• Nerve that innervates a joint also tends to innervate the muscles that move the joint and the skin that covers the distal attachments of those muscles
• For example, musculocutaneous nerve:
• Supplies biceps brachii + brachialis
• Also supplies the elbow joint with pain and proprioception fibres
• Also supplies the forearm skin around the elbow (close to the insertion of each of those muscles)

Melanoma history

• Age
• Occupation
• Outside work?
• Country of birth
• Past sun exposure
• Sunburnt?
• Skin type / Response to sun
• History of lesion
• When noticed
• When GP consulted
• Referrals
• Any other moles
• PMH
• FHx of skin or other cancer
  

Fungating man

• Differentials
• SCC / MM
• BCC never look like that
• Smell
• Farty smell = Anaerobes
  
• => Metroniazole

Melanoma staging

• Breslow thickness => 5-year survival
  
• <1 mm => 95-100% 
• 1 - 2 mm => 80-96% 
• 2 - 4 mm => 60-75% 
• >4 mm => 50%
• Ulceration is bad
• Nodes
• CT for haematogenous spread

Skin types (Fitzpatrick Scale)

• Type I
• Light, pale white
• Always burns, never tans
• Type II
  
• White; fair.
• Usually burns, tans with difficulty
• Type III
  
• Medium, white to light brown.
• Sometimes mild burn, gradually tans to a light brown
• Type IV
• Olive, moderate brown
• Rarely burns, tans with ease to a moderate brown
• Type V
  
• Brown, dark brown
• Very rarely burns, tans very easily
• Type VI
  
• Black, very dark brown to black
• Never burns, tans very easily, deeply pigmented

• Noncancerous benign skin growth
• Originates in keratinocytes
• Seen more often as people age
• Appearance:
• "Pasted on"
  
• Various colors, from light tan to black
• Round or oval
• Feel flat or slightly elevated (like the scab from a healing wound)
• Range in size from very small to more than 2.5 centimetres across
• Resemble
• Warts
• Melanoma