28 y/o male with family hx of skin cancer presented to the E | Figure 1

28 y/o male with family hx of skin cancer presented to the ED anxious about lesions on his back and side. Patient stated he has an appointment with dermatology in two weeks but couldn't wait. All the ED doc told the patient was that he couldn't do anything about it and to make sure he made it to his appointment. Discharged with the dx of possible malignancy of the skin. Do these look malignant to anyone else?

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Parent brings 6 mo old in for new onset mass with thick dark hair overlaying area of the mass on his right upper arm. He was in for his well visit about 2 to 3 weeks ago and it wasn’t there at that time. Mom states she noticed the lump a few days ago… It is not tender but has a definite lump about the size of a grape, maybe a little smaller, and has dark thick hair over it. It’s is Not erythematous or fluctuant. He is Afebrile, eating and drinking well, making diapers well and sleeping well. UTD on shots. No known injury. Looking for some ideas on a differential and if/where I should refer? my first thoughts were dermis cyst of nevus hypertricosis... but the mass appears to be fixed and pulling on the skin, so want to refer for appropriate management. Any help appreciated!

27 yo healthy male presented to the family medicine clinic with new skin lesion that developed on his 4th digit of his right hand. He first noticed this lesion around one month prior. Denies any trauma to the area. He originally thought it was “dirt”, but it did not come off with cleaning. The lesion is not painful and does not itch. On exam the lesion is flat with the skin, and appears as flat brown macules. What could this be? DDX? Attending in the clinic thought maybe solar lentigo vs new Nevis, but would need biopsy to rule out malignancy such as possible superficial spreading melanoma. Patient was sent to Dermatology for further evaluation.

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derm question: what is this? Patient states she has had birthmark since she was born. She is now an adult and it takes up one side of abdomen. Her mother always told her that it was "a piece of dried skin that didn't come off" and grew with her. It hasn't grown since her teens. Should she be concerned about malignancy at some point? Should she have it removed?

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