Part 2 book “Surgery - A case based clinical review” has contents: Newborn with bilious emesis, infant with bilious emesis, infant with nonbilious emesis, excessive drooling in a newborn, postoperative bleeding, postoperative decreased urine output , abdominal pain following motor vehicle accident, penetrating abdominal trauma, and other contents. | Part XI Skin Christian de Virgilio, Section Editor Recently Changed Skin Lesion 36 Arezou Tory Yaghoubian and Junko Ozao-Choy A 44-year-old fair-skinned Caucasian male who works as a lifeguard presents with a 1-cm pigmented skin lesion on the right forearm that has recently become variegated and larger in diameter. The patient denies itching, oozing, or bleeding associated with the lesion. He has a history of severe blistering childhood sunburns. The lesion is slightly elevated, asymmetric with ill-defined borders. There is no evidence of bleeding, ulceration, or excoriation. There are no satellite lesions or in-transit metastasis seen. Examination of the patient’s right axilla and neck reveals no obvious lymphadenopathy. No other skin lesions are identified on physical examination. . Yaghoubian, MD Plastic and Reconstructive Surgery, UCLA, 200 UCLA Medical Plaza, Los Angeles, CA 90095, USA e-mail: ayaghoub@ J. Ozao-Choy, MD (*) Division of Surgical Oncology, Harbor-UCLA Medical Center, 1000 W. Carson Street, Box 25, Torrance, CA 90509, USA e-mail: jozao-choy@ C. de Virgilio (ed.), Surgery: A Case Based Clinical Review, DOI , © Springer Science+Business Media New York 2015 367 368 . Yaghoubian and J. Ozao-Choy Diagnosis What is the Differential Diagnosis and What Clues on History and Physical Examination Might Direct You Towards Specific Diagnoses? Diagnosis Junctional nevi Malignant? Comments No Dark, flat, smooth lesions. They are occasionally hairy and develop from the basal layer of epidermis. Nevi that are located on the palms and soles are usually junctional. They are benign lesions with a very low risk of malignant degeneration. Most common mole of children, No Brown to black, well-circumscribed lesions that are 6 mm Evolution (changing lesion) Is the lesion round and symmetric or does it look asymmetric? Do the borders of the lesion seem smooth and circumscribed or are they jagged and .
