September 2021 - Case of the Month
A 24-year-old woman presented with a several year history of evolving 'lumps' especially on the central chest. The lady had mild facial acne and was otherwise well.
An 87 year old woman presented with a six month history of a lesion on her nose.
There was a large ulcerated lesion with surrounding crust (upper image).
What are the differentials and treatment options? Also looking at the post-treatment appearance (lower image) what treatment do you think the patient was given?
The main differentials are a squamous cell carcinoma (SCC) or a basal cell carcinoma (BCC). Given the relatively short history for a lesion of this size, ulceration, and lack of obvious features of a BCC, then an SCC would be most likely.
The patient had been correctly referred as a 2-week wait, a biopsy was taken and histology confirmed an SCC.
Treatment options included surgical excision with grafting, or radiotherapy. The patient opted for the latter.
Although the choice of radiotherapy would usually be given as a result of MDT discussion, patients may still come and ask for advice from the GP. In order to help you understand when radiotherapy may be appropriate, as well as the pros and cons, the PCDS have created a clinical chapter on Radiotherapy of the skin.
A 24-year-old woman presented with a several year history of evolving 'lumps' especially on the central chest. The lady had mild facial acne and was otherwise well.
A 52 year old man presented with a one year history of skin lesions predominantly on his hands, ears and scalp. He was also complaining of painful swollen fingers associated with morning stiffness. There was no family history of skin or joint problem...
A 72 year old man was referred with a rash, predominantly on the legs. The patient was systemically well and the lesions were only mildly symptomatic. The lesions presented as one to several at a time lasting several weeks. They had not res...
Welcome back to the new look PCDS website, and our first case. This lady was referred as a 2-week wait with a changing lesion on the right temple.
A 15 year old lady was referred for a diagnostic opinion for skin changes presenting in birth, affecting the right upper back, shoulder, antecubital fossa and dorsal wrist. The patient was asymptomatic and otherwise well.
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