67 years old, female. Hyperchromic lesion with superficial d | Figure 1

ReginaldoCastro
Internal Medicine

67 years old, female.
Hyperchromic lesion with superficial desquamation in distal 1/3 of the left forearm. Itching for 30 days. She works as a seamstress.

Diagnosis?

The author made an update to this case

Update 1 Melanoma (including nodular form on pre-existing nevus)
Pigmented, asymmetrical lesion, with two shades (brown background and purplish/erythematous central area), descaly surface and recent symptom change (started to itch), all this in elderly patient and in photoexposed area, is compatible with melanoma that can arise on previous nevus or lentigo.

Pigmented / inflamed basal cell carcinoma
In the elderly, CBC can present as a nodule or pigmented plaque, dark brown to violet, sometimes with crusts or peeling, often itchy; it can be confused with melanoma in nodular phase.

Seborrheic keratosis irritated / inflamed (less likely, but possible)
Seborrhoeic keratoses are very common in the elderly and can inflame, becoming pinkish or reddish, itchy and with a scaly surface, which can mimic melanoma or carcinoma; however, the purplish coloration and the solid nodular appearance leave the malignant hypothesis in greater evidence.

Diagnosis Added

Basal Cell Carcinoma Pigmented

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