Subspecialty Clinics: DermatologyOverview of Skin Cancer Detection and Prevention for the Primary Care Physician
Section snippets
ETIOLOGY
As with most malignancies, the risk of development of disease is a combination of inherent host characteristics and exogenous environmental influences.
Background
As with all fields of medical practice, the history of the presenting problem is essential. Dermatologic diagnosis is based on visual pattern recognition, and therefore physical examination of the lesions is appropriate during inquiry about their history. In fact, many questions such as prior therapy, past exposure to carcinogens, and duration of disease may be raised based on initial examination. The history should focus on the development, duration, changes, rapidity of growth, and other
TECHNIQUES OF EXAMINATION
Examination of the skin is not simply looking, but rather touching, stretching, pinching, rubbing, moistening, crossilluminating, and, most importantly, seeing. This skill can be refined by using and practicing various physical examination techniques. Excellent technique and an established routine allow detection of subtle early tumors, the goal in the diagnosis of skin cancers.
Total cutaneous examination is a fundamental requirement when screening for cutaneous tumors. Full body examination
PREVENTION
Along with impeccable clinical skill, the physician should attempt to improve patient awareness of skin cancer to facilitate primary prevention. Opportunity for patient education exists since some estimates are that 85% of the US population sees a physician at least once in a 2-year period.20 Patients must be educated about the importance of reducing unprotected exposure to UVR. In light of the recent evidence of the danger of childhood sunburn, parents in particular should be targeted and
CONCLUSION
The medical profession mentions the increasing epidemic of skin cancer, but the unique nature of the visibility and accessibility of the skin allows easy and rapid assessment of potentially malignant lesions. The only tools required are clinical acumen and a thorough knowledgeable approach. If more medical professionals practice these strategies regularly and routinely, a reduction in this epidemic is certainly an achievable goal. Because many of the etiologic factors are well described,
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