Pathophysiology of splenic cysts, systemic disorders, and skin conditions

Pathophysiology

Lesion characteristics assessed to aid determination of the lesion's cause

Lesion is caused by disease or trauma. In order to determine the cause of lesion you have to examine the patient and determine different aspects. First the practitioners can assess Cysts. Infection causes cysts and a doctor has to assess the cyst's size, pain caused by cyst and the role it plays when the doctor makes a decision to remove a splenic cyst. In case of motile cysts or many cancer cells the patient may require a surgery called splenectomy, to remove the spleen from the body. A patient with cysts acquires lesion from a disease.

Secondly, practitioner can assess traumatic injuries. Injuries as a result of accident or fighting in the lower abdomen can cause injury to the spleen. Doctors should take this spleen trauma with seriousness because it can cause spleen rupture leading to internal bleeding then death. Doctors can determine whether to remove ruptured spleen immediately or let it heal while providing proper care.

How systemic disorder affects nail and hair growth

Systemic disorder affects different organs and tissues or the whole body. The disorder causes dysfunction in many organs including the growth of hair and nails. Some systemic disorders cause disruption in the growth of figure and toenails. Nail plate or the hard keratin cover is generated by nail matrix which is located under the cuticle. During the growth process the area close to penetrate outside forms a deeper layer of nail plate and the part which remain deeper in the figure forms the superficial layer. The some process occurs in the growth of hair. Systemic disorders affect the growth process of hair by forming extra cells or reduce the numbers of cells required. Systemic disorders affect the connecting tissues which helps the growth of nails and hair (McCance & Huether, 2010).

How superficial and deep pressure ulcers differ in clinical and etiologic features

There is a profound difference between clinical and etiologic feature of superficial and deep pressure ulcers. Deep pressure ulcers are caused by inadequate supply of blood which leads to reperfusion after the blood re-enter into tissues. This is different from superficial ulcers because they are caused by trauma. Deep pressure ulcers occur when the blood flow affects or damages tissues causing death of cells. The two diseases differ in treatment. The patients with deep ulcer should allow redistribution of pressure in order to avoid application of pressure to the ulcers. 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 midback and Positive family history of dysplastic nevus syndrome (Marinkovi? et al.,2011).

Is there a relationship between dysplastic nevus syndrome and melanoma?

Yes there is a relationship between the as noted by Ackerman and Mihara (1985). 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