Skin Examination Component What to do/look for and rationale Scan the entire body or area in a systematic area. Scalp Nits Sebaceous glands. Metastasis Scalp alopecia Psoriasis Seborrhoeic dermatitis Dermatomyositis. Face Solar keratosis Xanthelasma HSV Cyanosis Acne SLE Malar flush Breasts Acanthosis nigricans. Spinder naevi. Arms Injection marks. Complicated injection sites. Scratch marks. Extensor surfaces: Psoriasis Dermatitis Herpetiformis General inspection Flexor surfaces: Lichen planus Hands Scabies Atrophy. Skin thinning E.g. aging, sun exposure, long term corticosteroids, ischemia, scleroderma, anaemia and genetics due to collage you should do skincare) Excoriation Scratch marks E.g. stress, jaundice. Papule Small -> less than 0.5 cm or 1 cm -> AMBOSS and Kumar and Clarck are contradicting each other LOL ? Palpable Circumscribed lesion E.g. increased oil on skin, infections, androgens, side effects of corticosteroids and anabolic steroids. Telangiectasia Abnormal visible dilation of blood vessels on the skin. E.g. rosacea, varicose veins, liver diseases. Blanching erythema Flushed red coloured skin -> caused by vasodilation which turns pale when pressure is applied. E.g. frost bite, pressure sores. Fissure Deep linear crack or crevieve -> often in thickened skin. E.g. dry skin, contact dermatitis, eczema, psoriasis, athletes foot, diabetes -> as all cause the skin dry -> hence hair and foot cream -> something I only do once in a blue moon. Petechia Pinched size Non blanching areas of haemorrhage. E.g. infections, endocarditis, sunburns, medications such as anti-depressants and blood thinning medications. Ulcer Deeper denuded area of skin. Full thickness epidermal and dermal loss. E.g. diabetic foot ulcers, venous insufficiency Bulla Large fluid filled blister. Annular Ring shaped Clear centre E.g. Tinea infection. Arcuate Curved E.g. Secondary syphilis. Confluent Lesions that have coalesced E.g. measles. Discoid Circular without clear centre. E.g. lupus. Eczematous Inflamed scaly poorly defined plaques E.g. atopic dermatitis Keratotic Thickened from increased keratin. Pattern Terms E.g. psoriasis, keratoacanthoma. Lichenified. Thickening and roughening of the epidermis. Associated with accentuated skin markings. Linear In lines. E.g. contact dermatitis. Papulosquamous Plaques associated with scaling. Reticulated In a network pattern. E.g. cutaneous parasite. Serpiginous E.g. sinuous. Melanoma BCC Usual phenotype -> pearly elevated patch of skin. Types Nodular -> pearly circular cystic pigmented nodule. Infiltrative -> invades dermis Micronodular -> solid coloured lesion Morphaeform -> flat white-yellowish waxy lesion. Superficial -> erythematous plaques -> usually on the upper trunk. SCC Small rough slow growing nodule -> module expands -> centre necrosis -> evolves to ulcer covered by red gro frequently scales and easily bleeds.