4.1 Basic Dermatology Flashcards
What is the structure of a dermatology history?
No different
SOCRATES
PMH
DH and Allergies
FH
SH
QoL and ICE
What do you need to explore in presenting complain?
SOCRATES
- Initial appearance and evolution
- Symptoms (itch and pain)
- Aggravating and relieving factors especially triggers
- Previous and current treatments, effective or not
What do you need to ask in PMH?
History of atopy?
- asthma, hay fever, eczema
History of skin cancer or pre-cancer
History of sunburn/sunbathing/sun-bed use
Skin type
What scale is used to determine skin colour types?
Fitzpatrick skin type scale
Label the image
The lighter the skin, higher risk of UV damage
What should you ask in family history?
History of:
- Skin disease
- Atopy
- Autoimmune disease
What should you ask in social history?
Occupation
Sun exposure
Contactants
Imporvement when away from work
What should you ask in drug history?
Regular and recent
Systemic and topical
Be specific with topical treatments
- Where?
- How much?
- How long for?
What steps do you need to follow when examining the skin?
Inspection
Palpation
Description
Systematic check
- Whole skin
- Hair
- Nails
- Mucous membranes
Mnemonic for describing skin
SCAM
Site- distribution (rash)
or size and shape (lesion)
Colour (and configuration)
Associated changes e.g. surface features
Morphology
Mnemonic for pigmented lesions
ABCD
Asymmetry
Border, irregular or blurred
Colour
Diameter
How do you describe the site and distribution of skin lesions?
Generalised/localised- all overan area
Flexural- at creases e.g. cubital and popliteal fossae
Extensory- other side of flexural lesions
Photosensitive
How do you describe the configuation of skin lesions?
Discrete
Confluent
Linear
Target
How do you describe the colour of a skin lesion?
Erythematous- red and blanching (be careful saying dark skin is erythematous, use hyperpigmented instead)
Purpuric-red or purple and non blanching
Brown or black-pigmented or hyperpigmented
Hypopigmented-depigmented if total loss of colour
How do you describe the surface features of skin lesions
Scale-built up keratin
Crust-dried exudate
Excoriation-erosion from scratching= pruritus
Erosin/ulceration-partial or full thickness loss
How do you describe morphology of skin lesions?
Macule- small flat area
Patch- larger flat area
Papule- small raised bumps
Plaque- larged raised area
How do you describe morphology of skin lesions?
Nodule- solid lump/nump
Vescile- small fluid filled blister
Pustule- small bump filled with pus
Bulla-Large fluid filled blister
How do you describe morphology of skin lesions?
Annular- ring shaped
Wheal- urticaria
Discoid/nummular
Comedone- open or closed seen in acne
How do you describe hair findings?
Alopecia-patchy
Alopecia- diffuse
Hypertrichosis- excessive hair growth
Hirtuism- lots of hair, androgen defined e.g. PCOS
How do you describe nail findings?
Koilonychia- spoon nails, occurs in iron deficiency anaemia
Pitting- occurs in psoriasis
Onycholysis- thickening and nail comes away from nail bed
Clubbing- caused by hypoxia
