Please respond to the classmates post related to the case study. I will post the case study first then the classmates response. case study: Mr. B, a 40-year-old avid long-distance runner previously in good health, presented to his primary provider for a yearly physical examination, during which a suspicious-looking mole was noticed on the back of his left arm, just proximal to the elbow. He reported that he has had that mole for several years, but thinks that it may have gotten larger over the past two years. Mr. B reported that he has noticed itchiness in the area of this mole over the past few weeks. He had multiple other moles on his back, arms, and legs, none of which looked suspicious. Upon further questioning, Mr. B reported that his aunt died in her late forties of skin cancer, but he knew no other details about her illness. The patient is a computer programmer who spends most of the work week indoors. On weekends, however, he typically goes for a 5-mile run and spends much of his afternoons gardening. He has a light complexion, blonde hair, and reports that he sunburns easily but uses protective sunscreen only sporadically. Physical exam revealed: Head, neck, thorax, and abdominal exams were normal, with the exception of a hard, enlarged, non-tender mass felt in the left axillary region. In addition, a 1.6 x 2.8 cm mole was noted on the dorsal upper left arm. The lesion had an appearance suggestive of a melanoma. It was surgically excised with 3 mm margins using a local anesthetic and sent to the pathology laboratory for histologic analysis. The biopsy came back Stage II melanoma. 1. What is the pathology of melanoma as well as the enlarged lymph node found on exam? Class mate response:Melanoma is caused by the malfunction of cell division pathways as skin producing pigments divide. Normally, melanocytes divide less than twice per year but in the setting of certain mutations, such as point mutations and copy number alterations, the cells will divide too quickly and without regulation. A patient may notice that a mole has gotten larger or thicker. Like other cancers, melanoma will grow rapidly and be poorly differentiated–as in the case of Mr B., the melanoma spread distantly to another part of the body. Metastatic melanoma is know to be associated with certain errors in cell cycle controlling genes, phosphatase-and-tesin homologue (PTEN) or tumor-protein p53 (TP53)(Schadendorf et al., 2018). The melanocyte is reproducing too fast and without the regulation of apoptosis. This allows the abnormal cancer cells to spread and invade other parts of the body, known as metastasis. The enlarged axillary lymph node nodule found in this case is very concerning tumor metastasis and the patient needs a biopsy immediately to confirm. Unfortunately, Mr B. had increased likelihood to develop melanoma due to a variety of reasons. His family history already put him at high risk for skin cancer, plus he spent a great deal of time out in the sun without protection. Any fair skinned, light eyed person should take great precautions in the sun, such as minimizing exposure with clothing and hats as well as reapplying sunscreen. This risk was even further compounded by the patient’s family history of lethal skin cancer. Melanoma is the most dangerous form of skin cancer and is formed by mutation in the pigment cells called melanocytes. As found on Mr. B, melanoma is characterized by a black lesion and often metastasizes to other organs (likely lymph nodes in this case). Sun exposure increases risk of melanoma development, particularly UVA and UVB radiation which penetrates the skin’s surface. Even intermittent sunburns can increase one’s risk in developing melanoma, let alone the persistent exposure done by Mr. B (Huether et al, 2020). 1. please use evidenced based articles only within last 5 years and american based. 2. Please be original as this has to go through turnitin
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