Basal cell carcinoma physical examination: Difference between revisions

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{{Basal cell carcinoma}}
{{Basal cell carcinoma}}


{{CMG}}; {{AE}} {{JH}}
{{CMG}}; {{AE}}{{M.N}}


==Overview==
==Overview==
The physical examination of basal cell carcinoma is based on a clinical exam.  
[[Patients]] with basal cell carcinoma usually have normal general appearance. [[Skin]] [[examination]] usually show [[papules]], [[plaques]], [[central]] [[ulceration]] with rolled borders, [[telangiectasias]].


_NOTOC_
==Physical Examination==
*[[Physical examination]] of [[patients]] with basal cell carcinoma is usually normal except some [[skin]] findings:
 
===Appearance of the Patient===
*[[Patients]] with basal cell carcinoma are usually normal
 
===Vital Signs===
*[[Vital signs]] of [[patients]] with basal cell carcinoma are usually within normal limits
 
===Skin===
* [[Skin]] [[examination]] of [[patients]] with basal cell carcinoma usually varies like<ref name="CameronLee2019">{{cite journal|last1=Cameron|first1=Michael C.|last2=Lee|first2=Erica|last3=Hibler|first3=Brian P.|last4=Barker|first4=Christopher A.|last5=Mori|first5=Shoko|last6=Cordova|first6=Miguel|last7=Nehal|first7=Kishwer S.|last8=Rossi|first8=Anthony M.|title=Basal cell carcinoma|journal=Journal of the American Academy of Dermatology|volume=80|issue=2|year=2019|pages=303–317|issn=01909622|doi=10.1016/j.jaad.2018.03.060}}</ref><ref name="pmid25134314">{{cite journal |vauthors=Sehgal VN, Chatterjee K, Pandhi D, Khurana A |title=Basal cell carcinoma: pathophysiology |journal=Skinmed |volume=12 |issue=3 |pages=176–81 |date=2014 |pmid=25134314 |doi= |url=}}</ref>
**Waxy [[papules]] or [[plaques]]
**Crusting
**Rolled borders
**Central [[ulceration]]
**[[Telangiectasias]] over the surface
**Shiny and pearly
 
===HEENT===
*HEENT [[examination]] of [[patients]] with basal cell carcinoma is usually normal.
 
===Neck===
*[[Neck]] [[examination]] of [[patients]] with basal cell carcinoma is usually normal
 
===Lungs===
*[[Pulmonary examination]] of [[patients]] with basal cell carcinoma is usually normal.
 
===Heart===
*[[Cardiovascular]] [[examination]] of [[patients]] with basal cell carcinoma is usually normal.


==Physical Examination==
===Abdomen===
The physical examination of basal cell carcinoma is based on a clinical exam.  
*[[Abdominal examination]] of [[patients]] with basal cell carcinoma is usually normal.
 
===Back===
*[[Back]] [[examination]] of [[patients]] with basal cell carcinoma is usually normal.
 
===Genitourinary===
*[[Genitourinary]] [[examination]] of [[patients]] with basal cell carcinoma is usually normal.
 
===Neuromuscular===
* [[Neuromuscular]] [[examination]] of [[patients]] with basal cell carcinoma is usually normal.
 
===Extremities===
*[[Extremities]] [[examination]] of [[patients]] with basal cell carcinoma is usually normal.


====Face====
===Image gallery===


<gallery>
<gallery>
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Image:Basal_cell_carcinoma_42.jpeg|Basal cell carcinoma.
Image:Basal_cell_carcinoma_42.jpeg|Basal cell carcinoma.
<SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=52>
</gallery>
====Neck====
<gallery>
Image:Basal_cell_carcinoma _16.jpeg|Basal cell carcinoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=52>
</gallery>
====Extremities====
<gallery>
Image:Basal_cell_carcinoma_31.jpeg|Basal cell carcinoma.


<SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=52>
<SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=52>


