Hello, I am looking for someone to write an article on Dematologic Disease or Condition Report. It needs to be at least 500 words. Dermatology Department Patient Report Patient John Smith Patient Number: 12-1234-21 Birth 15/1955 Report 3/08 Consulting Physician: Dr. Bryan Stewart
Patient is a 12-year-old male c/o a “colored patch” on the upper left arm and shoulder. Patient reports that the patch appeared recently, is non-traumatic in origin, and has been growing larger (Calonje, 2009). Patient reports no pain or pruritus (itching) of the area, and is otherwise asymptomatic (Rivers & Wiseman, 2010). Patient has a history of mild fungal infections of the feet and one pediculosis infestation as a child, and reports recent diaphoresis. this last symptom is most likely related to patients pubescent status.
Physical Examination: The patch has the appearance of a macular lesion, being non-palpable and flush with the skin, and is hyperpigmented though not keratinic. It is irregular in shape, and lacks raised wheals or pustular abscesses. No ecchymoses, petechiae, any other sign of epidermal or subdermal injury or damage are present near the hyperpigmented area (Calonje, 2009). There are several acneform papular lesions near the center of the patch (Rivers & Wiseman, 2010). No evidence of ulcers of any type is seen.
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Testing: Patient was sent for surgical biopsy, with the incision to be made at the center of the hyperpigmented area. Biopsy results are negative for malignancy and infection. The biopsy showed smooth muscle bundles within the dermis and an excess of melanocytes in the affected area, confirming diagnosis of Beckers nevus. (Rivers & Wiseman, 2010).
Treatment/Plan: Prognosis is good, as the area appears to be a benign lesion. Patient has been warned to expect hypertrichosis on the area, and referred to a laser hair removal center. Neither dermabrasion nor cryosurgery is indicated, as the pigmentation is within the dermal layers and cannot be removed in this manner. The condition is non-infectious, so treatment with antibiotics, antifungals, or parasiticides is unneccessary (Book, Glass, & Laude, 1997). Keratolytics will be similarly unhelpful at treating the pigmentation, despite sun exposure being a possible correlating factor (Tymen et al., 1981).
Further treatment is not necessary except on cosmetic grounds. however, if desired by the patient, laser treatment can reduce the excess pigmentation (Rivers & Wiseman, 2010). Patient has been told to return for further examination if the lesion shows major changes, excepting mild erythema resulting from laser treatments or shaving.
Diagnosis: Beckers nevus
CALONJE, PHILLIP. Diagnostic Atlas of Melanocytic Pathology. Edinburgh: Mosby, 2009.
Tymen, R., Forestier, J. F., Boutet, B., & Colomb, D. (1981). Late Beckers Nevus. One Hundred Cases (Authors Transl). Annales de dermatologie et venerolgie, 108(1).
Book, S. E., Glass, A. T., & Laude, T. A. (1997). Congenital Beckers Nevus with a Familial Association. Pediatric Dermatology, 14(5).
Rivers, J. K., & Wiseman, M. C. (2010). Becker Melanosis. Retrieved March 8, 2011, from http://emedicine.medscape.com/article/1068257-overview.