Another harmless ugly duckling
The ‘ugly duckling’ sign is very useful for spotting melanomas. Basically, any mole that looks significantly different to someone’s other moles, whether through unusual size, shape or colours, deserves a closer look.
However, many ugly ducklings are harmless. The dermoscope can be very useful for acquitting suspicious but harmless lesions.
Here we see a middle aged white male (sorry I cannot edit this wrongly angled picture, its the software) several pigmented lesions, and one by the right shoulder which is bigger than the others. Let’s take a closer look to see if the concern was justified.
Not looking so worrying. The shape is wonky but the border very smooth and several cream coloured round areas can be seen. Dermoscopy clarified further.
The cream coloured circles are milia like cysts, pointing to a seborrhoeic keratosis. These harmless lesions which are increasingly common past the age of 50 are the skin lesions most often suspected of being melanomas. In fact, many dermatologists will say that up to half of the suspected skin cancers’ referred to them urgently as possible melanomas are seborrhoiec keratoses.
If the only thing the dermoscope could ever do was eliminate these harmless ugly ducklings from enquiries at teh first consultation, they would be well worth using in every GP surgery.