Limited Lesion Review Averts Need For Time Off Work
A 21 year old professional ballet dancer presented for a routine digital skin check.
BEFORE THE SKIN CHECK
An existing lesion on her left great toe had developed irregular features, and some discussion followed about the best way for this to be managed.
AVAILABLE OPTIONS
The available options were to monitor the lesion, or to remove it.
If the lesion was to be excised - given the patient’s occupation - this would mean a period of up to a month off work to allow the skin of her toe to heal tightly enough to allow her to recommence ballet dancing. She had recently commenced a season as the Prima Ballerina at a well-known dance company in a high-budget production and was reluctant to take time off.
LESS DYSPLASIA LESS RELIABLE DIAGNOSIS
There is usually no option to perform punch biopsies on pigmented lesions of this nature as the amount of change (Dysplasia) across such lesions can vary enormously - and a biopsy may therefore be misleading if the area biopsied has less Dysplasia. The only reliable method to reliably diagnose such lesions is excisional biopsy where the whole lesion is removed and sent for analysis.
MELANOMA RISKS
If the lesion was in fact a Melanoma and were not removed in time this could ultimately lead to surgical removal of the whole toe ending the patient’s dancing career, and may lead to other complications, including death.
DIGITAL LIMITED LESION REVIEW
After an extended discussion the patient elected to return in 2-3 months for a Digital Limited Lesion Review. In approximately 30 seconds, without the need for an appointment, the lesion was re-imaged by our Melanographers and the image assessed for any significant change compared to the images on file by Dr Donnellan.
REVIEW FOUND NO SIGNIFICANT CHANGE
The patient was contacted with the results of that review same day as part of a digital service known as a Limited Lesion Review. As a result of this process it was decided that no significant change had occurred in the mole in question and so surgery was thought to be unnecessary.
The patient was able to continue with her dancing and her production enjoyed a record-breaking season.
