Basic Dermatology Skills Flashcards
What is important in a dermatological history?
- Presenting complaint.
- History of presenting complain.
- Past medical history.
- Social History.
- Family History.
- Drug History and allergies.
- Impact on QoL/ICE.
What are the important things to ask about in a presenting complaint?
- Nature (rash/lesion.
- Site.
- Duration.
- Initial appearance and evolution.
- Symptoms (itch/pain).
- Aggravating and relieving factors.
- Previous and current treatments.
What are the important things to ask about in the patients past medical history?
Systemic disease. History of atopy (asthma, hay fever and eczema). History of skin cancer/pre-cancer. History of sun exposure. Skin type.
Describe the Fitzpatrick Skin Types.
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.
What are the important factors to consider in family history of someone with a skin complaint?
Family history of skin disease.
Family history of atopy.
Family history of autoimmune disease.
What are the important factors to consider in a social history of someone presenting with a skin problem?
Occupation.
Sun exposure.
Contactants.
Whether it improves when away from work.
What are the important factors in a drug history to consider about someone who presents with a skin problem?
Regular or recent change in medication.
If the drugs are systemic or topical.
Ask specifically with topical treatments (where, how much and duration).
How can you assess the patients QoL and beliefs about their conditions?
Ask about ideas, concerns and expectations.
What are the main methods to do when examining the skin?
Inspect, palpate, describe and do a systematic check of the whole skin, hair, nails and mucous membrane.
How should you describe a skin problem?
SCAM:
Site, distribution (rash)/ Size and shape (lesion).
Colour and Configuration.
Associated changes (e.g. surface changes).
Morphology.
How can you describe pigmented lesions?
Asymmetry.
Border: irregular/blurred.
Colour.
Diameter.
What words can be used to describe distribution/site?
- Generalised: everywhere.
- Flexural: on the flexor areas.
- Extensor: on extensor areas.
- Photosensitive: where the sun hits the skin.
What words can be used to describe configuration of a skin problem?
- Discrete.
- Confluent.
- Linear.
- Target.
What words can describe the colour of a skin problem?
- Erythematous: red and blanching.
- Purpuric: red/purple and non-blanching.
- Brown or black: pigmented/hyperpigmented.
- Hypopigmented: dispigmented in total loss of colour.
What words can be used to describe the surface features of a skin problem?
- Scale: build up of keratin.
- Crust: dried exudate.
- Excoriation: erosion from scratching (pruritus).
- Erosion/ulceration: partial/full thickness loss.