Skin exam

Question 1

What are some indications for doing a TBSE?

Answer 1

Hx of skin cancer, increased melanoma risk, “concerning” growth, new rash, undiagnosed skin condition, F/u with extensive skin conditions

Question 2

What are the essential elements of a skin exam?

Answer 2

adequate lighting, patient in gown, privacy, ruler, magnifying glass, open mind

Question 3

What is the best lighting to perform a skin exam?

Answer 3

natural sunlight => open blinds in exam room => always turn on as many lights as possible

Question 4

What is the key to making the patient feel comfortable during an exam?

Answer 4

ask if they would like a chaperone

Question 5

When should you always bring a chaperone?

Answer 5

exam of breasts or genitalia

Question 6

What are 3 points for patient modesty?

Answer 6

do not keep waiting, ask permission, say what you are examining

Question 7

what is the initial position for a TBSE?

Answer 7

patient seated with legs draped over the side of the table

Question 8

Where do you start a TBSE?

Answer 8

head and neck

Question 9

What are 3 important facial features commonly skipped?

Answer 9

medial canthi (medial eye), alar creases (nose), conchal bowl (inner ear)

Question 10

After completing the head and neck followed by the arms in a seated position, what is the next location to examine?

Answer 10

chest (seated, lying or standing)