Pigmented skin lesions

This is part of a series of occasional articles on common problems in primary care. The BMJ welcomes contributions from GPs.What you need to knowPigmentation may arise from different structures and cells within the skin, including melanin, keratin, and vasculature, and can be categorised by typical colouration and textureUsing the ABCDE rule can help diagnose melanomaWhen using dermoscopy, look for specific patterns and features that may suggest whether a lesion is benign or malignantA 74 year old white man with fair skin that burns and tans easily has a pigmented lesion on the upper back that his partner noticed three months ago. It is slowly enlarging. The man is retired from office work. He grew up in Africa, and historically enjoyed a lot of outdoor activities. He has no family history of melanoma. Examining the entirety of the back, the lesion stands out compared with his other lesions, most of…
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