Department of Dermatology © 2013. To be able to accurately describe lesions and rashes to...

To be able to accurately describe lesions and rashes to

colleagues.

To be able to write a clear dermatology referral.



Also notice the pattern of the rash.


Urticaria is rarely visible when patients visit the doctor but can be diagnosed by history.


Patient may focus on an acute eruption and ignore

a chronic long-standing problem, which may be

related.


In Pityriasis Rosea, a solitary patch appears for several

days followed by large numbers all over the torso. The

original herald patch is important.


Leishmaniasis – North Africa / Mediterranean.

Cutaneous larva migrans – tropical beaches.


Some skin disorders follow a prior illness.

Sore throats caused by Streptococcus

precede guttate psoriasis.

Drug eruptions are common with

antibiotics.

The whole patient should be examined.

Examine in a systematic fashion, eg hands, then arms, face and

trunk.

Remember scalp, nails and feet.

Always palpate lesions/rashes.

◦ Request patient permission and check for pain first.


Lesion Example Lesion Example

Small macule/ large patch: Pustule:

Papule: Vesicle:



Nodule: Bulla (blister):

Plaque: Telangiectasia:


Colour

◦ Erythema (red)

◦ Pigmented (brown)

Crusting / scaling

Shape / patterns

◦ Annular / discoid / serpiginous

Well defined / ill defined



Scar: Necrosis:

Excoriation: Lichenification:


As always, patient history very important

◦ Check occupation

Key lesion terminology

For rash describe individual (primary) lesions and distribution


Divide into 3 groups:◦ Group 1 - Acne◦ Group 2 - Eczema◦ Group 3 - Psoriasis

Discuss the questions on the laminated sheets for 10 minutes

Plenary (7 minutes per group):◦ Nominate a spokesperson◦ Feedback to the whole group

This 17-year-old boy has had this problem since he was 13. He has bought numerous preparations from the pharmacy with little effect.•Describe the features seen in this photo.•Discuss the treatment options including follow-up and counselling issues.

This 16-year-old boy developed acne when he was 13. He has tried multiple other treatment with little success and is deeply disturbed about the appearance of his skin. •Describe the features seen in this photo? What severity of acne does this patient have and why? Discuss the likely treatments he may have received.•What is the treatment of choice? What counselling issues arise?

This 36-year-old man has had this type of eczema intermittently for two years. What questions do you need to ask this patient?What type of eczema is most likely?Discuss the management options.

This 7-year-old boy has had this type of eczema since he was a baby. Describe the features seen in this photo and describe potential complications.What type of eczema has this patient got? What are common exacerbating factors?Discuss the management options.

This 45-year-old man developed this problem over 25 years ago.•Describe the features seen in this photo•What type of psoriasis has this patient got?•What other body sites would you wish to check?•What treatment options and counselling issues would you discuss with the patient?

Department of Dermatology © 2013. To be able to accurately describe lesions and rashes to...

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