07-24-2006, 04:23 AM
A 73-year-old Scandinavian male was undergoing a routine physical examination when his physician noted a roundish spot about 6 mm (1/4 inch) in diameter that was slightly pinker than the remainder of the man's face. When he ran his finger across it he also noted that was dry and rough. The patient informed him that something had been going on with that spot for a year or so; its appearance seemed to wax and wane essentially disappearing once in a while but then returning, sometimes covered with white scales that then dropped off. When asked, the patient admitted that as a boy and a young man he spent countless hours at the beach body surfing and never used sunscreen. The physician cauterized the lesion with liquid nitrogen. Within 2 weeks the area became crusted, shrank and fell off. Two weeks thereafter the rough spot returned, and after a month, the patient developed an open sore at the same location that would not heal. The sore is most likely to be which one of the following?
A: Actinic keratosis
B: Basal cell carcinoma
C: Squamous cell carcinoma
D: Nodular melanoma
E: Herpes infection
A: Actinic keratosis
B: Basal cell carcinoma
C: Squamous cell carcinoma
D: Nodular melanoma
E: Herpes infection