Dermatology - History + Examinations Flashcards
What mnemonic is used for a dermatology examination?
SCAM
- site + distribution (rash)
- size + shape (lesion)
- colour + configuration
- associated changes
- morphology
What mnemonic is used to examine pigmented lesions?
ABCDE
- Asymmetry
- Border
- Colour
- Diameter
- Evolution
What family history is important to know for dermatology?
Skin disease
Atopy
Autoimmune disease
+ at what age they arose
What past medical history is important to know for dermatology?
- Systemic disease
- History of atopy
- History of skin cancer
- History of sun burn
- Previous dermatological issues
What social history is important to know for dermatology?
- home situation
- smoking, drugs + alcohol
- occupation
- diet
- cleaning products
What are worrying signs of pigmented lesions?
- asymmetry
- irregular, ill-defined border
- varying colours
- > 6mm diameter
- evolving in size, shape, colour or texture
Types of site + distribution of dermatology disease
Generalised
Widespread
Localised
Symmetrical
Asymmetrical
Flexural
Extensor
Pressure areas
Photosensitive
Dermatomal
Types of configurations of dermatological diseases
Discrete
Confluent
Linear
Targetoid
Well defined
Ill defined
Annular
Discoid/nummular
Types of colours of dermatological diseases
Erythema
Petechiae
Purpura
Ecccymoses
Hyperpigmented
Hypopigmented
Depigmentation
Vitiligo
Hyperkeratosis
Vocabulary to describe morphology - primary lesions
Macule
Patch
Papule
Nodule
Plaque
Vesicle
Bulla
Pustule
Abscess
Wheal/hives
Dome shaped
Comedone
Vocabulary to describe surface features - secondary lesions
Erosion
Excoriation
Lichenification
Scales
Crust
Ulcer
Fissure
Striae
Scar
Koehler phenomenon
Translucent
Umbilicated
Dermatological hair changes
Alopecia - patchy or diffuse
Hypertrichosis
Hirsutism
Dermatological nail changes
Clubbing
Koilonychia
Oncholysis
Pitting
What is flexural site?
Skin in joint bends
e.g. inner elbows, behind knees
What is extensor site?
Knees
Elbows
Shins
What is intertriginous site?
Affecting skin folds
What is photosensitive site?
Sun exposed areas
e.g. face, neck + back of hands
What is dermatomal site?
Follows area of skin supplied by single spinal nerve/the dermatome
Discrete vs confluent
- discrete: individual lesions separated from each other
- confluent: individual lesions merge together
What is targetoid configuration?
3 discrete colours of concentric rings
What is annular configuration?
Like a circle or ring with different morphology on edges vs inner
Define:
- macule
- patch
- papule
- nodule
- pustule
- plaque
- macule: flat area of altered colour <1cm D
- patch: flat area of altered colour >1cm D
- papule: raised lesion <1cm D
- nodule: raised lesion >1cm D
- pustule: small pus containing lesion
- plaque: palpable, raised lesion >1cm D
D - diameter
Vesicle vs bulla
- vesicle: raised clear fluid filled lesion < 1cm diameter
- bulla: raised clear fluid filled lesion >1cm diameter
What is an abscess?
Localised accumulation of pus on dermis or subcutaneous tissue
What is a wheal?
Transient raised lesion due to dermal oedema
Demarcated but not stable borders
Hives
What is comedone?
Pores or hair follicles that have gotten blocked with bacteria, oil or dead skin cells > bump on skin
Petechiae vs purpura vs ecchymoses
- Red or purple colour
- Non blanching on pressure
- petechiae: 1-2mm like pin prick
- purpura: 2-10mm
- ecchymoses: >10mm (bruise)
What is depigmentation?
Paler skin due to absence of melanin
Types of Alopecia
patchy: localised
diffuse
Hirsutism vs hypertrichosis
- hirsuitism: androgen dependent hair growth in female
- hypertrichosis: non androgen dependent pattern of excessive hair growth
What is koilonychia?
What is it often seen in?
Spoon shaped depression of nail bed
Iron deficiency anaemia
What is oncholysis?
What is it due to?
- Separation of distal end of nail plate from nail bed
- trauma, fungal infection, hyperthyroidism, psoriasis
What is pitting?
What conditions is it related to?
- Punctuate depression of nail bed
- Psoriasis, eczema, Alopecia areata
