Differential Diagnosis

This paper aims to demonstrate how issues in the differential diagnosis of prevalent skin infections can be addressed by implementing the fundamental science of seeing. This will be achieved by explaining and illustrating the results that can be used to differentiate one sort of tumor from the other.

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Chief Complaint (CC): Melanoma

Mathew, 69, is resigned from post office. He has become an enthusiastic member in recreational sports: while he was young, he played soccer and ice hockey and played tennis every a week for the last 5 years. He is today living in Maryland, but he was living in Texas for about 10 years as a middle aged man. Mathew has a wide range of sores and moles and rarely pays attention to them. However, one a week after taking a shower, he realized that the mole on his lower left leg looks a lot bigger, darker and alters in the manner an area of the skin looks. Mathew had also seen a formal announcement on television relating to risks of mole adjustments, and he called his primary HMO doctor for an initial consultation instantly (Schadendorf, 2013).

OBJECTIVE DATA

A uniform color such as tan, brown or black — with a distinct border separating the mole from the surrounding skin. They’re oval or round and usually smaller than 1/4 inch (about 6 millimeters) in diameter — the size of a pencil eraser.

Most people have between 10 and 45 moles.

ASSESSMENT:

Mathew is interrogated and examined by a clinical nurse specialist. Following the evaluation, the nurse will provide the following data.

He has a family history of skin cancer, his father has several squamous cell cancer removed from his face. He has many nevi on the body. This implies that perhaps the danger of melanoma could be transferred down through generations in families. To date, two genes have been mainly associated with family melanoma; they are termed CDKN2A and CDK4. A mutation (alteration) in one of these genes gives a person an increased risk of melanoma. However, changes in these two genes stand just for a tiny proportion of family melanoma.

A complete skin assessment reveals a pigmented lesion with characteristics included in the mnemonic “ABCDE” must be regarded as questionable for melanoma just after a clinical examination (Lipsker, 2013). Created both for doctors and patients to acknowledge the features mostly connected to melanoma, the ABCDE scheme involves Asymmetry – identify moles having uneven shapes, for instance two very different-looking halves, Border Irregularity – moles having uneven, notched or scalloped borders – ., Color Variegation – Melanoma is more probable to be quite dark black or blue and to vary in color than just a benign mole, which is most often regular in color and light tan or brown, and Diameter – greater than 6 mm, and Evolution or timing of lesion development – identify variations over time, which include a mole that develops in size or that alters color or shape. (Riley, 2004), Moles could also progress to grow different signs and symptoms, for instance, new itchiness or bleeding.

In addition, Melanoma happens whenever something went wrong in melanin-producing cells (melanocytes) that bring color for your skin. According to Lipsker (2013), skin cells develop in a regulated and orderly manner — normal fresh cells drive aged cells to the surface of your skin, for which they die and ultimately fall off. But if some cells acquire DNA damage, fresh cells may start to grow out of control and eventually create a mass of tumor cells. It is likely that a combination of factors, including environmental and genetic factors, develop melanoma. For the environmental factor, Ultraviolet light radiation (UVR) from sunshine is usually recognized as a significant risk factor for the growth of melanoma in skin cancer. However, the mechanistic aspects as to how sunshine triggers melanoma via UVR are still being clarified. Currently, it is believed that the carcinogenic, inflammatory, and immunosuppressive characteristics of UVR all add to the initiation, development, and metastases of main melanoma. For the genetic factor, family melanoma is a genetic or hereditary disorder.

The Dermatoscope, also is known as the Dermascope, should be used even further to boost the accuracy. This instrument is primarily used among dermatologists or any other specialized medical professionals. The dermatoscope is a unique lens which can enlarge the mole 15-25 times. This allows the doctor to see structures in the mole which cannot be seen with the naked eye.

In conclusion, I argue that, in this era of advanced medicine, we are forgetting one of the simplest, least expensive, and perhaps most important techniques of acquiring information-looking.

References

Lipsker, D. (2013). Clinical Examination and Differential Diagnosis of Skin Lesions. doi: 10.1007/978-2-8178-0411-8

Riley, P. A. (2004). Textbook of Melanoma: Pathology, Diagnosis and Management. Melanoma Research, 75. doi: 10.1097/00008390-200402000-00013

Schadendorf, D., Kochs, C., & Livingstone, E. (2013). Introduction to Cutaneous Melanoma. Handbook of Cutaneous Melanoma, 1–12. doi: 10.1007/978-1-908517-98-2_1.