Sunburn

Total body skin examination (TBSE)

In patients with skin types I-III who are at higher risk for sunburn and skin cancer, periodic TBSE should be considered. Although annual TBSE by dermatologists has been shown to be sensitive and specific for the detection of skin cancer, annual TBSE by family physicians has not been shown to decrease morbidity or mortality from skin cancer and has not been recommended by the US Preventive Services Task Force.[23]Berg AO. Screening for skin cancer: recommendations and rationale. Am J Nurs. 2004;104:87-91. http://www.ncbi.nlm.nih.gov/pubmed/15171121?tool=bestpractice.com Nevertheless, TBSE provides an excellent opportunity to assess the extent of chronic actinic damage as well as a patient's knowledge of the short- and long-term effects of sun exposure. Patients with significant chronic actinic damage and a history of sun-seeking behavior should be educated on sun-protective behaviors and the early signs of melanoma and nonmelanoma skin cancer.