In a 31-year-old female patient a new, rapidly growing pigmented skin tumour (3x3mm) appeared on her left upper leg (marker 3). She had skin type II, more than 100 small and larger non suspicious nevi, but the history of a melanoma in her own history (SSM, tumour thickness 0.45mm, Level II, upper leg left, July 1997).

In dermoscopy an asymmetric pigmented tumour with different sizes of ridges is visible. Pseudopods are seen at 3, 6, 7-8 and 9 o'clock. No regular network is presented. In total the tumour has dark brown till black, really clear colours. In the lower part of the centre a slight veil seems to develop (FotoFinder, 20fold magnification).

Histological diagnose
Severe dysplastic nevus

Remarks
Important is the hint of the patient who is checking herself regularly and who noticed the new appearance and growing.

Reference
Blum A, Hofmann-Wellenhof R, Luedtke H, Ellwanger U, Steins A, Roehm S, Garbe C, Soyer HP (2004) Value of the clinical history for different users of dermoscopy compared with results of digital analysis. J Eur Acad Dermatol Venereol 18: 665-669.

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

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