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Chapter 38: Screening for Skin Cancer

Buttaro: Primary Care: A Collaborative Practice, 6th Edition

Multiple Choice

1. During a total body skin examination for skin cancer, the provider notes a raised, shiny, slightly pigmented lesion on the patient’s nose. What will the provider do?

a. Consult with a dermatologist about possible melanoma.

b. Reassure the patient that this is a benign lesion.

c. Refer the patient for possible electrodessication and curettage.

d. Tell the patient this is likely a squamous cell carcinoma.

ANS: C a. Excisional biopsy b. Punch biopsy c. Shave biopsy d. Wide excision

This lesion is characteristic of basal cell carcinoma, which is treated with electrodessication and curettage. Melanoma lesions are usually asymmetric lesions with irregular borders, variable coloration, >6 mm diameter, which are elevated; these should be referred immediately. All suspicious lesions should be biopsied; until the results are known, the provider should not reassure the patient that the lesion is benign. Squamous cell carcinoma is roughened, scaling, and bleeds easily.

2. What is the initial approach when obtaining a biopsy of a potential malignant melanoma lesion?

ANS: A

NURSINGTB.COM

A suspected malignant melanoma lesion should be biopsied with excisional biopsy; if diagnosed, a wide excision should follow. Punch and shave biopsy procedures are appropriate for diagnostic evaluation of NMSC lesions.

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