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Patients with superficial ulcers should take antibiotics at intervals for treatment (McCance & Huether, 2010).
Difference in malignant melanoma and other skin lesions
There some characteristic which helps in differentiating malignant melanoma and other skin lesions.
i. Border; unlike other skin lesions malignant melanoma, have irregular borders. In case of irregular or distinct borders a practitioner should understand that the disease is not a normal skin lesion.
ii. Color; the color of malignant melanoma differs forms other skin lesions. When suffering from malignant melanoma a person will have a mixture of light, dark and medium areas of different colors. Unlike other skin lesions which have consistent color malignant melanoma color is inconsistent.
iii. Diameter; when suffering from malignant melanoma, an individual will have moles or pigmented areas of the skin which will be large than normal. Evaluations need to be carried on for moles larger than five to six millimeters because normal skin lesions do not have bigger moles. The diameter differentiates malignant melanoma from other skin lesions.
iv. Others; other signs which differentiate malignant melanoma form other skin lesions include new mole's areas only if they have significant traits of malignant melanoma. Formation of red color or discoloration or inflammation around the moles with an itching, pain or tingling effect. Changes in size and shape of the mole and appearance of sore-like moles is another characteristic of malignant melanoma which distinguishes with other skin lesions (McCance & Huether, 2010).
Part 2
Professional development: Cutaneous Malignant Melanoma
What of this patient's history are considered risk factors for melanoma, and what are other warning signs?
There are several risk factors that can be identified in the patients's history. These include History of numerous nevi since childhood, Presenting with a large, dark, irregular-shaped skin lesion on his...
Dysplastic nevus syndrome increases the chances of suffering from melanoma. It is a risk factor.
What is the relationship between sunlight and melanoma for this patient?
Sunlight is a source of ultraviolet (UV) rays. The work of Tucker (2008) indicated that a large body of evidence exist which implicates ultraviolet rays exposure as a main contributor to the etiology of melanoma.
What are the pertinent positive and negative findings of this patient's physical examination?
Positive findings
Numerous nevi and freckles.
5-mm, irregularly shaped, darker lesion, midback.
Moderate sun damage to face, neck, chest, and back.
Negative findings
Conjunctival and funduscopic examination without lesions.
No supraclavicular or cervical adenopathy.
Clear to auscultation and percussion, no axillary adenopathy.
Regular rate and rhythm (RRR) without murmurs.
Soft, nontender, no liver enlargement.
Strength and reflex +2 and equal bilaterally.
Does melanoma always appear on the skin?
Yes, but in different parts of the body in various sizes.
What are the most common sites of metastases?
The most common sites of metastases are skin, lungs, brain, bones, digestive system, kidney as well as heart.
What type of biopsy should be done for this patient?
The work of Lorusso, Sarma and Sawar (2005) indicated that excisional biopsies are the best suited procedures for lesions that are expected to be due to melanoma.
What does this tell you about his prognosis?
• Clark level IV.
• Breslow 2.2 mm.
• Superficial
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