Download Diagnosis and Management of Melanoma in Clinical Practice by J. A. H. Lee (auth.), Nigel Kirkham, Dennis W. K. Cotton, PDF

By J. A. H. Lee (auth.), Nigel Kirkham, Dennis W. K. Cotton, Roger C. Lallemand, John E. White, R. David Rosin (eds.)

In the decade there was no significant medical mono- graph in this more and more universal and tough malignancy that's a killer of children. the distance within the literature is now stuffed by means of this authoritative volumewhich could be crucial studying for any physique inquisitive about the examine or administration of melanoma.

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7) Fig. 1. FRECKLE I Size <5mm Evenly distributed I Orange brown I Present since infancy Appear/ darken in sun SEBORRHOEIC WART Slightly raised surface / / LENTIGO I Sun exposed sites only I age 35 LENTIGO MALIGNA I I SUPERFICIAL SPREADING MALIGNANT MELANOMA I Dark brown JUNCTIONAL NAEVUS I Size<7 mm (usually) No recent increase in \ diameter ~:ePfg~35\ Size> 7 mm (slightly raised) Irregular outline and \ colour Elderly> 20 mm sun exposed sites long history / / Gradual increase in diameter ______ I Size I I 2-10 Light brown cm ~~~::rs age 10 CAFE AU LAIT PATCH / No change in sun one/few lesions _ _ _ _ _ _ _ _ _ _ _ _______________ fixed in site ~~~rear ______ Surface never raised No recent i~crease in " diameter "- / Appear after birth - all lesions < 3 cm diameter Non-erythematous lesions Normal/smooth surface Macules and patches Brown colour t!

Dermatofibromas are often rather firm, slower growing lesions than nodular melanomas and the bulk of the lesion will be under the skin surface. Acral or Acral lentiginous Melanoma The acral or acrallentiginous melanoma is usually found on the soles of the feet, and in our Scottish series eight times as many lesions are found on this site as on the hands. The early lesion has a similar lentiginous spreading pattern to that of lentigo maligna, but over a period of months a raised invasive component develops, usually centrally (Fig.

Sometimes scaling is not present and the lesion exists as a fixed pink or brown macule. The diagnosis should not be difficult as nothing else produces such rough scaling on sun-exposed skin in elderly patients. Seborrhoeic warts occur in similar patients, but never have the same rough feel to palpation, and are generally seen more easily than felt. Bowen's Disease This is an intraepidermal squamous cell carcinoma. It looks just like a plaque of psoriasis or eczema, but gradually expands in size over many years and does not respond to topical steroids.

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