The Skin
Last updated (19 November 2003)
Good Stuff
Spot Diagnosis
Skin
Padding space 'Pigmented lesion'
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Pigmented Click on the image to download a larger version
This image is a picture of a skin lesion on a gentlemans back. Describe the lesion?

The answer

There is an ECG electrode visible over the right acromium process, and another ECG lead seen curving over the left shoulder. The patient is wearing a hospital gown, he is therefore presumably in theatre about to undergo a surgical procedure.

There is a pigmented lesion about 5 cm in diameter adjacent to the medial angle of the left scapula. The lesion appears to consist of a nodular area in the lateral aspect with the remaining lesion consisting of a numerous individual flat pigmented areas. The surrounding skin appears erythematous, perhaps due to recent removal of a dressing.

Of note

These are the cardinal features of a melanoma.

What the student may say

There is an obvious lesion over the left shoulder blade. The patient appears to be in theatre about to under go a procedure.

The lesion consists of a pigmented nodular area on the lateral side and multiple adjacent smaller pigmented areas. The lesion is irregular, assymetrical, of various colour intensities and is large. I would be quite concerned regarding the possibility of melanoma.

Adrian P. Ireland