Dermatology Physical Exam and History Taking
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Questions and Answers

What is the primary reason for the formation of crusts on the skin?

  • Erosion of the epidermis (correct)
  • Allergic reaction to environmental factors
  • Inflammation of the skin
  • Dryness of the skin
  • What is the characteristic shape of excoriations on the skin?

  • Triangular
  • Linear (correct)
  • Circular
  • Oval
  • What is the term for a skin lesion that is shaped like a coin or disc?

  • Annular
  • Discoid (correct)
  • Circular
  • Nummular
  • What is the most common inflammatory skin disease worldwide?

    <p>Atopic dermatitis</p> Signup and view all the answers

    What percentage of people are affected by atopic dermatitis during their lifetime?

    <p>15%</p> Signup and view all the answers

    What is the main treatment for atopic dermatitis in all age groups?

    <p>Topical corticosteroids</p> Signup and view all the answers

    What is a common factor that triggers atopic dermatitis?

    <p>All of the above</p> Signup and view all the answers

    What is the term for a superficial skin-colored or pale skin swelling?

    <p>Wheal</p> Signup and view all the answers

    What is the recommended treatment for face lesions in severe cases?

    <p>Methylprednisolone aceponate 0.1% ointment/FO once daily</p> Signup and view all the answers

    What is the recommended treatment for trunk and limb lesions in severe cases?

    <p>Mometasone furoate 0.1% ointment once daily</p> Signup and view all the answers

    What is the purpose of bleach baths in treating atopic skin?

    <p>To prevent bacterial infection</p> Signup and view all the answers

    What is the typical age range for cradle cap in infants?

    <p>3-12 weeks</p> Signup and view all the answers

    What is a characteristic of cradle cap versus atopic dermatitis?

    <p>No itching is present</p> Signup and view all the answers

    What is the recommended treatment for moderate cradle cap cases?

    <p>Massage liquid paraffin or baby oil into lesions overnight</p> Signup and view all the answers

    What should be avoided in treating cradle cap?

    <p>Food-containing products</p> Signup and view all the answers

    What is the typical outcome for cradle cap?

    <p>It clears spontaneously in a few weeks</p> Signup and view all the answers

    What is the term for a drug reaction that affects the structure or function of the skin, its appendages, or mucous membranes?

    <p>Cutaneous drug reaction</p> Signup and view all the answers

    Which of the following drugs is commonly associated with cutaneous drug reactions?

    <p>Beta-lactam antibiotics</p> Signup and view all the answers

    When should a pharmacist ask about a patient's history of previous reactions to drugs?

    <p>Before dispensing medication</p> Signup and view all the answers

    What should a patient's profile include in the event of a cutaneous drug reaction?

    <p>A record of the reaction</p> Signup and view all the answers

    Where should all adverse drug reactions, including cutaneous drug reactions, be reported?

    <p>The Adverse Event Management System (AEMS)</p> Signup and view all the answers

    Under what circumstances should a patient be referred to a doctor or GP?

    <p>All cutaneous drug reactions should be referred</p> Signup and view all the answers

    What is the primary purpose of a physical examination in dermatology?

    <p>To more accurately differentiate and diagnose skin conditions</p> Signup and view all the answers

    What is the significance of documenting the 'distribu/on' of a skin lesion?

    <p>It indicates whether the lesion is symmetrical or asymmetrical</p> Signup and view all the answers

    What is the importance of asking about animal contacts in a patient's history?

    <p>To identify potential sources of skin infections</p> Signup and view all the answers

    Why is it essential to use common terminology and descriptive terms in dermatology?

    <p>To communicate effectively with other healthcare professionals</p> Signup and view all the answers

    What is the primary purpose of asking about a patient's dietary history in dermatology?

    <p>To understand how diet affects the integrity of skin conditions</p> Signup and view all the answers

    What is the significance of asking about a patient's previous history or family history in dermatology?

    <p>To determine the patient's genetic predisposition to skin conditions</p> Signup and view all the answers

    What is the importance of considering privacy in a consultation room during a physical examination?

    <p>To ensure the patient's modesty is maintained</p> Signup and view all the answers

    Why is it important to clearly explain the procedure and gain the patient's consent during a physical examination?

    <p>To respect the patient's autonomy and rights</p> Signup and view all the answers

    What is the primary cause of contact dermatitis?

    <p>Skin contact with external agents</p> Signup and view all the answers

    What is the recommended treatment for irritant contact dermatitis?

    <p>Avoiding further contact with the allergen</p> Signup and view all the answers

    What percentage of the population is allergic to nickel?

    <p>8%</p> Signup and view all the answers

    Why is it important to allow sufficient time for absorption between topical applications?

    <p>To reduce systemic adverse effects</p> Signup and view all the answers

    What is the recommended treatment for severe and acute contact dermatitis?

    <p>Oral prednisolone</p> Signup and view all the answers

    What is the advantage of topical administration of drugs?

    <p>It reduces systemic adverse effects</p> Signup and view all the answers

    What is the primary location of contact dermatitis in most cases?

    <p>Hands</p> Signup and view all the answers

    What is the recommended treatment for occupational contact dermatitis?

    <p>Avoiding further contact with the allergen and using emollients</p> Signup and view all the answers

    Study Notes

    Dermatology

    • Importance of physical examination and history taking in dermatology
    • Key aspects of physical examination:
      • Accurate differential diagnosis
      • Consideration of privacy and patient consent
      • Empathy and gaining patient trust
    • Key aspects of history taking:
      • History of presenting complaint (onset, duration, periodicity)
      • Site of onset and distribution of lesions
      • Feel of lesions (smooth, rough, etc.)
      • Aggravating or relieving factors
      • Previous medical history and family history
      • Occupational and recreational activities
      • Dietary history and potential allergens

    Terminology of Skin Conditions

    • Importance of understanding and using common terminology
    • Descriptive terms:
      • Crusting (arises from plasma exudate through eroded epidermis)
      • Excoriation (scratching that removes epidermis or causes localized damage)
      • Annular, discoid/nummular, and wheal/weal lesions
    • Common types of dermatoses:
      • Nonspecific inflammatory response of the skin
      • Affects 1 in 5 people during their lifetime
      • Isolated short episodes vs. chronic conditions
      • Endogenous and exogenous causes

    Atopic Dermatitis (Atopic Eczema)

    • Most common inflammatory skin disease worldwide
    • Affects 15% of people worldwide
    • Inherited tendency, environmental factors, and triggers
    • Started in infancy, affecting up to 20% of children
    • Generalized skin dryness, itch, and rash
    • Treatment:
      • Avoid aggravating factors
      • Moisturize with emollients
      • Topical corticosteroids
      • Modified dressings
      • Treat infections (bleach baths, antibiotic therapy)

    Case Study 2: Infantile Seborrheic Dermatitis (Cradle Cap)

    • Key questions to ask:
      • Age of child
      • Itchiness
      • Rash location
      • Family history
      • Product usage
    • Treatment:
      • Self-limiting, clears spontaneously in a few weeks
      • Mild cases: gentle emollient and shampooing
      • Moderate cases: massage liquid paraffin or baby oil into lesions
      • Persistent cases: salicylic acid 2% + LPC 2% + Sulphur 2% in Aqueous Cream

    Case 3 - Contact Dermatitis

    • Key questions to ask:
      • Rash location
      • Onset of rash
      • Triggering factors
    • Treatment:
      • Avoid further contact with allergen
      • Use rubber gloves with cotton liner
      • Apply emollients after finishing work
      • Short course of topical corticosteroids
      • Oral prednisolone/sone 25-50mg once daily for 5-7 days (severe and acute cases)

    Topical Treatment of Skin Conditions

    • General considerations:
      • Topical administration preferred due to direct contact between drug and tissue
      • Minimizing systemic adverse effects
      • Allow sufficient time for absorption between applications
    • Side effects of topical corticosteroids

    Cutaneous Drug Reactions

    • Definition: Adverse reactions affecting skin, appendages, or mucous membranes
    • Common adverse skin reactions to systemic drugs:
      • Morbilliform or maculopapular skin reactions
      • Urticaria and angioedema
      • Fixed drug eruptions
      • Erythema multiforme
      • DRESS and Stevens-Johnson syndrome
    • Reporting cutaneous drug reactions:
      • Refer to prescribing doctor or GP
      • Record reaction on patient's profile
      • Report to TGA (Therapeutic Goods Administration)

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    Description

    Learn about the steps involved in performing a physical examination and taking a patient's history in dermatology, including gaining consent, demonstrating empathy, and recognizing skin problems.

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