Dermatology Case Study Discussion Board A 72 year old Caucasian male presents in your Primary Care practice for… -

Dermatology Case Study Discussion Board

A 72 year old Caucasian male presents in your Primary Care practice for a “bump” on his nose. He noticed it several months ago but did not seek medical attention since it did not hurt or was not itchy. He thinks it has grown and bleeds easily when irritated.

Past Medical History

• Hypertension, controlled on Lisinopril 5 mg daily x 4 years

• Allergic rhinitis, uses over-the-counter antihistamines

• Denies surgeries or serious illnesses/hospitalizations

Family History

• Father, hypertension

• Mother, asthma, atopic dermatitis

• Brother, atopic dermatitis

• Sister, diabetes

Physical Examination

• Vital signs; T 98.2, BP 126/78, RR 18, HR 80.

• General: Well developed and well appearing. No lymphadenopathy.

• Skin: pearly papule on tip of the nose, raised border with central depression.

Discussion Questions:

1. Based on the presentation and PE, what do you think is the most likely diagnosis? Include a brief rationale and cite. In your rationale, include common assessment findings that support your diagnosis and what diagnostic test would confirm your diagnosis.

2. Briefly discuss the guideline for sun exposure protection to decrease skin cancer.

1. Most Likely Diagnosis and Rationale

Diagnosis: Basal Cell Carcinoma (BCC)

Rationale:
Basal Cell Carcinoma (BCC) is the most common form of skin cancer, particularly in elderly, fair-skinned individuals with chronic sun exposure. The lesion described—pearly papule, raised borders, central depression or ulceration, and bleeding with minimal trauma—is characteristic of nodular BCC, the most common subtype. The lesion’s location on the nose, a frequently sun-exposed area, further supports this diagnosis (Alvarado et al., 2023).

Common Assessment Findings in BCC:

Pearly, flesh-colored papule or nodule
Rolled or raised border
Central ulceration or depression
Telangiectasia (may or may not be noted)
Tendency to bleed with minor trauma
Commonly found on sun-exposed areas (face, ears, scalp)

Confirmatory Test: A skin biopsy—either shave, punch, or excisional—is essential to confirm the diagnosis. Histopathology typically reveals nests of basaloid cells with palisading nuclei, confirming BCC.

2. Guidelines for Sun Exposure Protection

The American Academy of Dermatology (AAD) and the Centers for Disease Control and Prevention (CDC) provide clear recommendations for sun safety to prevent skin cancer, including BCC:

Apply Broad-Spectrum Sunscreen: Use sunscreen with SPF 30 or higher, and reapply every two hours, especially after sweating or swimming.
Seek Shade: Especially during peak sun hours (10 AM to 4 PM).
Wear Protective Clothing: Long sleeves, wide-brimmed hats, and UV-blocking sunglasses.
Avoid Indoor Tanning: Tanning beds emit harmful UV radiation and significantly increase skin cancer risk.
Routine Skin Checks: Monthly self-skin exams and annual full-body skin exams by a healthcare professional are recommended, especially for high-risk individuals.

Patient Education Tip: Emphasize the importance of year-round sun protection, as UV rays can damage the skin even on cloudy days.

References:

Alvarado, S. M., et al. (2023). Clinical diagnosis of basal cell carcinoma. UpToDate.
American Academy of Dermatology Association. (2023). Skin cancer prevention. Retrieved from https://www.aad.org
Centers for Disease Control and Prevention (CDC). (2023). Skin Cancer Prevention. Retrieved from https://www.cdc.gov/cancer/skin/

Struggling with where to start this assignment? Follow this guide to tackle your assignment easily!

Step-by-Step Guide for Writing Your Dermatology Case Study Response

Step 1: Analyze the Case Carefully Take note of key findings such as:

Patient demographics (age, skin type, sun exposure risk)
Description of lesion (pearly papule, central depression, bleeds easily)
Location (nose — a sun-exposed area) These all guide you toward the correct diagnosis.

Step 2: Structure Your Response Clearly into Two Parts

Part A: Most Likely Diagnosis and Rationale

Paragraph 1: State Your Diagnosis

Start with: “The most likely diagnosis for this patient is basal cell carcinoma (BCC).”

Paragraph 2: Justify Your Diagnosis

Describe key clinical signs that match BCC.
Explain why other differential diagnoses are less likely.
Mention that fair-skinned elderly males with sun exposure are high-risk.

Paragraph 3: Diagnostic Confirmation

Briefly describe the biopsy method (shave, punch, or excisional).
Mention expected histologic features confirming BCC.

Part B: Sun Exposure Guidelines

Paragraph 1: Present Prevention Strategies

Use information from trusted guidelines (e.g., AAD or CDC).
Discuss sunscreen use, shade-seeking, clothing, and avoiding tanning beds.

Paragraph 2 (Optional): Educate the Patient

Highlight that damage accumulates over time.
Stress importance of regular skin checks, even in winter.

Step 3: Cite Your Sources

Use APA 7th edition format.
Include at least 2–3 reliable sources like UpToDate, CDC, or AAD.

Step 4: Final Tips for Success

Keep your tone professional and informative.
Use proper paragraphing and avoid overly long blocks of text.
Proofread for clarity, grammar, and citation accuracy.
Use 12-point Times New Roman font, and follow any other format your instructor provides.

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