Dermoscopy is a visualization of cutaneous lesions with certain lights using a handheld device. The light could be polarized at different wavelengths. The visualization is done with magnification. It requires an experienced dermoscopist to distinguish nuances of skin changes. This modality is useful in determining whether atypical pigmented lesions are suspicious enough for biopsy. Dermoscopy can also help map out the periphery of melanocytic lesion prior to excision. This can predict for the patient and the surgeon what kind of margins are needed to clear the pigmented lesion.
HISTORY 53-year-old man presents with a recurrent upper eyelid induration and margin retraction for 3 months. Punch biopsy confirmed squamous cell carcinoma (SCC) recurrence. The first SCC excision with frozen sections and reconstruction was done 12-17-13 elsewhere. Subsequently, the eyelid was treated with LN2 in 2014 for surface AK. Carcinoma recurred at the lid…Read More
Peri-auricular subcutaneous lesions can be deceptive. These neoplasms have a higher risk of being non-dermal-related tumors than neoplasms of other areas of the face. Attempts at excision without consideration of a differential diagnosis can often lead to tumor compromise. Over the last several months, SCARS Center has treated several tumors previously excised partially by other…Read More
This series of photographs represents an approach to margin management of melanoma in situ. Some melanoma in situ margins are difficult to assess clinically, as is the case in our first series with extensively pigmented skin. In some settings, taking 7-9 mm margins exposes the patient to significant healing issues, as the second case shows…Read More
Ambiguous melanocytic lesions – those with histopathologic findings without a diagnostic consensus – are divided into thin and thick tumors. Thin lesions appear as dysplastic nevi and have a potential of being part of melanoma in situ or superficial spreading melanoma. We have explored diagnostic and therapeutic considerations of the thin lesions in a previous…Read More
HISTORY 64-year-old woman presents with recurrence of left ear basal cell carcinoma. She has a history of sun lamp tanning and scuba diving with multiple sun burns. Basal cell carcinoma was first removed from left scapha and treated with a skin graft in July 2009. The area subsequently developed crusting and was treated with…Read More
HISTORY 68-year-old woman presents with a many month history of squamous cell in situ of left hand. This large 2.5 cm lesion on the hand poses a unique challenge to ensuring hand function post-operatively. Treatment options include C&D (curettage and desiccation), curettage only with post-treatment imiquimod, Mohs excision with a skin graft closure, or superficial…Read More
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