Melanoma

QUESTION 53

A 51-year-old man presents to the dermatology clinic for an annual skin examination. He has no personal history of skin cancer but reports a history of multiple ‘abnormal moles’ that required removal throughout his adolescence and into early adulthood. He has a history of significant sun exposure over his lifetime and does not wear sunscreen. His family history is notable for skin cancer in his paternal grandmother. On examination, there is a red-brown slightly raised melanocytic papule with asymmetry and irregular pigmentation at the border (53a). Under dermatoscopy, the lesion demonstrates asymmetry, a scar-like depigmentation in the centre with an irregular pigment network and multiple colours (white, tan, red, brown) (53b).