Dermatology History and Examination Flashcards
Key features of a derm history
PC - nature - site - duration HxPC - initial appearance and evolution - symptoms - aggravating/relieving factors - previous/current treatments PMHx - systetmic diseases - atopy - skin cancer/pre-cancer FHx - skin disease - atopy - autoimmune disease SHx - occupation - sun exposure, contactants DHx + allergies ICE
Describing skin lesions
S - site, distribution for rash or size and shape for lesion
C - colour
A - associated changes
M - morphology
ABCDE for pigmented lesions
A - asymmetry B - border - irregular, blurred C - colour D - diameter E - evolution
Palpation of lesions
Surface Consistency Mobility Tenderness Temperature
Define pruritus
Itching
Define lesion
An area of altered skin
Define rash
An eruption
Define naevus
Localised malformation of tissue structures
Define comedone
Plug in sebaceous follicle containing altered sebum, bacteria and cellular debris
- open - blackheads
- closed - whiteheads
Description of distribution
Generalised - all over body
Widespread - extensive
Localised - restricted to one area
Flexural - body folds
Extensor - knees, elbows, shins
Pressure areas - sacrum, buttocks, ankles, heels
Dermatome - area of skin supplied by single spinal nerve
Photosensitive - sun-exposed area
Koebner phenomenon - linear eruption arising at site of trauma
Description of configuration
Discrete - individual lesions separated from each other Confluent - lesions merge Linear Target - concentric rings Annular - ring Discoid - round
Description of colour
Erythema - redness which blanches on pressure
Purpura - red or purple colour which does not blanch
Petechia - small pin-point macules
Ecchymoses - larger bruise-like patches
Hypopigmentation - areas of pale skin
De-pigmentation - white skin due to absence of melanin
Hyperpigmentation - darker skin
Description of morphology
Macule - flat area of altered colour
Patch - larger flat area of altered colour or texture
Papule - solid raised lesion < 0.5 cm in diameter
Nodule - solid raised lesion > 0.5 cm in diameter
Plaque - palpable scaling raised lesion > 0.5 cm
Vesicle - raised, clear fluid-filled lesion < 0.5 cm
Bulla - raised, clear, fluid-filled lesion > 0.5 cm
Pustule - pus containing lesions < 0.5 cm
Abscess - localised accumulation of pus in dermis or subcut tissue
Wheal - transient raised lesion due to dermal oedema
Boil - staphylococcal infection around or within a hair follicle
Description of secondary lesions
Excoriation - loss of epidermis following trauma
Lichenification - well-defined roughening of skin with accentuation of skin markings
Scales - flakes of stratum corneum
Crust - rough surface of dried serum, blood, bacteria and cellular debris that has exuded through eroded epidermis
Scar - new fibrous tissue which occurs post-wound healing
- atrophic - thinning
- hypertrophic - hyperproliferation within wound boundary
- keloidal - hyperproliferation beyond wound boundary
Ulcer - loss of epidermis and dermis
Fissure - epidermal crack often due to excess dryness
Striae - linear areas which progress from purple to pink to white with histopathological appearance of scar
Description of hair
Alopecia - loss of hair
Hirsutism - androgen-dependent hair growth in female
Hypertrichosis - non-androgen dependent pattern of excessive hair growth
