Danica Tiodorovic - Clinical Cases in Dermoscopy of Skin Cancers

Clinical Cases in Dermatology

This series of concise practical guides is designed to facilitate the clinical decision-making process by reviewing a number of cases and defining the various diagnostic and management decisions open to clinicians.

Each title is illustrated and diverse in scope, enabling the reader to obtain relevant clinical information regarding both standard and unusual cases in a rapid, easy to digest format. Each focuses on one disease or patient group, and includes common cases to allow readers to know they are doing things right if they follow the case guidelines.

More information about this series at http://www.springer.com/series/10473

Clinical Cases in Dermatology

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Springer Nature Switzerland AG 2020

Danica Tiodorovic

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Danica Tiodorovic

Numerous solar lentigines and seborrheic keratosis were detected with a few pigmented nevi of regular dermoscopic features. During the examination, apart from solar lentigines on the face, which were mainly located on the forehead, a newly developing lesion was noticed on the patients face (Fig. ). The lesion was irregularly shaped, forming a triangular figure, with 0.9 cm in diameter. It had light brown coloration in the central part of the lesion, while the edges were of a slightly darker brown coloration, located on the left temporal region. The history of the lesion was unreliable as the patient did not know the time of appearance of the lesion.

Although the clinical appearance did not indicate a suspicious lesion, the dermoscopic evaluation of the lesion revealed dermoscopic features which correlated with the diagnosis of early lentigo maligna. Namely, the fine lines of a zig-zag pattern presented by incompletely formed rhomboidal structures, together with discrete rhomboidal structures were detected. Both described dermoscopic terms encompassed by the term angulated lines are pathognomonic for lentigo maligna (Fig. ).

Dermoscopy is a non-invasive diagnostic method used for early recognition of melanoma and non-melanoma skin cancers. Clinical examination nowadays implies a dermoscopic examination as an irreplaceable diagnostic tool in everyday routine, so-called dermatologic stethoscope. Depending on dermatologic expertise, dermoscopy can be a powerful tool in the early recognition of skin cancers, both melanoma, and non-melanoma ones [].

Although this book is oriented to the resolution of clinical dermoscopy cases, it intends to provide a very brief review of the most important aspects of dermoscopy.

Lentigo maligna (LM) and its invasive form named lentigo maligna melanoma (LMM) are located on the face in the majority of cases. Though there is an extra-facial variant, it is much less frequent [].

Understanding the dermoscopic presentation of lentigo maligna is of crucial importance to make an early diagnosis and consequential surgical excision on the one hand, while reducing unnecessary surgical excisions among many mimickers of lentigo maligna such as solar lentigo, seborrhoeic keratosis, pigmented actinic keratoses, and others, on the other.