History and Examination

Question 1

Types of distribution

Answer 1

-Dermatomal
-Flexural
-Extensor
-Localised
-Generalised (everywhere)
-Widespread (less than everywhere)
-Unilateral
-Bilateral

Question 2

Types of shape

Answer 2

-Target
-Annular
-Confluent
-Discoid
-Discrete

Question 3

Types of lesions (primary)

Answer 3

-Patch
-Vesicle
-Pustule
-Purpura
-Petechiae
-Ecchymosis
-Nodule (>0.5cm)
-Papule
-Macule
-Bulla (>0.5cm)
-Abscess

Question 4

Types of lesions (secondary)

Answer 4

-Open/closed comedones
-Fissures
-Hypopigmentation
-Weal
-Excoriation
-Hyperpigmentation
-Scale
-Lichenification
-Scar
-Crust
-Ulcer (loss of epidermis)

Question 5

Dermatological symptoms

Answer 5

-Rash
-Skin lesion
-Pain
-Itch
-Bleeding
-Discharge
-Blistering
-Systemic symptoms: fever, malaise, weight loss and arthralgia

Question 6

Key history points

Answer 6

-Treatments
-Previous episodes and treatments
-Contacts (e.g. chickenpox)
-Travel
-Sun exposure
-Family history of melanoma

Question 7

Systemic enquiry in dermatology

Answer 7

-Systemic: fevers (e.g. cellulitis)
-Cardiovascular: peripheral oedema
-Respiratory: wheeze, dyspnoea (e.g. anaphylaxis)
-Gastrointestinal: abdominal pain and diarrhoea (e.g. Crohn’s disease)
-Neurological: confusion (e.g. meningococcal sepsis)

Question 8

Relevant medical conditions

Answer 8

-Previous skin cancer or other dermatological conditions
-Atopy
-Diabetes (e.g. acanthosis nigricans, scleroderma diabeticorum, necrobiosis lipodica)
-Inflammatory bowel disease (e.g. pyoderma gangrenosum, erythema nodosum)
-Other medical conditions requiring systemic immunosuppression (increased risk of skin cancer)

Question 9

Relevant medication history

Answer 9

-Emollients
-Ointments
-Topics steroids
-Antibiotics
-Systemic immunosuppressants (e.g. biologics)