From the Guidelines
When evaluating a potential skin cancer case, the most important anamnestic information includes the patient's personal and family history of skin cancer, sun exposure patterns, use of tanning beds, immunosuppression status, and previous radiation therapy, as these factors significantly increase skin cancer probability and may influence the urgency of intervention or follow-up recommendations. The patient's history should include documentation of when the lesion first appeared, any changes in size, shape, color, or symptoms (bleeding, itching, pain), and the rate of growth. Risk factors such as fair skin, light eyes, blonde or red hair, and numerous moles or freckles should be assessed, along with occupational sun exposure and geographic history (living in sunny climates) 1. Previous skin biopsies or treatments should also be documented. For melanoma specifically, inquiring about changing moles using the ABCDE criteria (Asymmetry, Border irregularity, Color variation, Diameter >6mm, Evolution) is crucial, as these characteristics are associated with an increased risk for cancer 1. A comprehensive history helps assess risk level and guides clinical decision-making. Key points to consider in the patient's history include:
- Personal and family history of skin cancer
- Sun exposure patterns and use of tanning beds
- Immunocompromised status
- Previous radiation therapy
- Changes in the lesion over time
- Risk factors such as fair skin, light eyes, and numerous moles
- Occupational and geographic sun exposure
- Previous skin biopsies or treatments
- ABCDE criteria for melanoma This information is essential for determining the likelihood of skin cancer and guiding further evaluation and management, as recommended by the US Preventive Services Task Force and other guidelines 1.
From the FDA Drug Label
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From the Research
Relevant Anamnestic Information for Skin Cancer
To obtain a comprehensive medical history in a case of skin cancer, the following information is crucial:
- History of sun exposure and sunburns, as ultraviolet radiation is a major cause of skin cancer 2
- History of immunosuppression, such as organ transplantation or lymphoproliferative disorders, as these conditions increase the risk of skin cancer 3
- Family history of skin cancer or genetic syndromes that predispose to skin cancer, such as familial melanoma 2
- History of previous skin cancers or precancerous lesions, such as actinic keratoses 2
- History of exposure to artificial UV radiation, such as tanning beds or lamps 2, 4
- History of radiation therapy, phototherapy, or other treatments that may increase the risk of skin cancer 2
- History of viral infections, such as human papillomavirus, which can increase the risk of squamous cell carcinoma 2
- Lifestyle factors, such as smoking and diet, which may influence the risk of skin cancer 2, 4
Risk Factors to Consider
When taking a medical history for skin cancer, it is essential to consider the following risk factors:
- Fair skin and chronic ultraviolet B exposure, which are major risk factors for skin cancer 5
- Age, as skin cancer risk increases with age 2
- Geographic location, as UV radiation levels vary by location and can influence skin cancer risk 2
- Occupational exposures, such as working outdoors or exposure to chemical carcinogens, which may increase the risk of skin cancer 2