Can you identify these 4 lesions seen in a primary care setting? Should biopsy be performed on any? All? Test your visual diagnostic skills.
A Lump, Two Bumps, and One Odd Pigmentation
This lesion on an older man’s ear
was an incidental finding; it had been present for years and similar lesions were common in his mother’s family. Is this lentigo, ephelides, melisma, or malignant melanoma?
Answer: A. Lentigo, scaphoid fossa (fossa helicis).
Diagnosis was made by the lesion's appearance and the clinical setting. Obtaining tissue for pathologic microscopy should always be considered but was deemed unnecessary in this case.
This 0.5cm skin colored lesion
at the top midline of a 17-yo female's head has always been present but had recently enlarged. Does this look like amelanocytic intradermal nevus, amelanocytic melanoma, simple wart, or melanocytic intradermal nevus?
Answer: A. Amelanocytic intradermal nevus.
The lesion was shave removed in the office via electrocoagulation of the base. Examination of biopsy specimen confirmed diagnosis.
( A ) 1-cm broad-based nodular submucosal right buccal lesion
began to enlarge after wisdom tooth extraction in a 31-yo woman.
( B ) Solid white 1.5x0.5x0.5 lesion
at left posterior edge of a 55-yo man’s tongue; developed 12 years earlier after trauma to tongue.
Which one(s) is/are the fibroma(s), if any?
The pathological diagnoses were: pink lesion ( A ) submucosal buccal fibroma; white lesion ( B ) benign fibroma.
Have a look at these 4 lesions seen in a primary care setting. Would any concern you? Which would you consider for biopsy? Test your visual diagnostic skills with a short quiz.
