Basic Dermatology Flashcards
What should be explored in PMH regarding skin conditions?
History of atopy - asthma? Hayfever? Eczema
Skin cancer or pre-cancer
Sunburn/sunbed use
Skin type
How are skin types classified?
Fitzpatrick skin types
1-6 light to dark
Light more risk of UV damage
What should be asked about in family history during a dermatological history?
Skin disease
Atopy
Autoimmune
What aspects should be covered in social history?
Occupation
Sun exposure
Contactants
Improvement when away from work?
What should be included in drug history?
Regular and recent medications
Systemic and topical
Specifics on topical usage - how much? Where? How long for?
What are the steps to follow when examining a skin lesion?
Inspect
Palpate
Systematic check of the whole skin, hair, nails, mucous membranes
Describe
What is the pneumonic for describing a skin lesion?
SCAM
Site, distribution (or size/shape)
Colour (and configuration)
Associated changes - surface features
Morphology
What are the key features to describe pigmented lesions?
Asymmetry
Border (irregular vs blurred)
Colour
Diameter
How can the site/distribution of a lesion be described?
Generalised/localised
Flexural/extensor
Photosensitive
What are the configurations to describe a lesion?
Discrete
Confluent (merging together)
Linear
Target
How can the colour of a skin lesion be described?
Erythematous - Red and blanching
Purpuric
Hyper/pigmented
Hypo/depigmented
What are the surface features of skin lesions?
Scale - build of keratin (psoriasis)
Crust - dried exudate (impetigo)
Excoriation - erosion from scratching from pruritus
Erosion/ulceration - erosion if partial, ulceration if deeper
How can the morphology of a skin lesion be described?
Macule - small flat area
Patch - larger flat area
Papule - raised small bump
Plaque - large raised bump
Vesicle - small fluid filled blister
Bulla - large fluid filled blister
Pustule - bump filled with pus
Nodule - solid bump
Annular - ring shaped
Wheal - urticaria, raised odematous in dermis
Comedones - open/closed, seen in acne
Discoid/nummular - round/disc shape
What are the hair findings that can be described?
Alopecia patchy
Alopecia diffuse
Hypertrichosis - lots of hair
Hirsutism - lots of hair, androgen defined hair eg PCOS
What nail findings can be observed in a dermatological exam?
Koilonychia - spoon nails, iron def anaemia
Pitting - psoriasis
Onycholysis - thickening and nail coming away from nail bed
Clubbing
What is the management for atopic eczema?
- Avoid irritants - soap, fragrance, HDM, wool, animal fur
- Emollients (moisturiser) to restore barrier
- Topical steroids daily until inflammation clear (mild-moderate for face, moderate or potent for body/limbs)
- Antihistamines for pruritis (sedating overnight)
Under what conditions should a suspected melanoma be referred?
Refer on urgent cancer pathway if:
* More than 3 points
* Dermoscopy suggests melanoma
* Suspected nodular malignant melanoma
What is the point system for suspected melanoma?
Major features (2 points)
* Change in size
* Irregular shape
* Irregular colour
Minor features (one point):
* Diameter >7mm
* Inflammation
* Oozing
* Change in sensation