</gallery>
</gallery>
====Perineal area====
<gallery>
Image:Basal_cell_carcinoma_36.jpeg|Basal cell carcinoma.
<SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=52>
</gallery>
====Skin====
<gallery>
Image:Basal_cell_carcinoma _06.jpeg|Basal cell carcinoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=52>
Image:Basal_cell_carcinoma _07.jpeg|Basal cell carcinoma.
<SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=52>
Image:Basal_cell_carcinoma _08.jpeg|Basal cell carcinoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=52>
Image:Basal_cell_carcinoma _17.jpeg|Basal cell carcinoma.
<SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=52>
Image:Basal_cell_carcinoma _18.jpeg|Basal cell carcinoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=52>
Image:Basal_cell_carcinoma_23.jpeg|Basal cell carcinoma.
<SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=52>
Image:Basal_cell_carcinoma_25.jpeg|Basal cell carcinoma.
<SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=52>
Image:Basal_cell_carcinoma_26.jpeg|Basal cell carcinoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=52>
Image:Basal_cell_carcinoma_27.jpeg|Basal cell carcinoma.
<SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=52>
Image:Basal_cell_carcinoma_28.jpeg|Basal cell carcinoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=52>
Image:Basal_cell_carcinoma_30.jpeg|Basal cell carcinoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=52>
Image:Basal_cell_carcinoma_39.jpeg|Basal cell carcinoma.
<SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=52>
Image:Basal_cell_carcinoma_40.jpeg|Basal cell carcinoma.
<SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=52>
</gallery>
==Overview==
Patients with basal cell carcinoma usually have normal general appearance.
==Physical Examination==
Physical examination of patients with [disease name] is usually normal.
OR
Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].
OR
The presence of [finding(s)] on physical examination is diagnostic of [disease name].
OR
The presence of [finding(s)] on physical examination is highly suggestive of [disease name].
===Appearance of the Patient===
*Patients with [disease name] usually appear [general appearance].
===Vital Signs===
*Vital signs of patients with basal cell carcinoma are usually within normal limits
===Skin===
* Skin examination of patients with [disease name] is usually normal.
OR
*[[Cyanosis]]
*[[Jaundice]]
* [[Pallor]]
* Bruises
<gallery widths="150px">
UploadedImage-01.jpg | Description {{dermref}}
UploadedImage-02.jpg | Description {{dermref}}
</gallery>
===HEENT===
* HEENT examination of patients with [disease name] is usually normal.
OR
* Abnormalities of the head/hair may include ___
* Evidence of trauma
* Icteric sclera
* [[Nystagmus]]
* Extra-ocular movements may be abnormal
*Pupils non-reactive to light / non-reactive to accommodation / non-reactive to neither light nor accommodation
*Ophthalmoscopic exam may be abnormal with findings of ___
* Hearing acuity may be reduced
*[[Weber test]] may be abnormal (Note: A positive Weber test is considered a normal finding / A negative Weber test is considered an abnormal finding. To avoid confusion, you may write "abnormal Weber test".)
*[[Rinne test]] may be positive (Note: A positive Rinne test is considered a normal finding / A negative Rinne test is considered an abnormal finding. To avoid confusion, you may write "abnormal Rinne test".)
* [[Exudate]] from the ear canal
* Tenderness upon palpation of the ear pinnae/tragus (anterior to ear canal)
*Inflamed nares / congested nares
* [[Purulent]] exudate from the nares
* Facial tenderness
* Erythematous throat with/without tonsillar swelling, exudates, and/or petechiae
===Neck===
* Neck examination of patients with [disease name] is usually normal.
OR
*[[Jugular venous distension]]
*[[Carotid bruits]] may be auscultated unilaterally/bilaterally using the bell/diaphragm of the otoscope
*[[Lymphadenopathy]] (describe location, size, tenderness, mobility, and symmetry)
*[[Thyromegaly]] / thyroid nodules
*[[Hepatojugular reflux]]
===Lungs===
* Pulmonary examination of patients with [disease name] is usually normal.
OR
* Asymmetric chest expansion OR decreased chest expansion
*Lungs are hyporesonant OR hyperresonant
*Fine/coarse [[crackles]] upon auscultation of the lung bases/apices unilaterally/bilaterally
*Rhonchi
*Vesicular breath sounds OR distant breath sounds
*Expiratory wheezing OR inspiratory wheezing with normal OR delayed expiratory phase
*[[Wheezing]] may be present
*[[Egophony]] present/absent
*[[Bronchophony]] present/absent
*Normal/reduced [[tactile fremitus]]
===Heart===
*Cardiovascular examination of patients with basal cell carcinoma is usually normal.
===Abdomen===
*Abdominal examination of patients with basal cell carcinoma is usually normal.
===Back===
*Back examination of patients with basal cell carcinoma is usually normal.
===Genitourinary===
*Genitourinary examination of patients with basal cell carcinoma is usually normal.
===Neuromuscular===
* Neuromuscular examination of patients with [disease name] is usually normal.
OR
*Patient is usually oriented to persons, place, and time
* Altered mental status
* Glasgow coma scale is ___ / 15
* Clonus may be present
* Hyperreflexia / hyporeflexia / areflexia
* Positive (abnormal) Babinski / plantar reflex unilaterally/bilaterally
* Muscle rigidity
* Proximal/distal muscle weakness unilaterally/bilaterally
* ____ (finding) suggestive of cranial nerve ___ (roman numerical) deficit (e.g. Dilated pupils suggestive of CN III deficit)
*Unilateral/bilateral upper/lower extremity weakness
*Unilateral/bilateral sensory loss in the upper/lower extremity
*Positive straight leg raise test
*Abnormal gait (describe gait: e.g. ataxic (cerebellar) gait / steppage gait / waddling gait / choeiform gait / Parkinsonian gait / sensory gait)
*Positive/negative Trendelenburg sign
*Unilateral/bilateral tremor (describe tremor, e.g. at rest, pill-rolling)
*Normal finger-to-nose test / Dysmetria
*Absent/present dysdiadochokinesia (palm tapping test)
===Extremities===
* Extremities examination of patients with [disease name] is usually normal.
OR
*[[Clubbing]]
*[[Cyanosis]]
*Pitting/non-pitting [[edema]] of the upper/lower extremities
*Muscle atrophy
*Fasciculations in the upper/lower extremity


==References==
==References==
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{{Reflist|2}}
{{Reflist|2}}


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Latest revision as of 14:57, 11 March 2019


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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Maneesha Nandimandalam, M.B.B.S.[2]

Overview

Patients with basal cell carcinoma usually have normal general appearance. Skin examination usually show papules, plaques, central ulceration with rolled borders, telangiectasias.

Physical Examination

Appearance of the Patient

  • Patients with basal cell carcinoma are usually normal

Vital Signs

Skin

HEENT

Neck

Lungs

Heart

Abdomen

Back

Genitourinary

Neuromuscular

Extremities

Image gallery

References

  1. Cameron, Michael C.; Lee, Erica; Hibler, Brian P.; Barker, Christopher A.; Mori, Shoko; Cordova, Miguel; Nehal, Kishwer S.; Rossi, Anthony M. (2019). "Basal cell carcinoma". Journal of the American Academy of Dermatology. 80 (2): 303–317. doi:10.1016/j.jaad.2018.03.060. ISSN 0190-9622.
  2. Sehgal VN, Chatterjee K, Pandhi D, Khurana A (2014). "Basal cell carcinoma: pathophysiology". Skinmed. 12 (3): 176–81. PMID 25134314.

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