Dermatology
Case 2: A Patient with A Pigmented Lesion on Her Arm
CASE
A 27‐year‐old national oarswoman attends with a new changing pigmented lesion on her left forearm. She says she is ‘moley’ but that this lesion is definitely new (6/12) and she thinks she recalls an insect bite. It has grown, become red then slightly brown black then lighter in the centre and bled. She is otherwise well and taking no medication and there is no relevant personal or family history (although she says all of her family are ‘moley’, especially on her mother's side and she says that an aunt died of a brain tumour).
On examination she is well‐built, fair, blue‐eyed and tanned where sun exposed (female rowing vest and shorts). There are numerous naevi, of different sizes, shapes and colours, widely distributed including affecting the scalp and scalp margin, buttocks and feet. She had iris lentigines. The presenting lesion is about 4 mm × 5 mm but very irregular of edge and pigment being black at the margins and red in the centre with the hint of erosion towards the centre which is just slightly elevated. There is an infected blister on the left hand and a 1 cm palpable lymph node in the left axilla. There is no organomegaly or other abnormal physical signs.
QUESTION 1
Your score this session: 0 of 0
The patient needs: