iHuman Comprehensive Case Study Week 2: Thomas Warren, 72-
Year-Old Male With Unusual Mole (Class 6531) – Outpatient Clinic
Assessment With Laboratory Capabilities 2026
This iHuman Week 2 case study analyzes Thomas Warren, a 72-year-old male presenting with an
unusual mole in an outpatient clinic with laboratory capabilities. The article covers clinical
assessment, differential diagnosis, diagnostic evaluation, and evidence-based management strategies
for suspicious skin lesions in older adults.
iHuman Week 2 case study,
Thomas Warren unusual mole,
72-year-old male skin lesion,
outpatient dermatology assessment,
,Patient: Thomas Warren
Age: 72 years
Setting: Outpatient Clinic with Laboratory Capabilities
Class: 6531
Presenting Complaint: Unusual mole
S – Subjective
Chief Complaint (CC):
“I noticed a mole on my arm that looks different than usual.”
,History of Present Illness (HPI):
Thomas Warren, a 72-year-old male, presents for evaluation of a mole on his left
forearm that he first noticed approximately 2 months ago. The patient reports that the
mole has changed in size and color. He denies pain, bleeding, or itching but expresses
concern about its irregular appearance. No new moles elsewhere have been noted. He
denies recent sunburns or trauma to the area. No family history of melanoma is
reported.
Past Medical History (PMH):
• Hypertension, well-controlled
• Hyperlipidemia
• No history of skin cancer
Past Surgical History (PSH):
• Appendectomy at age 30
Medications:
• Lisinopril 10 mg daily
• Atorvastatin 20 mg nightly
Allergies:
• No known drug allergies (NKDA)
Family History:
• No skin cancers
• Father had coronary artery disease
Social History:
• Retired teacher
• Non-smoker, occasional alcohol use
• Lives independently; enjoys gardening
Review of Systems (ROS):
• Skin: Reports new mole, no itching, bleeding, or pain
• Constitutional: Denies fever, weight loss, fatigue
• HEENT, Cardiovascular, Respiratory, GI, GU, Neuro, MSK: No additional
complaints
O – Objective
Vital Signs:
• BP: 132/78 mmHg
• HR: 78 bpm
• RR: 16/min
, • Temp: 98.4°F (36.9°C)
• SpO₂: 97% on room air
General Appearance:
• Alert, oriented ×3, no acute distress
Skin Exam:
• Left forearm: Single asymmetric mole approximately 0.8 cm × 0.7 cm
• Irregular borders, variegated color (tan, dark brown, small black speck), slightly
raised
• No ulceration or bleeding
• No satellite lesions
• No other suspicious lesions on full skin exam
Lymph Nodes:
• No palpable axillary or cervical lymphadenopathy
Other Systems:
• Cardiovascular, respiratory, abdominal, neurologic exams within normal limits
Laboratory/Diagnostics:
• Not yet obtained; plan includes baseline CBC, CMP if indicated prior to
surgical excision
• Dermoscopy recommended to assess atypical features
A – Assessment
Primary Diagnosis:
• Suspicious pigmented lesion – rule out melanoma
• Features concerning for atypical or dysplastic nevus: asymmetry, border
irregularity, color variation, diameter >6mm, evolving (ABCDE criteria)
Differential Diagnosis:
1. Dysplastic nevus – Atypical but benign mole
2. Melanoma – Malignant lesion requiring biopsy
3. Seborrheic keratosis – Benign, usually “stuck-on” appearance
4. Solar lentigo – Benign sun spot
5. Basal cell carcinoma (pigmented variant) – Less likely given mole
appearance
Risk Factors Present:
• Age >70
• History of cumulative sun exposure (gardening)
• Male sex
Year-Old Male With Unusual Mole (Class 6531) – Outpatient Clinic
Assessment With Laboratory Capabilities 2026
This iHuman Week 2 case study analyzes Thomas Warren, a 72-year-old male presenting with an
unusual mole in an outpatient clinic with laboratory capabilities. The article covers clinical
assessment, differential diagnosis, diagnostic evaluation, and evidence-based management strategies
for suspicious skin lesions in older adults.
iHuman Week 2 case study,
Thomas Warren unusual mole,
72-year-old male skin lesion,
outpatient dermatology assessment,
,Patient: Thomas Warren
Age: 72 years
Setting: Outpatient Clinic with Laboratory Capabilities
Class: 6531
Presenting Complaint: Unusual mole
S – Subjective
Chief Complaint (CC):
“I noticed a mole on my arm that looks different than usual.”
,History of Present Illness (HPI):
Thomas Warren, a 72-year-old male, presents for evaluation of a mole on his left
forearm that he first noticed approximately 2 months ago. The patient reports that the
mole has changed in size and color. He denies pain, bleeding, or itching but expresses
concern about its irregular appearance. No new moles elsewhere have been noted. He
denies recent sunburns or trauma to the area. No family history of melanoma is
reported.
Past Medical History (PMH):
• Hypertension, well-controlled
• Hyperlipidemia
• No history of skin cancer
Past Surgical History (PSH):
• Appendectomy at age 30
Medications:
• Lisinopril 10 mg daily
• Atorvastatin 20 mg nightly
Allergies:
• No known drug allergies (NKDA)
Family History:
• No skin cancers
• Father had coronary artery disease
Social History:
• Retired teacher
• Non-smoker, occasional alcohol use
• Lives independently; enjoys gardening
Review of Systems (ROS):
• Skin: Reports new mole, no itching, bleeding, or pain
• Constitutional: Denies fever, weight loss, fatigue
• HEENT, Cardiovascular, Respiratory, GI, GU, Neuro, MSK: No additional
complaints
O – Objective
Vital Signs:
• BP: 132/78 mmHg
• HR: 78 bpm
• RR: 16/min
, • Temp: 98.4°F (36.9°C)
• SpO₂: 97% on room air
General Appearance:
• Alert, oriented ×3, no acute distress
Skin Exam:
• Left forearm: Single asymmetric mole approximately 0.8 cm × 0.7 cm
• Irregular borders, variegated color (tan, dark brown, small black speck), slightly
raised
• No ulceration or bleeding
• No satellite lesions
• No other suspicious lesions on full skin exam
Lymph Nodes:
• No palpable axillary or cervical lymphadenopathy
Other Systems:
• Cardiovascular, respiratory, abdominal, neurologic exams within normal limits
Laboratory/Diagnostics:
• Not yet obtained; plan includes baseline CBC, CMP if indicated prior to
surgical excision
• Dermoscopy recommended to assess atypical features
A – Assessment
Primary Diagnosis:
• Suspicious pigmented lesion – rule out melanoma
• Features concerning for atypical or dysplastic nevus: asymmetry, border
irregularity, color variation, diameter >6mm, evolving (ABCDE criteria)
Differential Diagnosis:
1. Dysplastic nevus – Atypical but benign mole
2. Melanoma – Malignant lesion requiring biopsy
3. Seborrheic keratosis – Benign, usually “stuck-on” appearance
4. Solar lentigo – Benign sun spot
5. Basal cell carcinoma (pigmented variant) – Less likely given mole
appearance
Risk Factors Present:
• Age >70
• History of cumulative sun exposure (gardening)
• Male sex
