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October 21, 2015 / molehunter

seborrhoeic keratosis on head

People worry about melanoma skin cancer. Fair enough, it kills 6 people a day in Britain and can usually be cured by early detection.

This older white person presented concerning a pigmented lesion. Could it be a melanoma?

bland seb k forehead (2)

Not very alarming, but there is some mixed colour and it’s non-symmetrical and over 6mm so scores 3 on the ABCD rule. Lets dermoscope it-after all, if we have had some training and the scope is on our desk, it don’t cost nothing.’

Click on the image to enlarge

bland seb k forehead (1)

How many colours? Only brown, albeit a darker shade at the bottom right. The main structure is cerebriform (curved, parallel, broad lines) but note that where the lesion is darker, it is thicker and starting to lose the cerebriform structure. As I mentioned on the last case posted, the true cerebriform appearance is only seen in thin, early seb ks; it is gradually replaced by thicker structures as layers of keratin make it grow thicker. This change can be seen here.

Utterly harmless. The experienced dermoscopist only needs 2 seconds to dispel all fear about this lesion, saving the patient a trip to the hospital and 2 weeks of worry.

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