Family Nurse Practitioner Exam

What should be recommended for a 72-year-old female with a non-healing ulcer on her upper lip?

1. A) Triamcinolone acetonide (Kenalog) cream BID for 2 weeks

2. B) Triple antibiotic ointment BID x 2 weeks

3. C) Hydrocortisone 1% cream BID for 2 weeks

4. D) The patient needs to be evaluated by a dermatologist

The correct answer is: D) The patient needs to be evaluated by a dermatologist

For a 72-year-old female with a non-healing ulcer on her upper lip, the recommendation to have her evaluated by a dermatologist is crucial. Non-healing ulcers can indicate various underlying conditions, including malignancies, infections, or other dermatological diseases that require specialized assessment. Dermatologists have the expertise to perform detailed evaluations and may utilize advanced diagnostic tools to determine the nature of the ulcer. The distinction between benign and potentially malignant conditions is vital, especially in older adults, as the risk of skin cancers, such as basal cell carcinoma or squamous cell carcinoma, increases with age. Therefore, referral to a dermatologist ensures that the patient receives an accurate diagnosis and appropriate treatment plan based on her specific condition. The topical treatments mentioned in the other options may provide symptomatic relief or manage certain conditions; however, they do not address the critical need for a thorough evaluation of a persistent ulcer. Utilizing a dermatologist's expertise allows for a comprehensive approach to management, ensuring the best possible outcomes for the patient’s health.