A biopsy of a papule from a 23 year-old man with a 1 year history of multiple (15) painful skin-colored lesion in dermatomal distribution on his shoulder.

The consultation was requested to assess importance of mitotic activity in this lesion.

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A 70 year old white female with a history of multiple non-melanoma skin cancers presented with an erythematous 6 x 4 papule. Clinical considerations included basal cell carcinoma, persistent insect bite reaction and a lymphoid infiltrate.

The patient presented with a pigmented lesion on her right ankle in 2002, at the age of 39 years.  A biopsy showed malignant melanoma, surperficial spreading type, with an intraepidermal component.  Over the course of the next eight years she developed three additional pigmented lesions on the right lower extremity, proximal to the original lesion, which were also biopsied.  Photomicrographs of all four lesions are shown, from the most recent to the original lesion.

Middle-aged man.  Excision of back lesion.  History of hidradenoma excised from the same location.

A 31-year old woman presented with an incidentally-discovered right paravertebral retroperitoneal mass, which was well circumscribed A computed tomography-guided fine-needle biopsy was performed and  the retroperitoneal mass was subsequently excised.

Right temple lesion clinically suspicious for sebaceous carcinoma

A 60-year-old man with a lesion on the forehead which brings him in today. The lesion bled

occasionally. He has no personal or family history of skin cancer, atypical nevi, or

melanoma. When he was last seen 4 years ago he had several actinic keratoses. Efudex was

prescribed, and he did use this with good results.

Remaining exam was without significant dermatologica findings with exception of a few actinic keratoses.

ASSESSMENT:

1. Possible basal cell carcinoma on forehead.

2. Actinic keratoses.

58 year old male with erythematous papule on the forehead suspected to be basal cell carcinoma.

A 59 year-old otherwise healthy women presented with a 6 month history of slowly growing erythematous plaque on the right upper eyelid. A biopsy was performed and interpreted as squamous cell carcinoma in situ. Mohs micrographic surgery was attempted. During procedure, the surgeon realized that unlike typical squamous cell carcinoma, the tumor extensively involved conjunctiva and the clear margins could not be achieved in spite of multiple layers.

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		clinical image

50 year old man with lesion on cheek

27 year old woman with a skin colored nodule on the right shoulder.

Elderly patient.  Recurrent tumor on face.

Case for Practical Dermatopathology Update Scottsdale 4-16-2010

58 year old male with a lesion on the left middle finger.

25 year old female with irregular pigmented lesion in periclitoral area

38 year-old with slowly growing tumor on the buttocks.

46 year-old female with pigmented lesion on the leg.

46 year-female with recurrent pigmented lesion at the site of removal of a nevus.

86 year-old female presented with an erythematous papule on the right cheek. The biopsy was performed to confirm suspected basal cell carcinoma.