Basic Dermatology

Question 1

Dermatological history structure

Answer 1

Same as normal:
Presenting complaint
PMH
Drug history and allergies
Family history
Social history
Impact on Quality of Life /ICE

Question 2

What to explore about the presenting complaint with derm history?

Answer 2

SQITARS
+ Initial appearance and evolution
+ Previous and current treatments
+ Pay close attention to triggers

Question 3

What to ask about in PMH esp?

Answer 3

History of atopy - asthma? Hayfever? eczema?
Skin cancer or pre-cancer?
Sunburn/sunbed use
Skin type

Question 4

What are the different skin types - how are they classed?

Answer 4

Fitzpatrick skin types
1-6 light to dark
Light more risk of UV damage

Question 5

What to ask about in family history?

Answer 5

Skin disease
Atopy
Autoimmune

Question 6

What to ask in social history?

Answer 6

Occupation
Sun exposure
Contactants
Improvement when away from work?

Question 7

Drug history - what to ask?

Answer 7

Regular and recent
Systemic and topical
Get specific with topical - how much? Where? How long for?

Question 8

Steps to follow when examining skin lesion

Answer 8

Inspect
Palpate
Systematic check - whole skin, hair, nails, mucous membranes
Describe

Question 9

Pneumonic for describing skin lesion

Answer 9

Site, distribution (or size/shape)
Colour (and configuration)
Associated changes - surface features
Morphology

Question 10

Pneumonic for describing pigmented lesions (eg moles)

Answer 10

Asymmetry
Border (irregular vs blurred)
Colour
Diameter

Question 11

Ways to decribe site/distribution of lesion

Answer 11

Generalised/localised
Flexural/extensor
Photosensitive

Question 12

Ways to decribe configuration of lesion

Answer 12

Discrete
Confluent - merging together
Linear
Target

Question 13

Ways to describe colour of skin lesion

Answer 13

Erythematous - red and blanching
Purpuric - red/purple and non-blanching
Hyper/pigmented
Hypo/depigmented

Question 14

Ways to describe surface features of skin lesions

Answer 14

Scale - build of keratin (psoriasis)
Crust - dried exudate (impetigo)
Excoriation - erosion from scratching from pruritus
Erosion/ulceration - erosion if partial, ulceration if deepr

Question 15

Ways to describe morphology of skin lesion

Answer 15

Macule - small flat area
Patch - larger flat area

Papule - raised small bump
Plaque - large raised bump

Vesicle - small fluid filled blister
Bulla - large fluid filled blister
Pustule - bump filled with pus
Nodule - solid bump

Annular - ring shaped
Wheal - urticaria, raised odematous in dermis
Comedones - open/closed, seen in acne
Discoid/nummular - round/disc shape

Question 16

Hair findings description

Answer 16

Alopecia patchy
Alopecia diffuse
Hypertrichosis - lots of hair
Hirsutism - lots of hair, androgen defined hair eg PCOS

Question 17

Nail findings in derm exam

Answer 17

Koilonychia - spoon nails, iron def anaemia
Pitting - psoriasis
Onycholysis - thickening and nail coming away from nail bed
Clubbing