Patient Profiles

Patient Profiles

Below are representative case studies of individuals who developed forms of NMSC that may be of interest to nurses and other healthcare professionals. They illustrate the types of patients/lifestyles who are most likely to present with NMSC, and who may benefit from advice in avoiding risk factors.

Case 1: Mrs X is a 56-year-old lady who enjoys an outgoing sporty lifestyle, with hobbies such as gardening and going for long walks in the countryside. Mrs X has a villa in southern Spain which she visits every winter. Recently she presented with an irregularly shaped and slowly enlarging reddish-brown scaling lesion on her leg that was 10 mm in diameter. This was sore, itchy and would sometimes bleed.  After visiting the dermatologist, a biopsy was conducted and Mrs X was diagnosed with BD on her lower leg.

COMMENT: BD can appear to be very similar to eczema and a simple histological analysis can confirm differential diagnosis.  Mrs X is a prime example of a person who loves the outdoors and it is likely that the correct precautions against the sunlight were not taken.

Case 2: Mr Y is a 51-year-old man from southern France. Mr Y is a professional soccer coach so has spent most of his working life outdoors. Mr Y's neck is showing criss-cross furrows of solar elastosis and his face is very wrinkled. This indicates overexposure to the sun. There are also a few rough brown coloured patches on his ears. Mr Y was recommended to visit a dermatologist by his physician; the dermatologist quickly diagnosed AK.

COMMENT: Mr Y is showing the most common presentations of AK. His baseball cap may have protected his face and scalp; however his neck, ear and hands were not protected.

Case 3: Mr Z is a 62-year-old farmer and has spent most of his working life outdoors. Mr Z noticed that for the past two years the lump on his nose has been increasing in size. The lump started off as a small flesh-coloured bump, but it is now over 1 cm in diameter. The central part of the lump has an ulcerated crater and spidery veins are clearly visible on the lesion. After a visit to the dermatologist, a biopsy confirmed that Mr Z had nBCC.

COMMENT: Most nBCCs  need to be  surgically excised as they can be  invasive. However, in some circumstances surgery might not be the best treatment and non surgical approaches can be proposed.

Case 4: Mr A is an 80-year-old former Army Major, who joined the Army at the age of 18 and remained there until he retired. For the majority of his career he was posted in North Africa, the Middle East and the Far East. Due to the extremely high temperatures Mr A often wore no top garment, especially during the physical training sessions. No sun block was available.  In his retirement, Mr A presented with a scaly lesion on his scalp with a distinct rolled edge, redness and crusting. It was noted that the lesion had been spreading slowly for a few years. A dermatologist confirmed that Mr A had sBCC.

COMMENT: Many former Service personnel and other fair skinned people who have transferred to hot climates for extended periods of time can show typical symptoms of chronic exposure to sun.    

Case 5: Mrs B is a 48-year-old housewife who is a member of a country club where she regularly relaxes near the pool. She also has regular one-hour sessions on a tanning bed. Mrs B became concerned when she presented with rough patches of skin on her torso. The patches were small (less than 1cm). However, occasional bleeding was the most disconcerting aspect. The dermatologist diagnosed that Mrs B had AK.

COMMENT: Mrs B shows the typical symptoms of an individual who has been chronically exposed to UV-B light.