Merkel Cell Carcinoma
Merkel cell carcinoma. A barely noticeable 6-mm slightly dermal nodule below the hairline that had been present for about 6 weeks. Preauricular lymph node metastasis was also present.
Squamous Cell Carcinoma with Central Hyperkeratosis
Squamous cell carcinoma. A round nodule with central hyperkeratosis, firm and indolent. This lesion cannot be distinguished clinically from keratoacanthoma; it is easily distinguished from nodular BCC because BCC does not develop hyperkeratosis.
Basal Cell Carcinoma: Advanced Nodular BCC
Basal cell carcinoma. This is a farther advanced nodular BCC. A solitary, shiny, nodule with large telangiectatic vessels on the ala nasi, arising on skin with dermatoheliosis.
Malignant melanoma. Less than 2 percent of all melanomas occur during childhood. Nonetheless, attention must be paid to signs and symptoms suggestive of this potentially fatal disease. Variegations of color are of particular concern. Irregular or notched borders, bleeding, and ulceration are other signs of malignant change. The patient may give a history of itching, and the parents may have noted rapid growth of the lesion. Because the prognosis of a melanoma is most closely related to the thickness of the lesion at the time of treatment, emphasis should be on early diagnosis.
Lentigo Maligna Melanoma
Lentigo maligna melanoma. A large lentigo maligna on the left cheek with the typical variegation in color. The lesion is flat, macular, and represents in situ melanoma. In the center of the irregular lesion there is a pitch-black nodule indicating a switch from the radial to the vertical growth phase and thus invasiveness: the lesion is now called lentigo maligna melanoma.
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