Teaching Cases

History

This 58 year old female presented for a routine skin check, this lesion over the left biceps had been present as long as she could recall. The lesion was monitored and due for review at 3 months however the patient returned at 6 months and indicated the lesion was getting darker. The mole max comparison is shown below after 6 months with the Heine image also at 6 months review.

Question: What is your clinical diagnosis?

Answer: Difficult on this image. The history suggests a benign lesion but it is very dark and patients sometimes mislead!

Question: What is your dermatoscopic diagnosis?

Answer: The review molemax images show a change . The Heine gives more detail showing a symmetrical pimented lesion suggesting a dysplastic nevus.

Question: What do you think the histology will show?

Answer: Histology showed a severely dysplastic junctional naevus. No dermal or epidermal invasion is seen.

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