1. An Unusual Place For a Melanoma Salt Lake Valley Health Department STD Clinic

2. A 28 year old female came to the clinic complaining of abnormal vaginal discharge and genital irritation. She had no other complains. She had a steady partner and no history of any sexually transmitted diseases. A 28 year old female came to the clinic complaining of abnormal vaginal discharge and genital irritation. She had no other complains. She had a steady partner and no history of any sexually transmitted diseases.

3. During the pelvic exam a 1.5 cm lesion was noted above the clitoris and she had non-tender bilateral lymphadenopathy. During the pelvic exam a 1.5 cm lesion was noted above the clitoris and she had non-tender bilateral lymphadenopathy. The vaginal discharge was normal and no other problems were noted. All STD test results were negative. The vaginal discharge was normal and no other problems were noted. All STD test results were negative.

5. The patient was questioned about the lesion and she gave a history of a mole that she had there for many years that had recently changed and was causing some irritation. The patient was questioned about the lesion and she gave a history of a mole that she had there for many years that had recently changed and was causing some irritation. Note that the patient did not come in because of the lesion but for the discharge and irritation. We did not ask when she had her last pelvic exam. Note that the patient did not come in because of the lesion but for the discharge and irritation. We did not ask when she had her last pelvic exam.

6. The patient was immediately referred to the University of Utah and was seen the next day by one of the Dermatologists. The patient was immediately referred to the University of Utah and was seen the next day by one of the Dermatologists. That day she received an excision biopsy. That day she received an excision biopsy.

7. Multiple follow up calls were made to the patient but she did not return any of our calls. We did receive information from the dermatologist that the lesion was a melanoma. Multiple follow up calls were made to the patient but she did not return any of our calls. We did receive information from the dermatologist that the lesion was a melanoma.

8. We continued to have concern for the patient but she did not return our calls so 7 months later we checked with vital records and found a death certificate for the patient with the cause of death listed as metastasized melanoma. We continued to have concern for the patient but she did not return our calls so 7 months later we checked with vital records and found a death certificate for the patient with the cause of death listed as metastasized melanoma.

9. Disclaimer Copyright all clinical photos: Copyright all clinical photos: –Cammie Barrus, APRN, Salt Lake Valley Health Department, STD Clinic. Individual slides can be used for educational purposes with reference to source. Individual slides can be used for educational purposes with reference to source.