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The Rational Clinical Examination
David L. Simel, Drummond Rennie
Melanoma
David L. Simel, James M. Grichnik, Reviewed by John D. Whited
Clinical Scenario


Topics Discussed: melanoma

Excerpt: "A 40-year-old non-Hispanic white patient presents to your clinic with concern about some skin lesions. He has no personal history of dysplastic nevi and no one in his family has melanoma. He confesses that he is not particularly worried about them, but his girlfriend is worried. There are 2 lesions on the upper back, neither of which the patient can see directly. He can feel one and observes that perhaps it has changed in size. As a child, he typically went without a shirt during much of the summer and did not use sunscreen. Sometimes, he sunburned with prolonged exposure. He has not experienced sunburns since his teenage years. The lesions are shown in Figures 29-1 and 29-2...."
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