Basic Dermatology Skills Flashcards

1
Q

What is important in a dermatological history?

A
  1. Presenting complaint.
  2. History of presenting complain.
  3. Past medical history.
  4. Social History.
  5. Family History.
  6. Drug History and allergies.
  7. Impact on QoL/ICE.
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2
Q

What are the important things to ask about in a presenting complaint?

A
  1. Nature (rash/lesion.
  2. Site.
  3. Duration.
  4. Initial appearance and evolution.
  5. Symptoms (itch/pain).
  6. Aggravating and relieving factors.
  7. Previous and current treatments.
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3
Q

What are the important things to ask about in the patients past medical history?

A
Systemic disease.
History of atopy (asthma, hay fever and eczema).
History of skin cancer/pre-cancer.
History of sun exposure.
Skin type.
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4
Q

Describe the Fitzpatrick Skin Types.

A

Type 1: white, always burns, never tans.
Type 2: white, usually burns, difficulty in tanning.
Type 3: white, sometimes burns, average tan.
Type 4: moderate brown, rarely burns, tans with ease.
Type 5: dark brown: very rarely burns and tans very easily.
Type 6: black: does not burn, tans very easily.

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5
Q

What are the important factors to consider in family history of someone with a skin complaint?

A

Family history of skin disease.
Family history of atopy.
Family history of autoimmune disease.

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6
Q

What are the important factors to consider in a social history of someone presenting with a skin problem?

A

Occupation.
Sun exposure.
Contactants.
Whether it improves when away from work.

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7
Q

What are the important factors in a drug history to consider about someone who presents with a skin problem?

A

Regular or recent change in medication.
If the drugs are systemic or topical.
Ask specifically with topical treatments (where, how much and duration).

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8
Q

How can you assess the patients QoL and beliefs about their conditions?

A

Ask about ideas, concerns and expectations.

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9
Q

What are the main methods to do when examining the skin?

A

Inspect, palpate, describe and do a systematic check of the whole skin, hair, nails and mucous membrane.

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10
Q

How should you describe a skin problem?

A

SCAM:
Site, distribution (rash)/ Size and shape (lesion).
Colour and Configuration.
Associated changes (e.g. surface changes).
Morphology.

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11
Q

How can you describe pigmented lesions?

A

Asymmetry.
Border: irregular/blurred.
Colour.
Diameter.

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12
Q

What words can be used to describe distribution/site?

A
  1. Generalised: everywhere.
  2. Flexural: on the flexor areas.
  3. Extensor: on extensor areas.
  4. Photosensitive: where the sun hits the skin.
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13
Q

What words can be used to describe configuration of a skin problem?

A
  1. Discrete.
  2. Confluent.
  3. Linear.
  4. Target.
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14
Q

What words can describe the colour of a skin problem?

A
  1. Erythematous: red and blanching.
  2. Purpuric: red/purple and non-blanching.
  3. Brown or black: pigmented/hyperpigmented.
  4. Hypopigmented: dispigmented in total loss of colour.
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15
Q

What words can be used to describe the surface features of a skin problem?

A
  1. Scale: build up of keratin.
  2. Crust: dried exudate.
  3. Excoriation: erosion from scratching (pruritus).
  4. Erosion/ulceration: partial/full thickness loss.
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16
Q

What words can be used to describe the morphology of a skin problem?

A
  1. Macule: flat, under 5mm.
  2. Patch: large macule.
  3. Plaque: raised 5mm.
  4. Papule: raised over 5mm.
  5. Nodule: large papule.
  6. Vesicle: clear fluid.
  7. Pustule: pus filled.
  8. Bulla: large 1cm+ vesicle.
  9. Annular: ring shaped with central clearing.
  10. Wheal: urticaria. Smooth plaques.
  11. Discoid/nummlar: no central clearing.
  12. Comedone: open (Black head) or closed (white head).
17
Q

What words can be used to describe hair findings?

A
  1. Alopecia: patchy.
  2. Alopecia: diffuse.
  3. Hypertrichosis: excess hair everywhere, not related to areas.
  4. Hirsutism: polycystic ovarian syndrome, associated with females with male hair distribution.
18
Q

What words can be used to describe nail findings?

A
  1. Koilonychia: iron deficiency.
  2. Pitting.
  3. Onycholysis: where the nail separates from the nail bed.
  4. Clubbing.