PHYSICAL EXAMINATION OF THE SKIN, HAIR AND NAILS Flashcards
Derm Specific History what to ask
Onset:
Abrupt or gradual onset?
Derm Specific History what to ask
Location:
Where lesions first noted and where they are now.
Derm Specific History what to ask
Location:
Where lesions first noted and where they are now.
Derm Specific History what to ask
Duration:
Recurrences, remissions, exacerbations
Derm Specific History what to ask
Evolution:
Has it spread? Gotten itchier? More painful?
Derm Specific History what to ask
Character:
Pruritus/pain, bleeding, non-healing, wounds
Derm Specific History what to ask
Aggravating/Alleviating:
UV exposure, heat/cold, exposures (chemicals,medications, cosmetics, perfumes, plants, metals)
Derm Specific History what to ask
Temporal:
Constant, intermittent, worst at night, climate change.
Derm Specific History what to ask
Severity:
Severity of pain or pruritus (0/10 works for both).
Derm Specific History what to ask
Pertinent Derm Questions:
Previous occurrence(s), any close contacts with similar symptoms, new/change in hygiene products
Overall Skin Inspection algorithm
CUTSHP
Color (rule out potentially actue issues)
Uniform Appearance
Thickness
Symmetry (unilateral vs. bilateral presentation)
Hygiene (some conditions have predisposing hygienic concerns)
Presence of any lesions
Definition of what?
(a) Rated as I-VI on the scale
(b) Quasi-objective metric of amount of melanin pigment in the skin
Fitzpatrick Scale
_____ resistance is largely determined by melanocyte activity and melanocytic pigmentation of the skin.
UVR
What is the umbrella term used in dermatology for any observed skin change or finding
Lesions
Size of lesion is measured on what dimensions and in what measurement scale?
1)Length
2)Width
3)Depth is covered by noting elevation or depression
Always in mm or cm!
Lesion Shapes:
Ring shape with central clearing
Annular (Ring shaped)
Lesion Shapes:
a) Coin-shaped; solid circle or oval
b) Uniform appearance from the edges to the center
Round (nummular)
Lesion Shapes:
Often a result of incomplete formation of an annular lesion
Arcuate (arc-shaped)
Lesion Shapes:
Multiple different shapes located closely together (grab-bag)
Multiform:
Lesion Shapes:
Formed from coalescing circles, rings, or incomplete rings
Polycyclic:
Lesion Shapes:
Target-like, with a center darker than the periphery
Targetoid
Lesion Shapes:
Dot-like, typically around 1 mm
Punctate
Lesion Shapes:
a) With a central depression of the surface.
b) Also known as “delled”.
Umbilicated
Lesion Shapes:
a) Resembling a straight line
b) Ex: Poison Ivy or scratch marks
Linear
Lesion Shapes:
a) Serpentine or snake-like
b) Ex: Lymphadenitis
Serpiginous
What is the most important additional feature of a lesion other than primary morphology(Shape)
Lesion Color
The most common types of color on the skin are:
1) Variations in brown
2) Hyperpigmentation
3) Hypopigmentation
4) Variations in red (erythema)