[31F] With new skin lesion, tenderness, and history of Lynch syndrome

Patient Description

A 31-year-old female presents with a recently noticed raised, reddish lesion on her skin. The lesion appears inflamed, has a rough texture, and the surrounding skin shows signs of redness and possible irritation. The lesion has started to bleed and itch, and it hurts when touched. It has also become darker since it was first noticed. The lesion appeared suddenly. The patient has not experienced similar lesions in the past but has Lynch syndrome. Additionally, she has noticed a potentially similar lesion along her bikini line. She reports increased agitation and trouble sleeping but no fever, fatigue, unexplained weight loss, changes in appetite, or gastrointestinal symptoms. The patient also reports tenderness in a lymph node on her chest. Family history includes a grandmother who passed away from cancer and an uncle with cancer. The patient is currently taking Topamax (50 mg daily), Lamictal (200 mg daily), Hydroxyzine (25 mg daily), and Temazepam (45 mg daily). No known drug allergies.

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Arora's Assessment

What might be happening

Based on the information you’ve provided, there are a few possibilities for what might be happening:

  1. Skin Cancer (Melanoma or Non-Melanoma): Given the sudden appearance, changes in color, bleeding, and pain, this lesion could potentially be a form of skin cancer. Melanoma is a serious type of skin cancer that can develop in moles or other pigmented tissues. Non-melanoma skin cancers, such as basal cell carcinoma or squamous cell carcinoma, are also possibilities. Your family history of cancer and Lynch syndrome increases your risk.

  2. Infected or Inflamed Mole: The redness, irritation, and bleeding could indicate an infection or inflammation of a mole. This can happen if the mole is scratched or irritated.

  3. Dermatitis or Other Skin Conditions: The itching and redness could be due to dermatitis or another inflammatory skin condition. However, the bleeding and pain are less typical for these conditions.

What you can do

  1. Seek Immediate Medical Attention: Given the potential seriousness of skin cancer, it is crucial to see a healthcare professional as soon as possible. They can perform a thorough examination and may recommend a biopsy to determine if the lesion is cancerous.

  2. Avoid Further Irritation: Try not to scratch or pick at the lesion, as this can worsen the irritation and bleeding.

  3. Monitor for Changes: Keep an eye on the lesion and any other new or unusual moles or skin changes. Note any changes in size, shape, color, or symptoms.

  4. Document Your Symptoms: Take photos of the lesion to document any changes over time. This can be helpful for your healthcare provider.

  5. Follow Up on Family History: Given your family history and Lynch syndrome, regular check-ups with a dermatologist are important. They can provide personalized advice and screening recommendations.

  6. Use Sun Protection: Protect your skin from excessive sun exposure by using sunscreen, wearing protective clothing, and avoiding tanning beds.

Please remember that this advice is not a substitute for professional medical evaluation. It is important to seek care from a healthcare provider to receive a formal diagnosis and appropriate treatment. If you experience worsening symptoms or have any concerns, do not hesitate to contact a medical professional immediately.

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5 mo ago

People Also Ask


What are the signs that a skin lesion might be cancerous?

Signs that a skin lesion might be cancerous include changes in size, shape, or color, irregular borders, multiple colors, itching, bleeding, and pain. It's important to have any suspicious lesions evaluated by a healthcare professional.


How does Lynch syndrome affect the risk of developing skin cancer?

Lynch syndrome is a genetic condition that increases the risk of several types of cancer, including colorectal, endometrial, and potentially skin cancer. Individuals with Lynch syndrome should have regular screenings and be vigilant about any new or changing skin lesions.


What should I do if I notice a sudden change in a mole or skin lesion?

If you notice a sudden change in a mole or skin lesion, such as changes in color, size, or shape, or if it starts to bleed or itch, you should seek medical attention promptly. A healthcare provider may perform a biopsy to determine if the lesion is cancerous.


Can medications like Topamax, Lamictal, Hydroxyzine, and Temazepam affect skin health?

While medications like Topamax, Lamictal, Hydroxyzine, and Temazepam are not directly linked to skin cancer, they can have side effects that affect skin health, such as increased sensitivity to sunlight or skin rashes. It's important to discuss any concerns with your healthcare provider.


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