By HANS DUVEFELT

Today I saw a patient I have known for years. He suddenly pulled his mask down and said, “I’d like to know what you think I should do about this”.

On his nose was an 8 mm (1/3”) brownish-red flat spot with a crack or scrape through it.

“How long have you had it?”, I asked.

“Oh, a while now” he answered. That is about the least helpful time measurement I know of. I asked him to pin it down a bit more precisely. He settled for about a year. I prescribed a cream and made a two week follow-up appointment for either cryo or a biopsy. It’s probably just an excoriated, premalignant, actinic keratosis.