Recommendations for Skin Examination
On the whole, it is stated that the balance of benefits and harms that skin examination of patients by medics brings is unknown; however, it is suggested that skin examination may help prevent highly adverse patient outcomes due to skin cancer such as death (Tsao & Weinstock, 2016). Consequently, it is paramount for medics to know how to conduct skin examinations properly.
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First of all, during skin screening, the whole body of the patient should be thoroughly examined, including the areas on which hair grows, such as the scalp. Areas that are not frequently exposed to the sun, such as the oral mucosa, the palms, the groin and genitals, the soles, the buttocks, the perianal area, etc., should be checked as well; patients should be asked to remove the corresponding garments for examination (Agbai et al., 2014).
It is advised to utilize the ABCDE mnemonic to memorize what should be sought during a standard visual examination (Tsao & Weinstock, 2016). This mnemonic stands for “asymmetry, border irregularity, nonuniform color, diameter greater than 6 mm, and evolving over time” (Tsao & Weinstock, 2016, p. 399). It is stressed, however, that a deeper understanding of the various types of skin cancer and their manifestations is required to adequately employ the mnemonic (Tsao & Weinstock, 2016). Thus, it is pivotal to possess sufficient knowledge about skin cancer, as well.
Populations That Are at an Increased Risk of Skin Cancer
According to Agbai et al. (2014), individuals of White origins, especially those who have very pale skin, usually tend to develop skin cancer considerably more often than non-White populations. Nevertheless, it is stressed that non-Whites also can develop skin cancer. When there is an occurrence of this disease, it is usually detected at a later stage than in most White patients, which results in a worse prognosis (Agbai et al., 2014).
Also, Diao and Lee (2014) state that the following characteristics place individuals at risk: a) the previous incidence of skin cancer in the patient; b) family history of skin cancer; c) pale skin, freckling, tendency to get sunburns, blond or red hair, numerous nevi or moles, non-typical nevi; d) personal history of transplantation of organs, and the utilization of immunosuppressive medicines. Elderly age is also a risk factor for skin cancer (Delishaj et al., 2015; Templier et al., 2015).
Recommendations Regarding Sun Exposure
On the whole, it is recommended to minimize the exposure of the skin to the sun for the populations of all ages (Moan, Grigalavicius, Baturaite, Dahlback, & Juzeniene, 2015). It is advised to attempt not to be in the open sun, instead of seeking shade. Using clothes that cover most of the skin is also recommended, as well as utilizing hats with wide brims that permit for shading the neck and the face and employing footwear that cover the whole feet. Individuals are also prompted to wear sunglasses, the lenses of which absorb ultraviolet solar radiation, and to take vitamin D (Agbai et al., 2014; Rivas, Rojas, Araya, & Calaf, 2015). This advice should be useful for populations of all ages.
It is also recommended to use broad-spectrum sunscreens that possess the sun protection factor no less than 30; these should be applied 15-30 minutes before leaving indoor areas, and re-applied every 2 hours to all the skin that is exposed to the sun, as well as after swimming or intense perspiration (Agbai et al., 2014). Care should be taken for very young children, however, as their skin might be too sensitive for sunscreens. For such individuals, it is better to avoid being in the sun; the use of baby carriages with a cover that creates shade may be recommended. For older people, minimizing the exposure to the sun is also highly advised, especially because they are at higher risk of developing skin cancer (Delishaj et al., 2015; Templier et al., 2015).
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Agbai, O. N., Buster, K., Sanchez, M., Hernandez, C., Kundu, R. V., Chiu, M.,…Lim, H. W. (2014). Skin cancer and photoprotection in people of color: A review and recommendations for physicians and the public. Journal of the American Academy of Dermatology, 70(4), 748-762.
Delishaj, D., Laliscia, C., Manfredi, B., Ursino, S., Pasqualetti, F., Lombardo, E.,… & Fabrini, M. G. (2015). Non-melanoma skin cancer treated with high-dose-rate brachytherapy and Valencia applicator in elderly patients: A retrospective case series. Journal of Contemporary Brachytherapy, 7(6), 437.
Diao, D. Y., & Lee, T. K. (2014). Sun-protective behaviors in populations at high risk for skin cancer. Psychology Research and Behavior Management, 7, 9-18.
Moan, J., Grigalavicius, M., Baturaite, Z., Dahlback, A., & Juzeniene, A. (2015). The relationship between UV exposure and incidence of skin cancer. Photodermatology, Photoimmunology & Photomedicine, 31(1), 26-35.
Rivas, M., Rojas, E., Araya, M. C., & Calaf, G. M. (2015). Ultraviolet light exposure, skin cancer risk and vitamin D production. Oncology Letters, 10(4), 2259-2264.
Templier, C., Boulanger, E., Boumbar, Y., Puisieux, F., Dziwniel, V., Mortier, L., & Beuscart, J. B. (2015). Systematic skin examination in an acute geriatric unit: Skin cancer prevalence. Clinical and Experimental Dermatology, 40(4), 356-360.
Tsao, H., & Weinstock, M. A. (2016). Visual inspection and the US Preventive Services Task Force recommendation on skin cancer screening. JAMA, 316(4), 398-400.