• Jena Martin MD

Diagnosis Decisions - Not Melanoma

***Great Moments in Pathology TM***

This is not melanoma!⠀

It is especially satisfying because it came in from the clinic as a suspected melanoma. (Have I mentioned how much I don’t like melanoma?)

🖤 I diagnose it several times a day and it’s always serious, so to give someone the news that no, what you have is Not Melanoma makes me very happy. ⠀

This is a well recognized mimic of melanoma, typically arising on the heel of the foot. It is called Talon Noire, or Black Heel. It comes about from trauma, or irritation to the skin. The problem consists of hemorrhage within the top most layer of the skin, the stratum corneum. In this biopsy sample it is a whole layer of blood. To the doc and the patient it looked dark brown and was irregularly shaped - just like melanoma. That’s why you sometimes need a biopsy. ⠀ There’s no need for further treatment, just to heal from the biopsy (no pun intended).

***TM - This phrase: "Great Moments in Pathology" is my personal term for those amazing cases where we, the pathologist, clinches an unexpected diagnosis. It's a fist-pumping, celebratory moment when one recognizes these rarities. A Great Moment.

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