| Comments from Faculty and Members |
Julian Manzur M.D., Professor of Dermatology, Faculty
of Medicine,Havana, Cuba on March 7, 2007
My impression:
1. Penile lentigines (macular penile melanosis)
2. Nevomelanocytic nevi acquired
3. Very atypical condylomata acuminata
I preferred to biopsy
Khaled El-hoshy M.D., Troy, Michigan, USA on
March 7, 2007
Penile melanosis. No biopsy needed. Reassurance only.
Andy Affleck MRCP (UK), Clinical Fellow, Dundee, UK
on March 7, 2007
Diagnosis = benign penile lentiginosis. I would not biopsy
and I would not offer any treatment.
Robert Rudolph MD, FACP, Clinical Professor of Dermatology,
University of Pennsylvania, Philadelphia, PA, USA on
March 7, 2007
Looks like banal "penile melanosis". But, yes, I
would biopsy one to confirm the diagnosis, and to reassure the
patient about the benign nature of the lesions.
Shahbaz Janjua MD, Specialist Dermatologist, Ayza Skin
and Research Centre, Lalamusa, Pakistan on March 7,
2007
Excellent images of benign genital melanotic macules. I would
not biopsy these lesions unless I see something concerning.
Thamir Alkubaisi MD, Baghdad, Iraq, on March
7, 2006
A benign condition (penile melanosis), can also affect the
labia. It needs only observation. The biopsy is not very helpful
because atypical melanocytes occasionally can be present
Khalifa Shaquie MD, PhD, Professor of Dermatology,
College of Medicine, University of Baghdad, Baghdad, Iraq
on March 7, 2007
There is no clear cut diagnosis but it is not resolving lichen
planus, not a drug rash and not lentigo maligna. The mind has
the right to speculate about pigmented viral warts, early Kaposi
sarcoma that might present as pigmented macules in a healthy
man and other strange pigmented dermatoses. Shave biopsy will
give the clue.
Henry Foong FRCP, Consultant Dermatologist, Ipoh, Malaysia
on March 7, 2007
Clinically, this patient has benign penile melanosis. However,
the decision to biopsy or not to biopsy depends on a number
of other factors: the age of the patient, family history of
skin cancer, past history of skin cancer, increasing number
and size of lesions (?), atypical morphology of the lesions
and the prevalence of the genital malignancy etc. Unless there
are warning signs, I would not biopsy the lesion.
Ibrahim Mist MD, Amman, Jordan on March 8,
2007
My diagnosis is penile melanosis. It does not need biopsy.
I would keep it under observation.
Abbas Naji Alshammari MD, Consultant Dermatologist,
Qatar Armed Forces Clinic, Doha, Qatar on March 8,
2007
Exclusion of melanoma is a crucial element in suspected melanocytic
lesion. The case presented here with multiple lightly pigmented
macules unconfined to one area is very difficult to be suspected
as malignancy even if a high index of obsession is applied!
Simple lentigo or melanotic macules. How could a biopsy (increase
in melanocytes number or activity) is helpful in managing this
case?
Doing a biopsy is almost always a safe and simple procedure
for the physician but not as such for the patient, physically
or psychologically. Although, the case presented here is a simple
one but carry an important message in dealing with a huge number
of cases to decide honestly, when the biopsy is indicated? I
have been in touch with some patients to whom certain unjustifiable
investigations including biopsies were done. The result, a neurotic
factor was added to be the major new complaint!
Azar Maluki MD, Assistant Professor of Dermatology,
College of Medicine, University of Kufa, Najaf, Iraq on
March 11, 2007
Sometimes, biopsy may be so important both to the doctor and
the patient when a spot diagnosis can not be made easily, as
in this case. At least, the result of biopsy may determine further
follow up and the mode of managment.
Bushan Kumar MD, Former Professor of Dermatology, Chandigarh,
India on March 13, 2007
Benign penile lentiginosis. No Biopsy required. Reassure. Chances
of malignancy are remote.
Bernardo Gaia MD, Dermatology Resident, Rio de Janeiro,
Brazil on March 27, 2007
Before considering biopsy, I´d have a dermoscopic examination.
|
