Description: Dermoscopy image - There are peripheral brown clods and a central structureless zone. There is arguably a "maroon-white" veil but there are no convincing melanoma clues. This lesion was unusual. I assessed it as having 2 patterns and 3 colours (brown, red, white) and although there were no melanoma clues I could not make a confident specific benign diagnosis.

History:

This young lady had a borderline level 1 melanoma excised from her forearm at age 12. This scalp lesion was encountered at a routine skin examination and on specific questioning the patient believed that it had changed recently. Being on hair-protected scalp on a young person this was an unlikely site for a melanoma but with her past history and a history of change the lesion was excised. Histology was reported by David Weedon:-

"Sections show a level 2 (0.5mm thick) superficial spreading melanoma.
There is no ulceration or dermal mitoses. There is a mild lymphocytic
infiltrate with focal old regression only. The excisions appears
complete with lateral clearances of 1.6mm."

The histology slide has been sent to Harald Kittler. I will add his assessment here when he has reviewed the slide and he will also provide images of that slide which I will add to this posting.