Derma Case: 38-year-old Woman with a Mole on Her Left Leg

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.