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June 24, 2012 / molehunter

A questionable lesion on the neck

This greyish lesion with a history of recent change quite reasonably caused concern. The colours are mixed with some erythema and its an irregular shape. You can’t just ignore it. But before reaching for the scalpel, I reach for the dermoscope.

There are half a dozen milia like cysts mainly along the upper border. The global feature of looped vessels in halos is harder to see because of recent trauma and inflammation. These traumatised warts can be worrying.

Dermoscopy shows looped vessels in halos as a global feature, with a few areas of inflamation and/or ulceration or trauma. There are also several milia like cysts along the upper border. A tricky case for the beginner, but I was certain this was a traumatised seborrhoiec keratosis and so histology proved. Formal excision of the lesion with a 4mm margin would have been a lot more trouble at this site, the dermoscope in trained hands allowed a much less invasive procedure with no risk of hitting any blood vessels or nerves.

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