Dermatological Examinations
Not yet clinically reviewed
This protocol was migrated from the earlier Pharmapedia and Ward Guide apps for educational use. Follow your hospital's own policies and consult seniors when in doubt.
Dermatological examination Observe the type of lesion:
Macule
A flat, colored lesion, 2 cm) flat lesion with a color different from the surrounding skin. This differs from a macule only in size. Papule: A small, solid lesion, 5 cm in diameter.
Plaque: A large (>1 cm), flat-topped, raised lesion; edges may either be distinct (e.g., in psoriasis) or gradually blend with surrounding skin (e.g., in eczematous dermatitis). Vesicle: A small, fluid-filled lesion, 0.5 cm in diameter.
Wheal: A raised, erythematous, edematous papule or plaque, usually representing short-lived vasodilatation and Vaso permeability.
Telangiectasia: A dilated, superficial blood vessel.
Look at the distribution of the lesions over the body; observe their arrangement: isolated, clustered, linear, annular (in a ring).
Ask if the lesions are itchy. Look for a possible cause: insect bites; scabies, lice, other parasitic skin infections; contact with plants, animals, jewelry, detergents, etc.
Ask about any ongoing treatment: topical, oral or parenteral. Look for local or regional signs (secondary infection, lymphangitis, adenopathy, erysipelas) and/or systemic signs (fever, septicemia, distant infectious focus).
Consider the sanitary condition of the family, particularly for contagious skin diseases (scabies, scalp ringworm, lice).
Check tetanus vaccination status. Patients with skin disease often present late. At this stage, primary lesions and specific signs may be masked by secondary infection.
In these cases, it is necessary to reexamine the patient, after treating the secondary infection, in order to identify and treat the underlying skin disease.