Integumentary System

Dermatology Case Study

A 72 year old Caucasian male presents in your Primary Care practice for a “bump” on his nose.  He noticed it a few 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.  What three conditions would be considered in your differential diagnoses, with the most likely condition listed first.  Include a brief rationale (2 -3 sentences) and cite.  In your rationale, explain why you considered this condition as a differential diagnosis and why or how this diagnosis would be ruled out.

2.  What further history and further examination are warranted to explore your differential diagnoses and what findings would support your most likely diagnosis.  Cite.

3.  Briefly discuss the guideline for sun exposure protection to decrease skin cancer. Cite. For more information on Integumentary System check on this: https://en.wikipedia.org/wiki/Integumentary_system

What Is Ethical Judgment?

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