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Would you be concerned about this lesion

Discussion in 'General Issues and Discussion Forum' started by David Smith, Jun 19, 2013.

  1. David Smith

    David Smith Well-Known Member

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    67 year old lady - The pic shows a lesion that originally was the result of surgery to remove what the patient reported as a melanoma. She has had less invasive surgery to remove several other moles and skin lesions. The skin is indurated and tethered as you can probably see from the pic. At her regular chiropody appointment today I thought this has become larger in diameter and deeper. However she thought it had not changed and two weeks ago she saw her practice nurse for inspection of other lesions and she was not concerned about this one. I will monitor and review at next.
    What do you think?

  2. lucycool

    lucycool Active Member

    Is that scar tissue? How old is it? Was she your client when the melanoma was present? ie do you know the original size of it? If its getting bigger/deeper, I would get it checked out.. but Im over cautious when it comes to these things!

  3. LuckyLisfranc

    LuckyLisfranc Well-Known Member

    Looks like a normal skin graft. What's the time frame since it was done?

    If there has been previous melanoma excision, then follow up is prudent, if not essential.

    I would imagine the surgeon who removed the lesion would have the patient on a follow up plan, and providing the lesion was successful removed in full, then there should be a low risk of further problems.

    That being said, surgical scars and graft sites are not immune from malignant transformation either. A skin cancer colleague recently informed me of one of his cases of BCC developing within a site of full thickness burn.

  4. Lab Guy

    Lab Guy Well-Known Member

    Hi David,

    I am sure you know this but it appears the surgeon did a good job in completely removing the melanoma by going beyond the boundaries as well as going deep by removing the full thickness of the skin along with some of the underlying subcutaneous tissue with subsequent application of a graft.

    I think what is possibly occurring is that the underlying fascia/laciniate ligament (if i am viewing the photo correctly) is adhering to the under surface of the graft pulling it inward below the surface of the surrounding skin. Tension within the graft has caused scarring seen from the irregular thicken areas. When you try to digitilize the area from side to side you should be able to feel it being adhesed to the underlying fascia and not freely movable.

    Biopsy is always the answer to be sure it is only scar tissue and I would recommend the surgeon seeing the patient or the photo to get his insight.

    I would keep the area protected and keep any swelling down to a minimum to prevent an ulceration.

    Good luck

  5. David Smith

    David Smith Well-Known Member

    ok thanks all

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