Placement (additional things)

Question 1

What are important things to ask in a dermatological history

Answer 1

timing and location - limbs, trunk, scalp, nails, mouth
triggers / precipitating factors such as infection, new drugs, work, hobbies, koebnerisation
rash - changed in appearance, blistering, weeping, bleeding
anyone else affected
travel, previously unwell, pets, occupation
sun exposure
PMH
DH + allergies
SH - smoking, alcohol
FH
S/E - fever, weight loss…

Question 2

approach to describing skin lesions

Answer 2

Location and distribution 
- symmetrical 
- widespread 
- discrete vs confluent 
- localised 
- multiple vs solitary 
Configuration 
- annular
- discoid
- linear 
- Koebnerisation
Morphology 
- shape (papules, patches...)
- size 
- colour (red, pink, brown, hypopigmented)
- borders 
- raised 
- surface (scale, shiny, weeping, bleeding, crusting, blistering, erosions)
Mention what is there and also give negative features

Question 3

How could you differentiate guttate psoriasis from pityriasis rosea

Answer 3

pityriasis rosea has a herald patch that appeared first
guttate psoriasis is more widespread over the body including limbs whereas pityriasis rosea has more of a Xmas tree distribution over the back

Question 4

Describe lesions found in lichen planus

Answer 4

red/purple violaceous shiny topped papules

possible koebnerisation

Question 5

which other areas of the body would you examine if you suspected lichen planus and what would you expect to see

Answer 5

mouth - Wickham’s striae

nails - longitudinal ridging