Approach to the Patient with a Rash

Question 1

Macule

Answer 1

Small (less than 1 cm) circumscribed area of color change with no elevation/depression

Question 2

Patch

Answer 2

Large (more than 1 cm) area of color change with no elevation or depression

Question 3

Elevated lesions 
Papules
Nodules
Wheals
Plaques

Answer 3

Papules (less than .5 cm)
Nodules (more than .5 cm)
Wheals - pink, rounded, or flat topped elevations due to edema in the skin
Plaques - plateua-shaped often formed by coalescne of papules

Question 4

Fluid filled

Vesicles
Bullae
Pustules
Cysts

Answer 4

Vesicles - less than .5 cm in diameter and filled with serous or clear

Bullae - more than .5 with serous/clear

Pustules - less than .5 cm and filled iwth purulent

Cyst - more than .5 and filled with purulent

Question 5

Depressed

Erosion
Ulcers

Answer 5

Erosion - superficial loss of epidermis with a moist base

Ulcer - extending into dermis or below

Question 6

Atopic dermatitis
Seborrheic dermatitis
Psoriasis
Acne

Locations

Answer 6

Antecubital/popliteal fossa

Scalp and eyeborws/nasolabial folds

Traumatized areas like extensor surfaces of elbows and kness

Face, back, chest, sites of most pilosebaceous follicles

Question 7

Linear
Grouped
Dermatomal
Annular

Answer 7

Contact due to plants, psoriasis, warts, epidermal nevi

HSV, wats, molluscum contagiosum

HZ

Tinea corporis, granuloma annulae, erythema migrans, lupus

Question 8

Erythematous
Hyperpigmented
Hypopigmented
Depigmented

Answer 8

Pink or red…notice if blanch…if in vessels, compression of skin forces cells into deeper vessels…if non-blanching then petechiae, purpura or ecchymoses

Tan/brown/black

Amount of pigmented decreased

All absent (vitilog)

Question 9

Crusting
Scaling
Atrophy
Lichenification

Answer 9

Dried fluid seen follwoing rupture of vesicles or bullae

Epidermal fragments

Area of depression due to absence of a layer (thick and wrinked)

Thickening of skin from chronic rubbing or scratching/…normal marking s appear prominent