Nursing 211

N211: Health Differences Across the Lifespan I of 148 This skin cancer most commonly occurs in adults after age 40 in blond, fair-skinned, Caucasianmales. Prolonged sun exposure is the largest risk factor. Lesions usually occur on the face. They are small, smooth, pink, translucent papules that progress to firm raised bordered lesions with depressed centers. Basal cell carcinoma is the least aggressive type of skin cancer and rarely metastasizes to other origins. Superficial basal cell carcinoma is commonly found on the chest and back. It is an oval or irregular shaped lesion, slightly elevated and lightly pigmented. The lesion appears scaly and may resemble eczema or psoriasis. Risk factors for this lesion include arsenic ingestion. Medical Interventions include chemotherapy (5-fluororacil), surgical excision, radiation or chemosurgery. Interventions include high protein diet; avoid sun exposure and tender skin care to prevent bleeding. Squamous cell carcinoma occurs in Caucasian males over age 60 from sun exposure. Other risk factors include x-ray therapy, arsenic ingestion (i.e. gardener using insecticides), carcinogen exposure (tar, oil), and chronic skin inflammation and irritation. Squamous cell carcinoma occurs on skin frequently exposed to UV light such as face, ears, nose, lips and hands. Lesions of the lower lip and ears have a poor prognosis, but others have a good prognosis. This cancer appears as reddish, rough, thick, and scaly lesions that may be asymptomatic or become sore and bleed. Diagnosis is by biopsy. Medical treatment includes chemosurgery, radiation, electrodessication and curettage and excision. Malignant melanoma is more common in women than men, ages 50-70. This is a less common skin cancer arising from melanocytes. Risk factors include UV radiation via sunlight, tanning lamps or booths, fair skin type, pregnancy (hormones increase both growth and incidence), family history. Common locations are the head, neck, legs, and back. All moles (nevi) that change in color, size, texture, have drainage or bleed should be investigated. Diagnosis is by biopsy. Medical Intervention Surgical tumor removal with wide resection, lymphadenectomy, chemotherapy and radiation. Nursing Assessment includes history of sun (ultraviolet) exposure and review of other risk factors. Examination of any suspicious lesions and excisional biopsy. Nursing Diagnosis Knowledge deficit related to risk factors for development of skin cancer ©2012 Achieve Page 94