00:02
Today, we're going to talk about
dysplastic and malignant skin lesions.
00:07
First off,
let's go into a case.
00:09
So, a 38-year-old woman with no
significant past medical history
presents with a mole
on her left leg.
00:15
She notes that she has
always had a mole there
but it seems to have enlarged steadily
over the past six months.
00:21
No weight loss, no night sweats.
The lesion is somewhat itchy.
00:26
She said she's
a nonsmoker.
00:28
She recalls at least
three severe sunburns
that she's experienced
as a teenager.
00:33
She plays tennis avidly
for the past 20 years
and review of systems
is negative.
00:38
Initial vitals are afebrile.
Vital signs are stable.
00:42
Now, before I describe
the skin exam
it's important for you
to develop
some lingo and
correct terminology
for how to describe
skin lesions.
00:51
So, why don't you give it
your own shot?
How would you describe
the skin lesion
that you're seeing
illustrated here?
I would describe
the skin exam as follows.
01:00
This is a patient
with fair complexion.
01:02
What we're not seeing
at the moment is that
there are numerous subcentimeter
hyperpigmented macules
distributed over
sun exposed-areas.
01:10
But this lesion is on
the left lateral foreleg.
01:13
It’s 4x3 centimeters in size.
01:15
It’s a hyperpigmented macule
with heterogenous color and texture
and an irregular border,
without any evidence of scale.
01:25
Based on the information
we have so far
which of the following
is the most likely diagnosis?
Well, since this is a topic on
dysplastic and malignant skin lesions
I'm sure we're going to
talk about melanoma.
01:37
But let's start off by just taking a look
at tinea corporis first.