Skin neoplasms — Clinical Case (Wikimedia Commons)

Diagnosis: Skin neoplasms

Title Crusty Skin Lump Description A lump that bleeds or develops a crust may indicate skin cancer. Topics/Categories Cancer Types, Skin Cancer Cells or Tissue, Abnormal Cells or Tissue Type Color, . Clinical photograph sourced from Wikimedia Commons (Public domain). Attribution: Unknown photographer.

Clinical Presentation

Varies widely: waxy papules with telangiectasia (BCC), keratotic nodules (SCC), asymmetric pigmented lesions (melanoma), stuck-on papules (seborrheic keratosis). ABCDE criteria screen for melanoma.

Clinical History

UV exposure history, history of sunburns, prior skin cancers, immunosuppression, family history of skin cancer, exposure to arsenic or radiation. Organ transplant recipients at markedly increased risk.

Treatment

Benign: observation, cryotherapy, excision if symptomatic. BCC/SCC: Mohs surgery, standard excision, radiation. Melanoma: wide local excision with sentinel node biopsy. Advanced: immunotherapy (pembrolizumab, nivolumab), targeted therapy.

Differential Diagnosis

Basal cell carcinoma, Squamous cell carcinoma, Melanoma, Seborrheic keratosis, Actinic keratosis, Keratoacanthoma, Merkel cell carcinoma

Key Learnings

The ABCDE criteria for melanoma screening: Asymmetry, Border irregularity, Color variation, Diameter >6mm, Evolution. Dermoscopy improves diagnostic accuracy by 20-30%. Regular total body skin exams are essential for high-risk patients.

Tags: neoplasm, skin cancer, tumor, oncology