- Stella Ivaz, senior house officer—plastic surgery1,
- Hawys Lloyd-Hughes, senior house officer—plastic surgery1,
- Pippa Oakeshott, reader in general practice2,
- Saima Shah, senior teaching fellow in general practice2
- 1Department of Plastic and Reconstructive Surgery, Charing Cross Hospital, Imperial College NHS Trust, London W6 8RF
- 2Community Health Sciences, St George’s, University of London, London SW17 0RE
- Correspondence to: S Ivaz
- Accepted 1 May 2009
A 40 year old white woman is worried about a 5 × 7 mm brown and black lesion on her arm that has been getting darker over the past few months and has begun to itch. It has a regular border but is slightly raised. She has no axillary lymphadenopathy.
What issues you should cover
Is this a rapidly growing new mole or a long standing one that is changing in size, shape, colour, or sensation—for example, newly bleeding or itching?
What is the history of sun exposure? Ask about sunny holidays, occupational and recreational exposure, use of sun beds, and episodes of sunburn—particularly in childhood.
Photoprotection measures, for example, sunscreen use.
Personal history of malignant …