Question

Based on the following case study answer these 2 questions.

1) The patient in our case study, Mr. Bryan, has numerous skin tags. Are these skin lesions benign or malignant? What are some other skin tumors that we have to rule out in this case?

2) Is our patient prone to skin infections? What are the most common skin infections you know?

CASE STUDY

Personal Information

Name: Mr. Elliot Bryan

Age: 29 years old

Gender: Male

Description

Mr. Bryan is a 29-year-old married man who came to the medical office because, over the last three years, he has progressively increased the size of his shoes, and he has resized his wedding ring three times. He says his feet and hands have grown. He has also noticed that his face has turned coarse. He was a very active man and practiced sports, but now he fatigues just by walking and feels weakness in his muscles and stiffness in his joints. He is depressed because in the last few months he has been experiencing erectile dysfunction, which is affecting his relationship with his wife. He feels he is losing his vision as well.

Mr. Bryan does not drink alcohol, smoke, or use any recreational drug. His mother suffers from diabetes mellitus type II, and his father suffers from hypertension.

On physical examination we found:

Remarkable Signs on Physical by Regions

Head: Enlarged and coarsened facial features, prominent superciliary arches, prognathism

Neck: Thyroid is visible and palpable

Thorax: Barrel appearance

Abdomen: Hepatomegaly. Splenomegaly.

SOMA: Enlargement of the hands and feet. Generalized arthralgia.

Remarkable Signs on Physical by Systems

Integumentary system: Thick and oily skin. Numerous acrochorda disseminated throughout the body.

Cardiovascular system: Blood pressure 150/100. Radial pulse 72.

Digestive system: Megaloglossia. Diastema.

Lab Tests

Complete blood count (CBC)

GH measurement

IGF-I measurement

Growth hormone suppression test

Glucose level

Brain MRI

Abdominal CT scan

Echocardiogram

Diagnosis

Acromegaly

Answer 1

Ans.) The description of the patient’s condition given ere indicated that the patient is suffering from acromegaly. Basically it is a hormonal disorder that grows when the pituitary gland produces excessive growth hormone. This   excessive production of GH caused due to benign tumor on the pituitary gland. This excess GH leads to the mentioned symptoms of the patient. In addition,    these skin lesions Are benign not malignant.

2.) Yes, sometimes patient is prone to skin infections. Skin can be infected by bacteria, fungus and yeast also. Few of the most common skin infections are described below –

Impetigo – It is generally found on the skin usually caused by S. aureus.

Folliculitis – It is a superficial infection of the hair follicles.

Ecthyma - It is a cutaneous infection which have thick crusted erosions.

Erysipelas – generally, this infection is found on the surface of skin involving dermal lymphatic vessels.

Candidiasis – It is a group of infections caused by Candida albicans or by other members of the genus Candida.