All right, welcome. This is episode 647 of the Divine Intervention Podcasts. And in today's podcast, we're going to be finishing the series on the 386. This is going to be series 9. All right. So we're going to pick up from question 77. A 58-year-old man comes to the office because of a lesion on his lower lip that developed nine months ago.

He has not seen a physician during the past five years and says,

My wife made me come to see you today.

Physical examination of the lips discloses the findings shown in the photograph.

The lower lip is fixed to the anterior aspect of the mandible.

Which of the following is the most likely diagnosis right so we see this lesion right looks like an ulcer looks like an

ulcer it's kind of around the lower lip right this looks like cancer right this

looks like cancer this probably going to be squamous cell skin cancer right so I've got

an option E it can be option Aamous cell cancer, right? So we're going to go with option E.

It can't be option A, basal cell cancer because we're not seeing like those telenjectias

and things like that that we see with basal cell cancer.

And then this is not a kerato acanthoma.

A keratoicanthoma typically is going to be a raised lesion with a central crater, right?

So it's like a raised lesion with a central crater, right? So it's like a raised lesion with a

central crater. In fact, many times it's regarded as a kind of squamous cell cancer. So that's wrong.

Locopalicia, remember, we tend to find that in immunocompromised patients, HIV patients. It will be a lesion

that is on the lateral tongue or on the tongue, and it doesn't scrape off with a tongue depressor

unlike Canada, right?

And then melanoma tends to be a flat lesion, right?

So the right answer is going to be option E.

Now, a 10-year-old boy, so 78, a 10-year-old boy is brought to the ED by his father because of left flank pain and tenderness.

About four hours ago, the boy was hit hard on the

...