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October 26, 2012 / molehunter

Suspicious pigmented nodule on face.

This 9 by 6 mm diameter nodular lesion on a midle aged white person’s face was referred as a suspected skin cancer due to recent change.

This lesion had been present for several years but recently grown, leading to urgent referral as a suspected melanoma.

 

Dermoscopy revealed the textbook features of a haemangioma.

 

Observe the red, blue and purple lacunae of blood in a fibrous stroma. These form a global feature, i.e. they fill the whole lesion. There are no features here to suggest a melanocytic lesion or basal cell cancer.

Looking at the dermoscopic view, this initially worrying deeply pigmented nodule cannot possibly be anything other than a haemangioma. Even those dermatologists who are sceptical about non-specialists using dermoscopy will agree that with a modest amount of training and study, GPs and other doctors can learn to recognise the positive diagnostic features of a haemangioma and therefore safely reassure the patient at the first consultation, avoiding the expense and worry of an urgent referral for such cases.

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