E N D
A 48 year old man presents to you after noticing an irregularly shaped lesion on extensor surface of his left forearm. He has noticed that spot before, but it recently changed color from a light brown to a dark reddish pruple and not it seems to have been more raised than it use to be. You also note left axillarylymphandenopathy. • What is the likely diagnosis? • Malignant melanoma • What is the ‘spot’ he noticed before it changed? • Dysplastic nevus
Typical vs Dysplastic nevi • Color: evenly tan or brown, all moles look similar • vsmixture of tan, brown, and red/pink moles look different • Shape: distinct edge • vsirregular edge • Surface: flat/smooth or smooth bump • vs. Smooth, slightly scaly, rough, irregular pebbly • Size: <5mm • vs>5mm
A 48 year old man presents to you after noticing an irregularly shaped lesion on extensor surface of his left forearm. He has noticed that spot before, but it recently changed color from a light brown to a dark reddish pruple and not it seems to have been more raised than it use to be. You also note left axillarylymphandenopathy. • What are the recommended treatments? • Surgical excision along with regional lymph node dissection • Chemotherapy • IL-2 treatment for metastatic disease
A 34 year old woman presents complaining of a skin rash. The rash appears to consist of well-demarcated coral-colored plaques with silvery scales over the scalp, elbows, and knees. You discover that removing the scales results in pinpoint areas of bleeding. The patient tells that she suffers from some arthritic symptoms.
What is the most likely diagnosis? Psoriasis • Name some causes? • autoimmunity and genetics postulated • What are the treatments? • topical corticosteroids, UVB exposure, methotrexate.