TOH Dermatology Clinic Consult Note

<u>Dermatology Consultation Note</u> Referring Doctor: Dr. Emily Carter Reason for Referral: Evaluation of a suspicious mole on the patient's back. Chief Complaint: Patient presents with a new and changing mole on their back that they are concerned about. Impression: * Suspicious nevus, likely dysplastic. * Rule out melanoma. Plan: * Excisional biopsy of the suspicious mole. * Patient education on sun protection and skin self-exams. * Schedule follow-up appointment for biopsy results. Counselling: Discussed the importance of sun protection, including the use of sunscreen, protective clothing, and avoiding peak sun hours. Explained the procedure for the biopsy and potential risks and benefits. Reviewed the signs and symptoms of melanoma and the importance of regular skin self-exams. Follow up: Patient to return in 2 weeks for biopsy results and further management. --- --- History: The patient noticed a new mole on their back approximately 3 months ago. The mole has been changing in size, shape, and colour. There is no family history of skin cancer. Previous Dermatologic Issues: None. Previous Dermatologic Medications: None. Physical Exam: Atypical mole noted on the patient's back, measuring 8mm in diameter, with irregular borders and multiple colours. No other suspicious lesions noted. Past Medical History: Unremarkable. Medications: None. Allergies: No known drug allergies. Family History: Non-contributory. **Social History:** The patient works outdoors and reports frequent sun exposure. Insurance Type: NHS Procedure Note: Excisional biopsy of the suspicious mole performed. Local anaesthesia used. The site was closed with sutures. Dr. Thomas Kelly, Consultant Dermatologist On behalf of Dr. Sarah Jones