint point vessels, most of them in the centre but not homogenous distributed.
The patient did not notice any change. She was skin type II, more than 300 small and larger, non suspicious nevi in clinic and dermoscopy (FotoFinder, 20fold magnification). Her history was: 2003 melanoma (0.32mm) on her right foot, 2004 sarcoma on her left foot and 2005 lung cancer.
Three months later a re-image was taken: Dermoscopically an increase of the central asymmetry and the lower part of the tumour was visible. The greyish veil in centre increased, also the variety of the differential structures. More globules were detectable ? however the vessels seemed to concentrate more to the centre, but with an increase of different vessel lumen (FotoFinder, 20fold magnification).
Histology
Severe dysplastic melanocytic nevus
Remarks
In the indication of follow-up images these should be taken within three months. In this time period trend-setting changes of the tumour are clear visible (the lentigo maligna could be an exception here) and help to make a good decision for the patient.
References
1. Altamura D, Avramidis M, Menzies SW (2008) Assessment of the optimal interval for and sensitivity of short-term sequential digital dermoscopy monitoring for the diagnosis of melanoma. Arch Dermatol 144:502-506
2. Menzies SW, Kreusch J, Byth K et al. (2008) Dermoscopic evaluation of amelanotic and hypomelanotic Melanoma. Arch Dermatol 144:1120-1127
Prof. Dr. A. Blum
Seestrasse 3a
78464 Konstanz
Alemagne