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A 32-year-old farmer comes to your office because of an upper respiratory infection. While he is there he points out a lesion on his forearm that he first noted approximately 1 year ago. It is a 1-cm asymmetric nodule with an irregular border and variations in color from black to blue. The patient says that it itches and has been enlarging for the past 2 months. He says he is so busy that he is not sure when he can return to have it taken care of.

In such cases the best approach would be
a.perform a punch biopsy and have the patient return if the biopsy indicates pathology
b. perform a shave biopsy, with a recheck in 2 months for signs of recurrence
c. use electrocautery to destroy the lesion and the surrounding tissue
d. perform an elliptical excision as soon as possible




answer is a


u gotta perform an elliptical excision ,becoz the patient is not sure when he will be able to come ,it can be a malignant nodule also ,so in this case excision is the best


Kaplan explained it like...
The situation is potentially more grave than the patients busy schedule. So a biopsy now to establish the specific dx and then further management accordingly.

I believe thats from Step3 qs.


i will go for d


It seems to be melanoma. If follow up is not sure, better excise and biopsy. Axis of excision to run along the lymphatic paths.


neither Shave or Punch Biposy, if you suspect melanoma
(it loks like that)
2 electrocautery could diseminate it
answer must be Elliptical excision


i agree with ur opinion

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