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#1
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07-11-2014, 10:08 PM
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The Devil's Birthmark
A 50-year-old woman presented to the emergency department, reporting 1 day of bleeding from a lesion on her back (Figure), which had been present since birth and progressively increased in size. The lesion had become painful and swollen during the past 2 weeks, without associated pruritus, trauma, or constitutional symptoms. Physical examination revealed a 20×15-cm midback lesion with many multicolored proliferative nodules of varying size, without active bleeding, ulceration, or purulence. Diagnosis Congenital melanocytic nevus Large or giant congenital melanocytic nevi affect about 1 in 20,000 births and may be disfiguring. Superinfection resulting in sudden swelling, discharge, pain, or ulceration is the most common complication. Malignant transformation into melanoma is the most common life-threatening complication and occurs in 5% to 8% of cases. Half of these malignant transformations develop by age 5. Rarely, neurocutaneous melanocytosis, which includes leptomeningeal melanosis and central nervous system proliferation of melanocytes, may develop. Individuals with a congenital melanocytic nevus in the posterior axial location and more than 20 satellite nevi have a 5-fold increased risk for neurocutaneous melanocytosis. Acceptable treatment options include close observation or surgical excision. Surgical management often requires staged surgeries, skin grafting, or tissue expanders. Our patient received a diagnosis of a superinfected congenital melanocytic nevus and was treated with oral doxycycline, chlorhexidine gluconate washes, and topical mupirocin ointment. The suspected superinfection resolved 2 weeks later. Because the lesion had not exhibited recent malignant behavior, the consulting dermatologist opted for conservative management of serial photography and examinations with low threshold for future lesion biopsy. |
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#2
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07-11-2014, 10:17 PM
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Re: The Devil's Birthmark
WTF "which had been present since birth and progressively increased in size." OMG...that is disgusting! She is 50 years old...I would have had that thing removed 49 years ago! |
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#5
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07-13-2014, 06:27 AM
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| ★ Legacy Member ★ Poster Rank:366 Join Date: Jan 2013 Posts: 3,209 Mentioned: 2 Post(s) Quoted: 288 Post(s)
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Re: The Devil's Birthmark
looks like a usgs topographical map of somewhere i dont want to go fuck me
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