Basel Cell Carcinoma (BCC

Diagnosis

The patient appears to suffer from the most common human cancer, Basel Cell Carcinoma (BCC). Also known as basal cell epithelioma, the cancer occurs on sun-damaged skin. The disease is gradually increasing in incidence among the elderly population and also the general population due to widespread radiation exposure (Fania et al. 2020). While BCC has a low mortality rate, it can be destructive and result in the disfiguring of local tissues.

Rationale

            BCC is a form of skin disease and the patient is complaining about a ‘bump’ on his nose. According to Dika et al. (2020), BCC accounts for 50% of all cancers in the United States, making it highly probable that the patient is suffering from the condition. The patient is equally 72 years old. One of the primary risk factors for BCC is age, as the probability of occurrence increases as a person gets older. White Caucasians of 65-79 years of age recorded the highest surge in BCC incidence rates in the last decade (Dika et al. 2020). Age is also associated with the decline of biological functions, including cell and tissue repair. Therefore, aged skin is more likely to develop cancerous cells from little solar exposure.

            Skin phototype is another risk factor for BCC that the patient exhibits. According to the patient’s family history, both the mother and brother suffered from atopic dermatitis (AD). AD is also a common skin disease. Dermatological research indicates the AD is positively associated with a greater risk of skin cancers (Zhu et al. 2022). While it is not clear whether the condition is hereditary, science affirms that AD can result in the development of BCC.  Therefore, the family’s medical history, the patient’s age and the BCC’s incidence rate all justify a BCC diagnostic evaluation.

Common Assessment Findings for the Diagnosis

            The physical exam will show a rough tip on the nose with a central depression. Such a form of carcinoma will have a dark spot or lesion, a flat patch with rough edges, a shiny bump and a white, wax-like wound that acts like an opening (Fania et al. 2020). The wax can also be found on the central depression depending on the patient. The lesion can either be black or brown in colour.

            The most suitable diagnostic test for BCC is a skin biopsy. Rhoads and Petersen (2020) inform that the process entails collection a small section from the lesion for laboratory testing. A microscopic assessment reveals whether the collected sample has malignant cell growth. If it is true, the biopsy will also reveal the type of skin disease (Rhoads & Petersen, 2020). The biopsy technique used is dependent on the size and type of skin lesion observable on the patient.

Guidelines for Solar Exposure

The patient can make several behavioural modifications to better protect their skin from the sun. Such actions include:

1. Covering the skin at all time. Skin cancer is preventable if a person’s skin remains under shade or receive minimal contact with solar radiation (Fania et al. 2020). One can achieve this by wearing clothes with long sleeves. Hats can provide shade for the face, ears and necks.
2. Apply recommended lotions, such as sunscreen. Certain dermatological products are known to reduce solar exposure by allowing the skin’s surface to reflect back radiation as opposed to absorbing it (Fania et al. 2020).
3. Use sunglasses to protect the eyes from ultraviolet rays.

References

Dika, E., Scarfì, F., Ferracin, M., Broseghini, E., Marcelli, E., Bortolani, B., Campione, E., Riefolo, M., Ricci, C., & Lambertini, M. (2020). Basal cell carcinoma: A Comprehensive Review. International Journal of Molecular Sciences, 21(15), 5572. https://doi.org/10.3390/ijms21155572

Fania, L., Didona, D., Morese, R., Campana, I., Coco, V., Di Pietro, F. R., Ricci, F., Pallotta, S., Candi, E., Abeni, D., & Dellambra, E. (2020). Basal cell carcinoma: From pathophysiology to novel therapeutic approaches. Biomedicines, 8(11), 449. https://doi.org/10.3390/biomedicines8110449

Rhoads, J. & Patersen, S. (2020). Advanced health assessment and diagnostic reasoning [3^rd ed]. Jones & Bartlett Learning, LLC.

Zhu, Y., Wang, H., He, J., Yang, L., Zhou, X., Li, Z., Zhou, H., Zhao, H., & Li, Y. (2022). Atopic dermatitis and skin cancer risk: A systematic review. Dermatology and Therapy, 12(5), 1167–1179. https://doi.org/10.1007/s13555-022-00720-2