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- W1994936723 abstract "A 99 year old white woman presented with a 12 month history of nodules and plaques on her left shin. They had been slowly increasing in size and bled intermittently. She denied any history of trauma to her leg and had been systemically well. She reported having high blood pressure and that she had previously had “skin problems” affecting her lower left leg that required surgery. Her only regular drug was bendroflumethiazide, and she had no known drug allergies. She was a non-smoker and drank minimal alcohol. She lived in a ground floor flat and used a walking stick. On review of her medical notes, it was discovered that two areas of squamous cell carcinoma were excised from her left shin 10 years earlier.On examination, she was fair skinned (Fitzpatrick skin type II). There were several distinct, shiny, well circumscribed nodules on her left shin with surrounding hyperkeratotic plaques. These lesions were tender on palpation.### 1 What is the most likely diagnosis?#### Short answerSquamous cell carcinoma (SCC). Given her history of SCC, these lesions are highly suspicious of a recurrence.#### Long answerIn a patient with a history of slow growing nodules (figure⇓) at a site where SCC had previously been excised, SCC is the most likely diagnosis. SCC is a malignant tumour that arises from the keratinising cells of the epidermis. It is locally invasive and has metastatic potential. The density of these lesions is highest on the face and neck, although lesions are more common on the extremities (arms, backs of hands, and lower limbs).1 SCC is more common in people over the …" @default.
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- W1994936723 date "2012-11-15" @default.
- W1994936723 modified "2023-09-27" @default.
- W1994936723 title "Multiple enlarging nodules on the lower limb" @default.
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- W1994936723 doi "https://doi.org/10.1136/bmj.e7409" @default.
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