The ABCD Rule: Detecting the Symptoms of Skin Cancer

Mary noticed a large, brown spot on her skin. She has been playing tennis in the sun for several years without sun protection. She reported the discovery to a friend, who told her to apply the ABCD rule to determine whether or not she had malignant melanoma. Her friend told her that if her answer was "no" to the questions that were asked by the ABCD rule, she had nothing to worry about. What is the ABCD rule and should she ignore the spot if her answers are negative? My Mom had skin cancer, so I learned as much as I could about it. I knew the very basics from working in the hospital but as a respiratory therapist my knowledge was limited.

The ABCD rule is a simple method by which an individual can screen themselves, friends and family members for melanomas. A is for Asymmetry. If you find a mole and draw an imaginary line through it both sides should look the same, if they do not than that mole would be considered asymmetrical. B is for the border. When looking at a suspicious mole the outline or edges of the mole should be smooth with the skin, if they are raised, blurry or irregular in any way it would be considered an irregular border. C is for the color of a mole. If the color of your moles or a mole has changed it would be cause for concern.

For example if you have a tan mole that you have had since you were ten and it turned black, or patchy or even red you would have reason for concern. D is for diameter. Moles should not be greater than I believe 5 or 6 millimeters. If a mole has grown in size many times it will be accompanied by one of the other letters A, B or C. Any of these abnormalities in moles need to be addressed by a physician the sooner the better. If Mary were my friend and she were able to answer no to the ABCD melanoma questions I would still encourage her to make an appointment with her physician.Skin cancer can appear anywhere on the body, moles are not the only site for skin cancer.

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It is for this reason I would still be concerned for Mary. It is a new spot, and it is large and brown. This “new” large brown spot on Mary’s skin could be the very early stages of malignant melanoma and could be removed and biopsied by her physician. Another reason I would be suspicious of this brown spot on Mary’s skin is the amount of time she has spent in the sun without protection. I am going to say that Mary’s friend that told her not to worry about it is not looking out for Mary’s best interests.Perhaps she wants Mary out of the Tennis Club Championship so her chances of winning are better? It is important for everyone to know how to screen themselves for many things. The ABCD’s of skin cancer are well known to my family, especially my children.

They get quite tired of me looking at their moles routinely. We have lived in Arizona for 18 years and we love the outdoors, so exposure to the Sun’s harmful rays is unavoidable even with sunscreen there is going to be some damage. Being aware of what your bodies normal are can literally save your life.My Mom had a large melanoma on her shoulder, and watching her go through the treatment was painful. She was lucky, as she survived and still golfs just about every day. 2. What is the importance of membranes in the body? What are the three types of membranes? Compare and contrast each type.

What homeostatic imbalances may occur relating to membranes, and what are their implications? Membranes are important to the body because they cover body surfaces, line body cavities and act as a protective covering for organs they can also provide lubrication that allows an organ to rub against another organ without causing harm.There are three types of membranes in the human body; serous, cutaneous and mucous. There is a fourth membrane which is synovial it it different from the other three in that it is composed entirely of connective tissue whereas the other three are composed of both connective and epithelial tissues. Each of them plays their own role in maintaining the bodies’ homeostatic balance keeping us healthy and alive. Serous membranes make up the lining of the closed ventral cavities. It’s main purpose is to prevent and or reduce friction between internal organs.It consists of two layers the visceral which covers the outside of an organ and the parietal layer which lines a body cavity.

An example of this would be lungs. They have both a visceral and parietal layer and lining. This allows for the lungs to expand and deflate with inhalation and exhalation. The serous membrane of the lungs prevents them from creating friction with the heart and diaphragm. A good example of a homeostatic imbalance of the serous membrane is a pneumothorax. There a different types of pneumothorax’ for my example I will use a traumatic pneumothorax, which could be the result of being stabbed.Blood can fill up in the serous membrane of the lung which will cause it to collapse, when this happens it becomes extremely difficult and painful for the patient to breath.

If left untreated it can be fatal, the patient go into respiratory failure and can bleed to death. A chest tube needs to be inserted to allow the blood and or air to drain out thereby re-inflating the lung and allowing the patient to breath. I have seen these when I worked in a trauma center, and have assisted with the insertion of a chest tube it is not pretty and often done quickly.Serous membranes are vital to life, and upsetting them or destroying them can lead to painful or even fatal consequences. Cutaneous membranes are our “suits” they cover our bodies and make them appealing to look at. Of course they have more important functions than looking good. The cutaneous membrane functions to protect us from chemical, thermal and bacterial damage.

It is our raincoat so to speak and aids in the regulation of body temperature. The receptors in our cutaneous membranes alert us when we are in contact with hot, cold or sharp things and give us time to get away from the danger.When I curl my hair and the iron just brushes up against my neck I instantly feel the hot and pull the iron away, usually spilling my coffee which can land on my feet which can cause me to jump back. Many things can and will upset our bodies homeostatic balance if our Cutaneous membranes are damaged. One such example would be a cactus needles. Last month we had a four year old come in to the ER, she fell into a cactus I cannot remember what kind but there were literally hundreds of cactus needles in her back and arms.Pulling them out one at a time was not going to work.

The doctor had seen on “Real stories of the ER” a similar situation where they used hair wax remover to pull them out. Surprisingly it worked; of course the girl was sedated with ketamine. The parents were not sedated and Mom passed out. If left in the girls skin, they would most likely have become infected and she could have ended up one sick little girl. The cutaneous membrane does what it can to protect us from outside invaders, but it can only do so much and sometimes it fails.Another example is a preterm baby when they are delivered one of our major concerns is their body temperature; we need to get them warm and keep them warm. We initially wipe of the material left on them from the delivery and continuously changed the blankets they are wrapped in with warm ones.

Their skin is not developed enough to keep body heat in, so we have to provide a second skin until they are stable and in an incubator. Mucous membranes, these I know well. They serve to excrete mucous in the respiratory digestive and urogenital tracts.If we are unable to secrete mucous, it can create all kinds of havoc on our bodies. When a patient is intubated and placed on a ventilator they are unable clear their own mucous secretions and it is imperative that we do it for them. We use inline suction; simply put we advance a suction catheter down their trachea just to the carina stimulating a cough and then pull back the catheter while suctioning the mucous out. If this is not done enough a patient can end up with what we call Ventilator Acquired Pneumonia.

This can be fatal or at the very least extend their stay in the ICU.Keeping a patient’s lungs clear of mucous is essential to their recovery. Synovial membranes serve to provide movement in our joints, by producing synovial fluid that reduces friction between moveable joints. Unlike the other three membranes that were discussed, synovial membranes are composed of only connective tissue. I have gained a new appreciation of my synovial membranes, specifically those located in my lumbar spine. Friday I had to go in and have a spinal ablation done because my synovial membranes are not doing their job and thereby causing my excruciating back pain.Friction in any joint or lack of synovial fluid can cause bone on bone rubbing which can destroy joints, and gravely limit a person’s ability to move around independently.

The membranes that cover our bodies inside and out play a vital role in maintain our homeostatic balance and allowing us to live life to the fullest. Any upset in these membranes can carry some pretty serious consequences and it is important both as a health care professional and a Mom to have the knowledge necessary to identify when there is a problem be able to assess it and put a plan of care into action to regain homeostasis.

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