The patient is a 58 yo man in fair health. He suffers from anxiety and depression as
well as diabetes and coronary heart disease and is status past CABG. He was brought in by his female companion who
noticed a lesion of the left ala.
O/E There is a nine mm indurated lesion with some surface
erosion.
Image:
A 3 mm punch biopsy was difficult because of his severe agitation. The pathology showed a deeply infiltrating
basal cell.
Questions:
Given this patient’s pervasive anxieties, should one
consider XRT over Mohs surgery? The
latter might also cause some deformity and may require a complicated
reconstruction. Of course, I will lay
out the choices to the patient and his companion; but I thought this was a good
question for our members to consider and weigh in on. Some great unknown medical sage said, “Sometimes,
it is may be more important to treat the patient who has the lesion, than it is
to simply treat the lesion the patient has.”
No comments:
Post a Comment
We welcome your comments. We endeavor to serve your patients and you. If you want us to respond, please add your name and email address. Some people have trouble uploading comments. In that case, please send comments directly to djelpern@gmail.com. Thank you.