Question

A 52 year old Caucasian man presents to the dermatologist after his wife noticed a dark, bleeding lesion on his back. The patient was unaware of the lesion until his wife noticed it. Upon further questioning to the patient's wife, she reports first noticing the lesion a few months prior. The lesion has since changed shape, and she grew more concerned when she noticed the bleeding and increased size. The patient denies any history of atypical moles. He reports that he used to spend summers working as a lifeguard when he was much younger. He mentions that he rarely used sunblock. On physical examination, a 7 mm symmetrical lesion with irregular borders and nonuniform color is observed on the right upper back.

1. What are some risk factors for this condition? Please note: there are some risk factors in the patient's history and other risk factors that are not mentioned. List at least 5 risk factors?

Answer 1

This condition could be malignant melenoma i.e. the patient may have a cancerous tumor at the back. As patient history shows that he worked as a lifeguard during summers but never used sun block which may have caused utravoilet radiation to interfare with the DNA and led to cancer. And now the patients melenoma is bleeding, increasing size and shape which again gives evidence for cancer.

Risk factors:-

Ultraviolet (UV) light exposure

As his history suggest he has worked as a lifeguard and never used sun blocks it would have exposed him to UV.

Being older

Melignant melenoma is more likely to be found in older aged people and he is already in his 50s.

Being male

European men have more chances to have melenoma as compared to women after their 50s before 50s risk is more for women.

Light skin color

Risk of melanoma is much higher for whites than for dark skin colored people. Whites with red or blond hair, blue or green eyes, or fair skin that freckles or burns easily are at increased risk. And being a Cucasian he would be white.

Weak immune system

Immune system helps in fighting with diseases. If the person has weak immune system it will not fight cancerous cells.

Moles

Moles can be cancerous or not. For most of the people with less moles its normalmand non cancerous but in people who have more moles there are more chances to have cancer.