Case Study - Dysplastic Naevus Syndrome

Pre-Cancerous Lesions Due To UV Exposure

A 33 year old roofer and regular surfer presented for his second check after a period of some 8 years, despite advice he required checks every 6 months at the time of his first check with us.

He is very fair skinned, has red hair, Celtic origins, burns easily, has a huge number of freckles over all sun exposed areas, and a very large number of ‘funny-looking’ moles all over his body.

Full Body Scan Result

His skin was digitally mapped and no less than 8 lesions were advised to require excision.

Over the next 4 visits, 2 lesions at a time were excised as per the management plan that was devised for him as the lesions were in varying body areas and a sequence was devised to make aftercare simpler.

Pathology revealed every lesion excised was Dysplastic (pre-cancerous), and 4 of them were Severely Dysplastic - meaning they were very close to a diagnosis of Melanoma. The patient was given the option of wide-area excision and these were performed in all 4 cases, as there is some uncertainty as to whether such lesions are in fact Melanoma and the safest approach may involve wide-area excisions which removes any long-term doubt.

Long-Term Strategy

He was advised of strategies to reduce his UV exposure and long-term to consider moving to a more administrative role (indoors) with his employer to reduce his professional UV exposure.

Routine sequential digital monitoring has been advised on a 6 monthly ongoing basis.

In the event a lesion were to arise in between these checks, the patient has been advised to present the lesion for review.

Limited Lesion Review

In approx 30 seconds, without an appointment of any kind, the lesion can be re-imaged by our Melanographers and the image assessed for any significant change compared to the existing images on file by Dr Donnellan and the patient contacted with the results of that review same day as part of a digital service known as a Limited Lesion Review. This ensures any change is identified and significant intervention occurs as early as possible.

Early Intervention

As this patient is very close to being in the highest risk category for Melanoma, early intervention as occurred with the 8 lesions that were removed are very likely to have secured the patient a very different outcome to that which he would otherwise have been facing.