Skin Malignancies
History
- SOCRATES of presenting complaint (ABCDE of moles)
- assessing genetic skin type
- when you first go out in the sun each summer, do you burn?
- if so, do you always burn? easily? do you blister when you burn?
- can you tan? is it easy for you to tan? do you develop a deep tan? or just a shade darker?
- sun/ UV exposure
- jobs/ hobbies (includes the past and childhood)
- sun avoidance, sun screen and protective clothing
- perform self examinations? or had skin checked by doctor?
- solar tanning?
- PMHx and FHx of freckles, naevi, melanomas and other skin cancers
- PMHx of radiotherapy (ie. other cancers) or immunosuppression (autoimmune meds, steroids, Tx etc)
- SHx - smoking, ETOH
- * if pregnant, moles can look darker
Examination
- Technique: good lighting, binocular loop, palpate and slightly stretch any suspicious lesion
- Lymph nodes
- Asymmetric shape
- Border irregularity
- Colour irregularity
- Diameter> 6mm
- Evolving over time
- Refer if >3 or clear change or itching, bleeding or oozing
Source
OHCS 8th edn 2009
Dr Clark 2014
- SOCRATES of presenting complaint (ABCDE of moles)
- assessing genetic skin type
- when you first go out in the sun each summer, do you burn?
- if so, do you always burn? easily? do you blister when you burn?
- can you tan? is it easy for you to tan? do you develop a deep tan? or just a shade darker?
- sun/ UV exposure
- jobs/ hobbies (includes the past and childhood)
- sun avoidance, sun screen and protective clothing
- perform self examinations? or had skin checked by doctor?
- solar tanning?
- PMHx and FHx of freckles, naevi, melanomas and other skin cancers
- PMHx of radiotherapy (ie. other cancers) or immunosuppression (autoimmune meds, steroids, Tx etc)
- SHx - smoking, ETOH
- * if pregnant, moles can look darker
Examination
- Technique: good lighting, binocular loop, palpate and slightly stretch any suspicious lesion
- Lymph nodes
- Asymmetric shape
- Border irregularity
- Colour irregularity
- Diameter> 6mm
- Evolving over time
- Refer if >3 or clear change or itching, bleeding or oozing
Source
OHCS 8th edn 2009
Dr Clark 2014