Lecture 7- Basic dermatology skills Flashcards
taking a dermatological history
ASK QUESTIONS FIRST THEN LOOK AT COMPLAINT
1) Presenting complaint
- Usually a single symptom
- Nature (e.g. rash vs lesion)
- Site
- Duration
2) History of presenting complaint
- Initial appearance and evolution
- Time line
- E.g. has it just appeared or have you just noticed it
- Has it changed?
- Symptoms (particularly itch and pain)
- Blanching? etc
- Aggravating and relieving factors
- Previous and current treatments (effective or not)
3) Past medical history
- Systemic disease
- History of atopy (asthma, hay fever, eczema)
- History of skin cancer or pre-cancer
- History of sunburn/sunbathing/sun-bed use
- Skin type
4) Family history
- Fx of skin disease
- Fx of atopy
- Fx of autoimmune disease
5) Social history
- Occupation
- Sun exposure
- Contactants
- E.g. latex glove allergic- dermatitis
- Improvements in PC when away from work
6) Drug history and allergies
- Regular and recent
- Systemic and topical
- Get specific with topical treatments
- Where??
- How much?
- How long for?
7) Impact on quality of life / ICE
What is used to TYPE skin
Filzpatrick skin types
physical exam
describe acronymn
-
S
- Site, distribution (rash)
- Size and shape (lesion)
-
C
- Colour and configuration
-
A
- Associated changes e.g. surface features
-
M
- Morphology
ABCD for pigmented lesions
- Asymmetry
- Border (irregular or blurred)
- Colour
- Diameter
terms used for describing site and distribution
- generalised
- flexural
- extensor
- photosensitive
generalised
lesions distributed randomly over most of the body surface area (widespread) or within an anatomical region.
flexural
related to flexion, or skin folds, such as the backs of knees, the armpits, the elbow creases and the groin.
extensor
involving extensor surfaces of limbs. Contrast with flexor surfaces.
e.g. elbows
photosensitive
increase in the reactivity of the skin to sunlight.
terms used for describing colour
- erythematous
- pupurpic
- brown or black
- hypopigmented
erythematous
red and blanching
Blanching of the skin is defined by the paling or whitening of skin
pupuric
bleeding into the skin, either as petechiae (small red, purple or brown spots) or ecchymoses (bruises); purpura does not blanch with pressure (diascopy).
brown or black
Hyperpigmentation — darkened skin compared to normal; it can be localised or generalised.
hypopigmented
skin colour that is paler than normal.
terms used for describing configuration
discrete
confluent
linear
target