Alex Anne Brown, PA-C

Home
United States
Bradenton, FL
Alex Anne Brown, PA-C

To request a skin exam with me, click https://nextpatient.co/p/2921/30289/appointments

How many more lives can you save?

Dermoscopy allows for more accurate diagnosis of sub-clinical melanoma and non-melanoma skin cancers.

10/06/2023

Happy Friday, everyone! Figured I’d ask here first 😊 I’m looking for co-authors to assist with research articles and textbook chapters. Hoping to get everything published in 2024. If you’re interested, comment below or DM me 🫶🏻

09/22/2023

How often are you overlooking aggressive melanomas? The scalp is a crucial part of a skin exam and must be examined in every patient.

Scalp melanomas have the highest mortality rates (compared to melanomas on other body sites). These lesions are tricky because they can manifest dermoscopic features of both facial and body melanomas.

Shown here is a 0.2mm melanoma in a 50 yo male with prior history of non-melanoma skin cancer. This lesion was biopsied due to regression structures (gray granularity) and a bland but atypical network.

Please don’t overlook this area on your patients 😳

09/19/2023

Where’s the melanoma? 🚩

Shown here is an evolving melanoma in-situ in a 67 yo with no prior history.

Even the small lesions deserve dermoscopy! What questions do you have?

I’ve missed you all! Im finally started to feel better after a several month hiatus. Thank you to everyone who has checked on me 💕

06/14/2023

Comment what you would like to see more of on my account. All suggestions welcome 🙂

In the meantime, what structures do you see here?

02/07/2023

Where’s the invasive melanoma? ☠️

If you see polymorphous vasculature and shiny white structures, think melanoma! 🚩

Shown here is a 0.4mm BD, vertical, T1a melanoma in a 70 yo M with no prior history

02/01/2023

How often do you skip over the ears during your skin exam? Hopefully never 🚩🚩

Shown here is a 0.75mm (at least) BD. Lesion was present at the base. Final thickness TBD

There are 4 stages in the progression of facial melanomas. It often starts as grey dots that accumulate around the hair follicle until they form angulated lines and rhomboidal structures. Late stage melanoma on the face will show homogenous brown areas that obliterate the hair follicles

01/18/2023

How do you differentiate a regressing SK from a regressing melanoma?

Regression that starts in the center and expands outwards is more concerning for melanoma 🚩

When a lentigo/SK involutes, it usually regresses from the outer edge towards the center (centripetally). You can usually see remnants of these benign lesions at the opposite edge.

As a reminder, there are 2 types of regression structures: scar-like depigmentation (fibrosis) and granularity (melanin). Both structures are shown in this example. Granularity is accentuated with non-polarized dermoscopy (3rd photo)

Melanoma in-situ in a 49 yo male with no prior history of skin cancer

01/09/2023

Where is the melanoma? 🚩

Dermoscopic examination of ALL skin lesions is the only way to identify melanoma that clinically appears benign

One of the most common dermoscopic presentations of melanoma in-situ (MIS) is a flat, reticular lesion with subtle atypical network as in this example

Shown here is a MIS in a 66 yo F with history of non-melanoma skin cancer.

Look closely and catch them early ✔️

01/06/2023

Don’t overlook melanomas on your high risk patients. On chronically sun-damaged skin, these melanomas can be subtle 😅

Melanomas on sun-damaged skin will often manifest one of the following features:
• Patchy peripheral islands of pigment or structureless areas
• Grey dots/granularity (regression)
• Angulated lines (see Nov 8 post for example)

Shown here is a 0.3 mm BD melanoma in a 68 yo F with no prior history

01/01/2023

Please don’t treat melanoma with liquid nitrogen 🥴 If you don’t use dermoscopy prior to LN2, you could be inappropriately freezing a melanoma

I’ve seen it too many times to count

Shown here is a 0.2mm BD T1a melanoma in a 65 yo F with no prior history

12/19/2022

It is impossible to differentiate a benign lentigo from subtle lentigo maligna without dermoscopy

To make matters more difficult, lentigo maligna dermoscopic criteria cannot be seen in its earliest stages (which is exactly when you want to find them). My favorite method for these tricky lesions is the Inverse Approach

To use this method, look for criteria that rule-in a benign lesion of pigmented AK, seborrheic keratosis (SK), or solar lentigo (SL) rather than looking for lentigo maligna criteria.

For pigmented AKs, look for scales, white and wide follicular openings/rosettes, or erythema. For SK/SL, look for reticular or parallel lines, sharp demarcation, and other classic SK criteria (milia-like cysts, comedone openings, etc.).

One of these features has to be PREVALENT throughout the entire lesion

Shown here is a melanoma in-situ on chronically sun-damaged skin

Lallas A, Lallas K, Tschandl P, Kittler H, Apalla Z, Longo C, Argenziano G. The dermoscopic inverse approach significantly improves the accuracy of human readers for lentigo maligna diagnosis. J Am Acad Dermatol. 2021 Feb;84(2):381-389. doi: 10.1016/j.jaad.2020.06.085. Epub 2020 Jun 24. PMID: 32592885

12/14/2022

Beware of the subtle melanomas ☠️

Clinically, this lesion looks similar to the numerous lentigines and macular SKs seen on her shoulders. The clue is in the dermatoscope

In melanoma, dots and globules vary in size, shape, and color. You can often find them focally at the periphery of the lesion. If network is present, it is usually atypical which further reinforces the need for a biopsy

Shown here is a 0.3mm BD, t1a melanoma in a 60 year old with no prior history

Address

5301 4th Avenue Circle E
Bradenton, FL

Telephone

+19417612900

Website

http://www.dermoscopyislit.com/

Alerts

Be the first to know and let us send you an email when Alex Anne Brown, PA-C posts news and promotions. Your email address will not be used for any other purpose, and you can unsubscribe at any time.

Shortcuts

Want your practice to be the top-listed Clinic in Bradenton?