Skin Check Up

A skin check-up, primarily aimed at detecting skin cancer early, is a critical preventive health measure. Here’s a detailed overview of what should be done during a skin check-up:

  1. Pre-Check Preparation:
    1. Medical History Review: Check the patient’s medical history, including any personal or family history of skin cancer, recent changes in skin lesions, and exposure to risk factors (e.g., sun exposure, tanning bed use, history of sunburns).
    2. Patient Concerns: Ask the patient if they have noticed any changes in their skin or have specific areas of concern.
  2. Visual Inspection:
    1. Full Body Examination: Conduct a thorough examination of the entire skin surface, including often-missed areas like the scalp, ears, under the nails, between the toes, soles of the feet, and the back. A dermatoscope, a specialized tool for skin examination, may be used for better visualization.
    2. Identification of Lesions: Look for any moles, growths, or lesions on the skin. Pay special attention to new lesions or changes in existing ones.
  3. Assessment of Lesions:
    1. ABCDE Criteria: Evaluate moles using the ABCDE criteria – Asymmetry, Border irregularity, Color variation, Diameter greater than 6mm, and Evolving or changing in size, shape, or color.
    2. Ugly Duckling Sign: Identify lesions that look different from the surrounding moles, known as the “ugly duckling sign.”
  4. Additional Tools:
    1. Dermoscopy: Use a dermatoscope for a more detailed examination of suspicious lesions. It provides a magnified view of the skin surface and subsurface structures, aiding in the identification of malignant features.
    2. Photography: For patients with multiple moles, total body photography can be useful for monitoring changes over time.
  5. Post-Check Counseling:
    1. Discuss Findings: Inform the patient about the results of the examination.
    2. Management Plan: Discuss the management plan for any lesions that require monitoring or treatment.
  6. Biopsy of Suspicious Lesions (if within the scope of practice):
    1. Perform Biopsy: If a lesion is suspicious for skin cancer, a biopsy may be performed for definitive diagnosis.
  7. Follow-Up and Referral:
    1. Routine Follow-Up: Schedule regular follow-up visits for patients at higher risk or with numerous moles.
    2. Referral to a Specialist: Refer suspicious lesions to a dermatologist for further evaluation, which may include a biopsy or removal of the lesion for histopathological examination.
  8. Documentation:
    1. Record Keeping: Document findings, patient education provided, and the plan for follow-up or referral.
  9. Patient Education:
    1. General Skin Care: Provide general advice on skin care, including moisturizing and avoiding harsh chemicals or irritants.
    2. Sun Protection Advice: Educate the patient on the importance of sun protection, including the use of sunscreen, wearing protective clothing, and avoiding peak sun hours.
    3. Self-Examination Tips: Instruct the patient on how to perform regular self-examinations of their skin.

Conclusion:

The skin check-up is an integral part of preventive health care, especially for individuals at high risk of skin cancer. Regular professional skin examinations combined with patient education and self-examination can significantly aid in the early detection and treatment of skin cancers.