Basics Flashcards
What questions in history/?
Onset Course Duration Severity Timing Precipitants Relieving Associated symptoms Past episodes
Duration Site of onset Spread Evolution Distribution Itch/pain Trauma Previous treatments?
PMH DH - any new medication FHx - atopy, psoriasis Six: Occupation - chemicals Cosmetics Shower jel/soap History of atopy Pets Sexual history
Impact
Mood
Sleep
Concentration impact
What should you examine in dermatology?
Skin
Scalp/hair
Nails
Mucous membranes
What should you look for on examination to describe?
Shape of lesions:
- monomorphic (one form) or polymorphic, ring like, active edge, healing centre, linear, discoid
Patterns of lesions
- grouped, scattered, generalised, crops of lesions, target like
Border of lesion
- distinct, well demarcated, indistinct
Surface
- scaly (epidermal) or smooth (dermal), excoriations, erosions, lichenified (thickened), scarring
Elevation
- Raised or flat
Colour
- erythema? Blanching (suggesting erythema from increased blood in small vessels) Non blanching (suggested leakage of blood in dermis
Temperature
- hotter or cooler than normal
Evolution
- different stages
What does blanching/non-blanching erythema suggest?
Blanching - erythema from increased blood in small vessels
Non-blanching - purport from leakage of blood in the dermis
What does a symmetrical/asymmetrical distribution suggest?
Symmetrical - Endogenous/systemic cause
Asymmetrical - External cause e.g. insect bites, infection, trauma or contact dermatitis
What should you consider about distribution?
Symmetry Certain areas - - flexor in eczema - extensor in psoriasis - area in contact with jewellery or cosmetics in allergic contact dermatitis - area of sun exposure
What is cream? Ointment? Emoolient?
Creams are emulsions of oil and water well absorbed into skin
Ointments are greasy preparations that have no added water and are more occlusive. Mild anti-inflammatory effect
Emollients are ointments, creams, lotions that soothe and hydrate the skin
What is a macule?
Flat, non-palpable change in skin colour < 0.5cm diameter
What is a patch?
Flat non-palpable change in skin colour > 0.5cm
What is a vesicle?
Fluid within the upper layers of the skin < 0.5cm
What is a bulla?
Large fluid filled lesion below the epidermis > 10 cm
What is a blister?
Fluid within the upper layers of the skin > 0.5cm
What is a pustule?
Visible collection of pus in the subcutis
What is a papule?
Raised area < 0.5 cm diameter
What is a nodule?
A raised area > 0.5cm
What is a plaque
A raised are > 2cm
What is a wheal?
Dermal oedema
What is a callus?
Hyperplastic epidermis - often found on soles, palms or other areas of friction
What is an erosion?
Partial epidermal loss
Heals without scarring?
What is a fissure?
A linear crack
What is an ulcer?
Full thickness skin loss
What is atrophy?
Thinning of the epidermis
Loss of tissue (epidermis/dermis and or subcutaneous
What is a scale?
A small thin piece of horny epithelium
What is a crust?
Dried exudate of blood/plasma or tissue fluid
What is excoriation?
A scratch mark
What is lichenification?
Thickening of the epidermis with exaggerated skin markings (bark like) usually due to repeated scratching
What is telangiectasia?
Easily visible superficial blood vessels
What is spider naives?
A signe telangiectatic arteriole in the skin
What is purpura?
A rash caused by blood in the skin - often multiple petechiae
What is petechia?
Micro-haemorrhage 1-2mm in diameter
What is ecchymosis?
A bruise - form of purpura
What is erythema?
Reddening of the skin due to local vasodilation
