Normal and abnormal findings

Question 1

History of Skin Disease

Answer 1

Normal Findings: No significant skin disease. Birthmarks or tattoos without complications.
Abnormal Findings:
Family history of allergies, psoriasis, or eczema.
Allergic reactions to medications, plants, or animals.
Tattoos applied with non-sterile equipment (risk of hepatitis C).

Question 2

Change in Pigmentation

Answer 2

Normal Findings: Localized changes (e.g., freckles, effects of sun exposure).
Abnormal Findings: Generalized changes indicating systemic illness (pallor, jaundice, cyanosis).

Question 3

Change in Mole

Answer 3

Normal Findings: Stable size, shape, and color.
Abnormal Findings: Changes in size, color, or shape; sudden tenderness, bleeding, or itching suggest possible neoplasm.

Question 4

Excessive Dryness or Moisture

Answer 4

Normal Findings: Moisture levels appropriate for climate and activity.
Abnormal Findings:
Seborrhea (oily skin) or xerosis (dry skin).
Persistent dryness/moisture suggesting systemic or skin-specific disorders.

Question 5

Pruritus (Itching)

Answer 5

Normal Findings: No itching or mild, temporary itching from known causes.
Abnormal Findings:
Intense or persistent itching due to dry skin, allergies, jaundice, or lice infestation.
Excoriation from scratching.

Question 6

Excessive Bruising

Answer 6

Normal Findings: Occasional bruising from identifiable causes.
Abnormal Findings:
Multiple bruises in various stages of healing.
Unexplained bruises above knees/elbows (consider abuse, neurological, cardiovascular, or substance-related causes).

Question 7

Rash or Lesion

Answer 7

Normal Findings: No rash or single lesion resolving with care.
Abnormal Findings:
Spreading rash or lesions with unusual color, texture, or odor.
Rashes linked to fever or systemic symptoms.

Question 8

Environmental/Occupational Hazards

Answer 8

Normal Findings: No exposure to harmful agents. Adequate protection (e.g., sunscreen, gloves).
Abnormal Findings:
Unprotected exposure to dyes, chemicals, or radiation.
Excessive sun exposure increasing risk of skin neoplasms or lesions.

Question 9

Colour (General Pigmentation)

Answer 9

Normal Findings: Consistent with genetic background; even tone.
Abnormal Findings:
Vitiligo: Patchy melanin loss.
ABCDE Danger Signs (Asymmetry, Border irregularity, Colour variation, Diameter >6 mm, Elevation/Evolution).

Question 10

Temperature

Answer 10

Normal Findings: Warm, symmetrical skin; slightly cooler extremities.
Abnormal Findings:
Hypothermia: Generalized (shock) or localized (arterial insufficiency).
Hyperthermia: Generalized (fever, exercise) or localized (infection, trauma).

Question 11

Edema

Answer 11

Normal Findings: No fluid accumulation or “pitting.”
Abnormal Findings:
Pitting edema graded on a 4-point scale.
Severe edema linked to heart/kidney failure or peripheral arterial insufficiency.

Question 12

Older Adults – Pigmentation

Answer 12

Normal Findings:
Senile lentigines (flat, brown macules).
Seborrheic keratosis (raised, greasy plaques).
Abnormal Findings: Actinic keratosis (red-tan scaly plaques; premalignant).

Question 13

Older Adults – Moisture

Answer 13

Normal Findings: Xerosis (dry skin) common due to reduced gland activity.
Abnormal Findings: Excessively dry, flaky skin indicating systemic issues.