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Zero to Finals > Dermatology > Flashcards

Dermatology Flashcards

1
Q

How to take a dermatological history ?

A

For dark lesions or moles, pay attention to questions marked with an asterisk (*).

PRESENTING COMPLAINT:

-Nature, site and duration of problem

HISTORY OF PRESENTING COMPLAINT:

  • Initial appearance and evolution of lesion*
  • Symptoms (particularly itch and pain)*
  • Aggravating and relieving factors
  • Previous and current treatments (effective or not):
  • Recent contact, stressful events, illness and travel
  • History of sunburn and use of tanning machines*
  • Skin type (see page 70)*

PMH:

  • History of atopy i.e. asthma, allergic rhinitis, eczema
  • History of skin cancer and suspicious skin lesions

FAMILY HISTORY:

-Family history of skin disease*

SOCIAL HISTORY:

  • Occupation (including skin contacts at work)
  • Improvement of lesions when away from work

MEDICATION AND ALLERGIES:

-Regular, recent and over-the-counter medications

IMPACT OF QOL:

-Impact of skin condition and concerns

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2
Q

Structure of describing a rash ?

A
  • Distribution – where is it? E.g. flexures/extensor
  • Configuration – grouping of the rash – e.g. linear, annular, clustered
  • Morphology – what sort of lesions
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3
Q

How to examine the skin ?

A

INSPECT:

  • General observation
  • Site and number of lesion(s)
  • If multiple, pattern of distribution and configuration

DESCRIBE the individual lesion:

(SCAM)

  • Size (the widest diameter), Shape
  • Colour
  • Associated secondary change
  • Morphology, Margin (border)
  • If the lesion is pigmented, remember ABCD (the presence of any of these features increase the likelihood of melanoma):
  • (A)symmetry (lack of mirror image in any of the four quadrants)
  • Irregular (B)order
  • Two or more (C)olours within the lesion
  • (D)iameter > 6mm

PALPATE the individual lesion:

  • Surface
  • Consistency
  • Mobility
  • Tenderness
  • Temperature

SYSTEMATIC CHECK:

  • Examine the nails, scalp, hair and mucous membranes
  • General examination of all systems
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4
Q

What do each of these configuration terms mean ?

  • Discrete
  • Confluent
  • Linear
  • Target
  • Annular
  • Discoid/ nummular
A
  • Discrete = Individual lesions separated from each other
  • Confluent = Lesions merging together
  • Linear = In a line
  • Target = Concentric rings (like a dartboard)
  • Annular = ring shaped
  • Discoid / nummular = A coin-shaped/round lesion
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5
Q

What is a macule ?

A

Flat (non-palpable) area of altered colour <0.5cm e.g. freckle

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6
Q

What is a patch ?

A

Flat area of altered colour >0.5cm e.g. port-wine stain

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7
Q

What is a papule ?

A

Solid raised lesion <0.5cm e.g. xanthomata

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8
Q

What is a nodule ?

A

Solid raised lesion >0.5cm with deeper component e.g. granuloma

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9
Q

What is a vesicle ?

A

Raised, clear, fluid filled lesion <0.5cm e.g. HSV

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10
Q

What is a bulla ?

A

Raised, clear, fluid filled lesion >0.5cm

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11
Q

What is a pustule ?

A

Pus containing lesion <0.5cm e.g. acne

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12
Q

What is a abscess ?

A

Localised accumulation of pus in dermis or subcutaneous tissuee.g. periungual

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13
Q

What is a weal ?

A

Transient, raised lesion due to dermal oedema e.g. urticaria

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14
Q

What is a boil ?

A

Staphylococcus infection around or within hair follicle

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15
Q

What is excoriation ? (secondary lesion)

A

Loss of epidermis following trauma e.g. eczema

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16
Q

What is lichenification ? (secondary lesion)

A

Well-defined roughening of skin with attenuation of skin markings

17
Q

What is scale ? (secondary lesion)

A

Flakes of stratum corneum e.g. psoriasis (silver scaling)

18
Q

What is crust ? (secondary lesion)

A

Rough surface of dried blood, serum or bacteria e.g. burst blister

19
Q

What is a scar ? (secondary lesion)

A

New fibrous tissue occurring post wound healing, may be atrophic (thinning), hypertrophic (hyperproliferation within boundary), or keloidal (beyond boundary)

20
Q

What is an ulcer ? (secondary lesion)

A

Loss of epidermis and dermis

21
Q

What is a fissure ? (secondary lesion)

A

Epidermal crack due to excess dryness, e.g. eczema

22
Q

What are striae ? (secondary lesion)

A

Linear areas, purple, pink, or white e.g. steroids

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