Based on the presentation and PE, what do you think is the most likely diagnosis?  Include a brief rationale and cite.  In your rationale, include common assessment findings that support your diagnosis and what diagnostic test would confirm your diagnosis.

Dermatology Case Study Discussion Board

A 72 year old Caucasian male presents in your Primary Care practice for a “bump” on his nose.  He noticed it several months ago but did not seek medical attention since it did not hurt or was not itchy.  He thinks it has grown and bleeds easily when irritated.

Past Medical History

•     Hypertension, controlled on Lisinopril 5 mg daily x 4 years
•     Allergic rhinitis, uses over-the-counter antihistamines
•     Denies surgeries or serious illnesses/hospitalizations

Family History

•     Father, hypertension
•     Mother, asthma, atopic dermatitis
•     Brother, atopic dermatitis
•     Sister, diabetes

Physical Examination

•     Vital signs; T 98.2, BP 126/78, RR 18, HR 80.
•     General: Well developed and well appearing. No lymphadenopathy.
•     Skin: pearly papule on tip of the nose, raised border with central depression.

Discussion Questions:

1.   Based on the presentation and PE, what do you think is the most likely diagnosis?  Include a brief rationale and cite.  In your rationale, include common assessment findings that support your diagnosis and what diagnostic test would confirm your diagnosis.

2.   Briefly discuss the guideline for sun exposure protection to decrease skin cancer. Cite.

Use the references below:

Rhoads J. & Petersen, SW. Advanced Health Assessment and Diagnostic Reasoning, 4th edition.

https://www.cdc.gov/cancer/skin/basic_info/sun-safety.htm

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