Case Study: A 70-year-old farmer with red, scaly skin changes and a suspect 2 cm pigmented lesion on his face.
A 70-year-old farmer came to the doctor with multiple red, scaly changes on his face. During the examination, the doctor also noticed a pigmented 2 cm wide lesion on his face with irregular edges, which was slightly depigmented in the center.
Key Question:
What is the most likely carcinogen causing these skin changes?
- A) Epstein-Barr virus (EBV)
- B) Aflatoxin
- C) UV radiation
- D) Hepatitis B virus (HBV)
- E) Radiation therapy
Diagnosis Focus: Identification of the causative carcinogen.
Detailed Explanation:
The symptoms described, particularly the red, scaly lesions and the irregular pigmented lesion on the farmer’s face, point towards UV radiation as the primary carcinogen. These manifestations are typically associated with sun damage, a significant risk factor for various skin cancers, including:
- Squamous cell carcinoma: Indicated by red, scaly lesions.
- Melanoma: Suggested by the irregular pigmented lesion.
Given the patient’s occupation as a farmer, it is reasonable to infer prolonged exposure to UV radiation, which heightens the risk of these skin cancers.
Contrast with Other Options:
- Radiation therapy: Can cause skin changes and secondary cancers, but no history suggests this in the case.
- Hepatitis B virus (HBV) and Aflatoxin: Linked to hepatocellular carcinoma, not directly to skin cancers.
- Epstein-Barr virus (EBV): Associated with Hodgkin lymphoma, Burkitt lymphoma, and nasopharyngeal cancers, but not typically with skin cancer.
Educational Takeaway
This case highlights the importance of understanding the relationship between occupational exposure and health risks. For medical students, it’s crucial to consider a patient’s entire background, including their profession, when diagnosing and recommending preventative measures.
Motivational Note
As future healthcare professionals, your keen observation and comprehensive knowledge can make a significant difference in patient care. Remember, every study session brings you a step closer to becoming the doctor who can change lives. Keep pushing forward!
For more resources and study aids, consider exploring the MedBrane app for interactive learning experiences tailored to medical students. MedBrane is available on iOS and Android.