Case history
Case history #1
A 36-year-old woman with Fitzpatrick type I (white) skin presents with a dark, irregular, pigmented patch that she noted 4 months ago on the right posterior calf. It has gradually increased in size. She reports approximately 6 sunburns in the past and has been using tanning beds several times yearly for the past few years. Family history is positive for melanoma in her uncle. On physical examination, approximately 15 normal-appearing nevi, ranging in size from 3 mm to 5 mm, with symmetry, uniform brown coloration, and regular borders, are noted elsewhere on the torso and extremities. The pigmented lesion on the right calf is asymmetric along 2 axes, measures 1 cm x 0.8 cm, is deeply pigmented with several shades of brown, and has a jagged border.
Case history #2
A 71-year-old man presents with a large, dark, bleeding nodule on his back. He reports it has been present and growing in size for at least 1 year, but he did not seek medical attention until now. On examination, a 2-cm ulcerated black nodule with an irregular border is present overlying the left posterior scapula. The left axillary nodes are clinically palpable.
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