NR 603 Week 5 Assignment Virtual Interactive Student Evaluation (VISE)
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Vital signs were stable and he denied systemic symptoms such as fever, chills, or weight loss. His past medical history also includes hypertension. Because of his history of skin cancer and the concerning characteristics of the nasal lesion, I believe he needs urgent dermatologic evaluation, including biopsy to rule out recurrence of basal cell carcinoma. Additionally, I would appreciate your recommendations for management of his chronic psoriasis and atopic dermatitis, as his current regimen is no longer controlling symptoms. I have encouraged the patient to use sun protection consistently and counseled on reason for referral and management in Dermatology. Since primary care cannot definitively diagnose or manage potential recurrent skin cancer, I am referring him to you for biopsy, diagnostic clarification, and treatment planning, including topical, procedural, and systemic options as indicated. Client Profile • Name: Robert H. • Age: 66 years old • Sex: Male • Past Medical History: o Malignant neoplasm of skin of the nose (previous basal cell carcinoma, status post excision 2 years ago) o Chronic atopic dermatitis o Plaque psoriasis affecting arms, knees, and lower back • Medications: o Triamcinolone 0.1% ointment PRN for eczema flares o Calcipotriene ointment for psoriasis Amlodipine 5 mg daily for HTN • Allergies: NKDA • Family History: Mother with eczema; father with melanoma • Social History:
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