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Skin Cancer Algorithm - Differential Diagnoses of Brown Colored Lesions
Melanoma
- amelanotic melanoma
- often red, vascular looking without pigment
- may have only small flecks of pigment
Dermatofibroma
- firm usually on legs and arms
- may be red or brown, occasionally black
- feels in the skin, not raised above the surface
- dimpling sign on squeezing from the sides
Mole
Seborrhoeic Keratosis
- mostly on the trunk
- well defined, brown, raised, look stuck on to the skin
- warty surface which is often soft
- sometimes smooth surface with keratotic plugs
- inflammation and crusting may occur after trauma
Pigmented Actinic Keratosis
- often multiple on fair skin with chronic sun exposure
- face, hands, scalp and legs of women
- often can be felt early on better than seen
- erythematous, rough adherent scale
- may be hyperkeratotic, atrophic, occasionally pigmented
- may be indistinguishable from SCC in situ
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