Case #14 Discussion

Summary: This is a localized pigmented surface lesion Lesions to Exclude from Differential Diagnosis: Intravascular blood lesions   ~Blanch upon pressure   ~Color – red, blue or purple Extravasated blood lesions   ~Red, Blue or Purple, not brown Ephelis   ~Flat and not thickened   ~Occurs only on sun-exposed skin Oral Melanotic Macule   ~Flat and not thickened Lesions to Include in the Differential Diagnosis: Nevus Melanoma Tattoo from pencil lead Management: Excisional biopsy is indicated for any lesion in which nevus or melanoma are included in the differential diagnosis.  Explain the differential diagnosis to the patient and parents and the indications for biopsy.  Melanoma in a child is rare but must still be considered. Final Diagnosis: Nevus