4: History taking

Question 1

The most important part of a derm consultation is taking the patient’s ___.

Answer 1

history

Question 2

What are important things to ask about in a derm consultation?

Answer 2

History of presenting complaint

Past medical history

Drug history

Social / occupational history

Family history

Question 3

History of presenting complaint

Answer 3

When did you first notice the lesion?

Where?

Has it changed? (Size, shape, colour etc.)

What were you doing at the time?

Associated symptoms - itching, pain

Exacerbating and relieving factors

ICE - how does it impact the patient?

Question 4

Past medical history

Answer 4

Have you had anything like this before?

Past history of atopy - asthma, hayfever, eczema

Have you been in hospital before? Consider associations like sarcoidosis, Crohn’s disease, HIV etc.

Question 5

Drug history

Answer 5

What drugs are you currently taking?

Complementary therapies?

Make-up? Other cosmetics

Question 6

Social / occupational history

Answer 6

Where do you work? Contact with chemicals, irritants etc.

Hobbies?

Alcohol intake

Smoking

Travel? Do you spend a lot of time in the sun?

Sexual history

How are things at home?

Question 7

Family history

Answer 7

Does anyone in the family have the same problem?

Do any skin diseases run in your family?