Raised
Skin & Subcutaneous Tissue
0
{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/P16_F1.jpg"}},{"insert":"\n\n"},{"insert":"So far, so good - it has been a busy morning at your family practice.\r\n\r\nYour next patient is 12-year-old Simon, accompanied by his mother, Peggy. You greet them with a smile.\n"}]}
1
{"ops":[{"insert":"\u0022Doctor, Simon has a strange mole on his right sole. I first noticed it a couple of months ago, and I think it\u0027s become bigger over time,\u0022 she says.\r\n\r\nYou ask a few questions, and find out that Simon is asymptomatic and completely healthy. His family history is unremarkable.\r\n\r\nYou proceed to the physical examination.\n"}]}
2
{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/P16_F3.jpg"}},{"insert":"\n\n"},{"insert":"Simon is a caucasian child with fair skin.\r\n\r\nYou immediately note an intensely-black dome-shaped maculopapular lesion over the right plantar region, measuring ~1 cm in diameter, with regular margins.\n\nInstead of stopping there, you proceed to do a complete skin assessment. This reveals a brown macule over the left thigh, with a maximum diameter of ~3.8 cm; its margins are irregular, but well-defined.\r\n\r\nPeggy notices your scrutiny. \u0022Oh, he\u0027s had that since he was a baby,\u0022 she says.\r\n\r\nThe remainder of the examination is unremarkable.\n"}]}
3
{"ops":[{"insert":"What do you think Simon has?\n"}]}
1. A Spitzoid melanocytic lesion and congenital melanocytic nevus
2. A Spitz tumor and congenital melanocytic nevus
3. A Spitzoid malignant melanoma and congenital melanocytic nevus
6
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5
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4
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