Diagnosis: Cutaneous melanoma
Case submitted by dermRounds Dermatology Network to the dermRounds community.
Clinical photograph(s) submitted for peer review and discussion.
Submitted by dermRounds Dermatology Network. Originally posted June 21, 2008.
See case discussion.
• Dysplastic (atypical) nevus • Seborrheic keratosis • Blue nevus • Pigmented basal cell carcinoma • Pigmented dermatofibroma • Thrombosed hemangioma • Solar lentigo
• ABCDE criteria: Asymmetry, Border irregularity, Color variation, Diameter >6mm, Evolving • "Ugly duckling sign" — the lesion that looks different from the patient's other moles • Breslow thickness is the single most important prognostic factor • Sentinel lymph node biopsy recommended for lesions ≥0.8mm or with ulceration • Subtypes: superficial spreading (most common), nodular, lentigo maligna, acral lentiginous • Acral lentiginous melanoma: most common type in dark-skinned individuals — check palms, soles, nails • Hutchinson sign in subungual melanoma: pigment extending to nail fold • Immunotherapy (anti-PD-1, anti-CTLA-4) and targeted therapy (BRAF/MEK inhibitors) revolutionized treatment of advanced melanoma
Tags: cutaneous, melanoma, dermrounds dermatology network