Diagnosis:
1. Actinic Keratosis
- Assessment, likely diagnosis for Issue 1: Actinic Keratosis
- Differential diagnosis for Issue 1: Squamous cell carcinoma in situ
- Treatment for Issue 1: Cryotherapy
Treatment:
Cryotherapy to multiple actinic keratoses on the face.
Follow-up:
Review in 3 months.
Investigations:
Biopsy of suspicious lesion.
Investigations with results: 01/11/2024, Biopsy results: Actinic Keratosis.
Past Skin History:
01/01/2020, Treatment for basal cell carcinoma.
Past Medical History:
2018, Hypertension.
Medication:
Amlodipine 5mg daily.
Allergies:
No known allergies.
Family History:
Mother with melanoma.
Social History:
Frequent sun exposure, uses sunscreen inconsistently.
I reviewed the above 62 year old gentleman. My clinical notes from today are as follows:
Subjective:
Patient presents with multiple scaly lesions on the face, which have been present for several months. The lesions are asymptomatic but have been increasing in number. Patient reports a history of significant sun exposure over their lifetime. No previous treatment.
Objective:
Vitals: BP 130/80, HR 72.
Physical examination findings: Multiple erythematous, scaly papules and plaques on the face, consistent with actinic keratoses. Dermoscopy revealed atypical vessels in some lesions.
Assessment:
1. Actinic Keratosis, diagnosed based on clinical presentation and dermoscopy findings. Treatment plan includes cryotherapy.
Management Plan as above:
Cryotherapy to multiple actinic keratoses.
Additional Notes:
Patient educated on the importance of sun protection and regular skin self-examination.
Next Steps:
Follow-up appointment in 3 months to assess response to treatment and monitor for new lesions.
I would recommend www.bad.org.uk and dermnetnz.org for information on the above.