Stage IV Angiosarcoma of the scalp. | Figure 1

Stage IV Angiosarcoma of the scalp.

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Looks for some guidance/advice on this lesion.. 34 yo male with HX of htn, paroxysmal AFib, OSA w/CPAP, and depression. They noticed this dark spot on the ventral aspect of the L great toe ~2 months ago. They have been monitoring it thinking it was a bruise but has not changed. No known injuries/trauma. The first photo is a collage of the left image from around two months ago and the right side shows current. I have also attached a dermatoscopic image as well as a furrow ink test image. It is asymptomatic. He has no other known history with cancers. I am I wonder about an acral nevus but concerned about is being an acral melanoma with the pigment looking to run parallel along the ridges. Likely will have biopsied. Just wondering what the community thinks about the images. If it is melanoma and it's at least 2 months old (could be a bit older but didn't notice it), is there much risk for metastasis? Thanks!

Massive metastasis of melanotic melanoma in the duodenum, ileum and part of the ascending colon in a patient operated on a few years earlier for advanced vulvar melanoma (Breslow thickness: 4.5 mm, Clark level: V).

60s yo female adm for mechanical fall w headache. 2 months previously dx and treated for lung cancer. Deconjugate gaze, and poor cerebellar function, dysarthric. Multiple supra and infratentorial sub centimeter lesions. Larges lesion was right cerebellar w mass effect on 4th ventricle. Extensive conversation w pt and family, they requested surgery. Path c/w metastatic small cell carcinoma. Post op cerebellar function improved, and participated well w therapy. Ultimately passed 3 weeks after resection due to pulmonary detoriation and family desire for hospice.

A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis. He had a history of hypertension, long-term smoking, and a sedentary lifestyle. On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.

A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets. Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.

A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.

patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this ekg that would warrant further work-up or is this just a pediatric ekg?