Who you are:
You are FY2 in the GP clinic.Who the patient is:
Hary Charles, a 50-year-old man presented with a skin problem.What you must do:
Talk to the Mr Charles, take focused history and address his concerns
Patient’s information (Station flow):
- Your name is Hary Charles. You are 50-year-old man.
- You are working as a fire fighter.
- You came today as you are having rash on your chest that is getting worse the last 3 month, it spread to your arm and you are worried .
Data Gathering
GRIPS
- History of skin lesions
- Durations
- How many lesions
- Colour
- Increasing in size or number
- Symptoms with bleeding, color, etc
Differential diagnosis
- Malignant melanoma
- Spider naevi
- Congenital haemangioma
- Kaposis sarcoma
- Cherry angiomas
Typical features of cherry angiomas
- 1-3 mm in size
- Typical bright cherry red colour, but may appear blue
- Non-blanching
- Usually occur on the trunk and upper extremities
- Usually asymptomatic
Other history
- PMAFTOSA
- ICE
- Effects of symptoms
Examination
- I would like to have a look at your lesion.
- I’ll have a member of the medical team with me at all times throughout the examination as a chaperone, and I’ll ensure your privacy.
Management
- Diagnosis
- Cherry Angiomas
- Benign skin lesions
- They appear in the middle age or older
- They formed four dilated small blood vessels called capillaries.
- Reassure - the lesions usually require no treatment.
- Treatment is rarely needed especially if they are widespread. (usually treatment such as sclerotherapy, electrocautary, curettage are used.)
- Explain that in his case, no treatment is required.
- Offer leaflet