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Author9 Posts
  #1

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




  #2

C?


  #3

answer is a


  #4

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


  #5

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.


  #6

i will go for d


  #7

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


  #8

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


  #9

drrabines
i agree with ur opinion





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