basic dermatology skills Flashcards
what are the features of a dermatological history
presenting complaint history of presenting complaint past medical history drugs and allergies family history social history ice, impact on life
what features should you ask about presenting complaint in dermatological history
- nature - lesion? rash?
- location + distribution - where is it, is it bilateral?
- duration - when did you first notice it, and where did it start?
what features should you ask about the history of presenting complaint in dermatological history
- associated symptoms - itching? bleeding? discharge?
- when did it begin, and how has it progressed
- have you tried anything for the problem? creams? OTC?
- did you or have you noticed any triggers? soaps? change in creams?
- systemically/ red flags - joint pain? fever? weight loss?
what features should you ask about the past medical history in dermatological history
- history of atopy - hayfever, eczema, asthma
- history of rheumatological disease/ autoimmune disease
- history of systemic features
- history of skin cancer or pre-cancer (moles), has this happened before?
- history of sunburn or sun-bed use or sunbathing - do you spend much time in the sun? do you wear suncream?
- skin type? do you burn easily?
what is the criteria used to categorise skin types
Fitzpatrick skin types
what are the different skin types
type i = white = always burns but never tans
type ii = white = usually burns, difficult to tan
type iii = white = sometimes burns, average tan
type iv= moderate brown = rarely burns, tans with ease
type v = dark brown = very rarely burns and tans very easily
type vi = black = does not burn, tans very easily
what features should you ask about the family history in dermatological history
- history of atopy
- history of autoimmune conditions - psoriatic arthritis
- history of skin cancer, skin conditions
what features should you ask about the social part in a dermatological history
- do you live alone? ALD,
- impact of condition of life, psychology
- do you smoke? pack years
- do you drink - units per week
- are you working currently - occupational exposure - chemical, sun exposure
are your symptoms better when you’re on your day off
what features should you ask about drugs and allergies in dermatological history
- how do you manage your conditions
- do you have any allergies to drugs, what happens if you take the drugs
- take any over-the-counter drugs or prescribed drugs? any creams? where, how much, how long for
describe how skin examination is done
adequate exposure and lighting
- inspection
- palpation
- systemic check = whole skin, hair, nails, mucous membranes
- examine other systems if appropriate = joints, lymph nodes
describe the acronym used in describing skin
- SCAM for rash. site/distribution or shape or size. colour or configuration. associated changes -surface features. morphology
- ABCD for pigmented lesions - asymmetry, border, colour, diameter
descriptive words and pictures on notion
describe the management of atopic eczema (dermatitis)
- avoid irritants e.g: soaps, fragrance, wool, animal fur
- emollients to restore skin barrier
- topical corticosteroids daily until inflammation clear
- anti histamines for pruritus
important fact about anti histamines used in atopic eczema
sedating effect, take overnight
what are the principles behind managing suspected melanoma
- refer to urgent cancer pathway if score 3 points or more on 7 point checklist
- refer if suspected nodular MM
- dermoscopy suggest melanoma
