|Skin Cancer Doctors Ltd - Whangarei||
This lesion (shown in two pictures) is 10 cm in diameter and has been present on a man's ankle for many years. It has been treated as Dermatitis. Biopsies confirm this to be a superficial Squamous Cell Carcinoma.
This lesion is a raised firm nodule with branched and serpentine blood vessels coursing over it an is likely to be a nodular BCC.
This next picture is how we dealt with the lesion above. We could have done a graft however the only place to harvest sufficient non hair bearing skin was behind the ear or above the clavicle. On the nose it would be quite obvious that the skin was different so a bilobe flap repair is a better option.
Next picture shows the edges for those having difficulty seeing the BCC
This lesion is on the scalp of a 44 yr old lady. There is a blue/gray clod with scattered chaotic pigment and some radial lines at 5 o'clock. This is a suspicious lesion and needed to be removed. The report came back as a Blue Nevus which fortunately is of no concern
Central white clods from a keratin plug. This rpaidly growing lesion is likely to be a Keratoacanthoma but could also be a Squamous Cell Carcinoma
This lesion is on the lower leg and the white lines show the SCC extending well out to the edge of the picture. This one will require a large excision
SCC on the forearm. The bubbles in the picture are from the gel that is applied to allow better visualisation of the blood vessels
This 62 yr old lady came to see me a few weeks after a pigmented lesion on her face had been treated with cryotherapy. From 10 o'clock around to 5 o'clock, you can see a grey area of pigmentation. This creates a diagnostic problem from the point of view of a dermatoscopist. Grey pigment is in the dermis and therefore it has the potential to be abnormal and can indicate the development of a melanoma. In this case the grey pigment is uniform and without chaos the chances of a melanoma are small. I chose to leave the lesion and check it again in three months and the picture below was taken three months. later
Now you can see the final result after healing.
The next picture shows more detail
The main area of interest here is from 1 o'clock to 3 o'clock where you can see a uniform arrangement of pigment that has been taken up by macrophages in the process of repair. This is normal. The original lesion is a Solar Lentigo and where you see regression like I have described above it is called Lichen Planus Like Keratosis (LPLK). Regression can occur either as a result of cryotherapy like in this case or as a normal autoimmune response where ones own immune system tries to remove the lesion.
This lesion on the back of a lady looks clinically like a Seborrheic Keratosis and the dermoscopy picture also suggests that when looking at the lower edges. A closer look reveals some lines of pigment dots and also dot blood vessels making this likely to be a Pigmented Intraepidermal Carcinoma which is what the report has confirmed. Below is the closer view of the pigment.
Same lesion as above - Pigment lines present in the centre of the picture
The pigment in this lesion is arranged in a random pattern of small dark brown clods and this is more likely to be seen in a Pigmented Basal Cell Carcinoma. Once again, that is the diagnosis
You will note that it is symmetrical compared to skin cancers which generally are erratic in structure. There is central crusting with surrounding erythema from the increased vascular activity. This man had numerous lesions like this that indicates a systemic cause. In his case the Dermatitis had been induced by work stress.
This lesion is on the face of a man who had surgery performed by his GP only some weeks ago. It has returned and is growing very rapidly. He was referred to the hospital and would have had to wait at least two months to have it removed.
Anyone who is having treatment for Leukemia like this man is, should have very regular skin checks and lesions such as these need to be removed urgently. There is a very high risk that growths of this nature will spread to lymph nodes and eventually causing the patients demise. Two months wait for surgery is two months too long.
Lip BCC on a sailor
Histology Macronodular Basal Cell Carcinoma
This lesion is in the central back of a lady. It has a shiny surface over a cystic lesion. Both the serpentive blood vessels and the pattern of the pigmentation suggests that it is a Basal Cell Carcinoma BCC
This man has been a heavy smoker for many years. The white thickening is scarring from the smoking and there is early Leukoplakia within this scarred area that requires close followup as it can easily change to become and squamous cell carcinoma. Clear message - DO NOT SMOKE as it increases the incidence of ALL cancers.
Man in his fifties with this sore on his forehead that has been present for at least 12 months. This lesion is 2 cm across and will require a flap procedure to close the defect.
Clear message - any skin that doesn't heal within a month needs to be presumed to be a skin cancer unless proved otherwise
Typical serpentine blood vessels indicating that this lesion is likely to be a Basal Cell Carcinoma
Anyone who is enthused by looking at skin lesions is welcome on this blog. My aim is that we all learn from each other.