Dermatology Flashcards
When taking a dermatological history, what aspects should be explored?
Presenting complaint History of presenting complaint Past medical history Family history Social history Drug history Quality of life impact and ICE
What aspects of the presenting complaint should be explored?
Nature (rash/lesion) Site Duration and changes
What aspects of the history of the presenting complaint should be explored?
Initial appearance and evolution Symptoms (particularly itch/pain) Aggravating and relieving factors Previous and current treatments
What aspects of the past medical history should be explored?
Systemic diseases History of atopy Skin cancer Sunburn/sun-bed use Skin type
What are the atopic conditions?
Asthma Eczema Hay-fever
What system can be used to analyse skin type?
Fitzpatrick skin types
What aspects of family history should be explored?
Family history of skin disease (e.g. psoriasis) Family history of atopy Family history of autoimmune disease (e.g. alopecia, vitiligo)
What aspects of social history should be explored?
Occupation Sun exposure Exposure to chemicals Improvement of symptoms when away from work
What aspects of a drug history should be explored?
Regular and recent drugs Systemic and topical treatments used
How should the use of topical treatments be explored?
Where applied? How much? How long for?
How should quality of life impact and ICE be explored?
Impact of skin on life Ideas Concerns Expectations
When examining the skin what parts should be examined?
All sites, including: Nails Mucosa Hair
How should a dermatological examination be conducted?
Inspect Palpate Describe
When palpating the skin, what should be assessed?
Flat/raised Warmth
What mnemonic can be used to describe the skin?
S - site and distribution/size and shape C - colour A - associated changes M - morphology
How can colour be described?
Erythema (blanching redness) Purpura (red or purple non-blanching) Pigmented/hyperpigmented (brown/black) Hypopigmented
How can a lesion/rash’s morphology be described?
Macule Papule Patch Plaque Nodule Vesicle Pustule Bulla Annular Wheal Discoid Comedone
How does a macule feel on palpation?
Flat
How does a papule feel on palpation?
Raised but in a small area
How does a patch feel on palpation?
Flat but in a large area
How does a plaque feel on palpation?
Raised, but broader than it is high
How does a nodule feel?
Like a papule but >1cm
What is a vesicle?
A clear fluid filled lesion
What is a pustule?
A pus filled lesion
What is a bulla?
A large fluid filled lesion
What shape is an annualar lesion?
Ring shaped
What presents with a wheal?
Urticaria
What shape is a discoid lesion?
Coin shaped
What forms can a comedone come in?
Open (black head) Closed