1. Lumps and Ulcers

2. Lumps: History When first noticed? What made patient notice the lump? Symptoms of the lump? Change since first noticed? Does it ever disappear? Any other previous lumps? Does patient know the cause?

3. Lumps: Examination 1 Exact position Colour and texture of skin Temperature Tenderness Shape Size Surface

4. Lumps: Examination 2 Edge Composition Reducibility Relation to surrounding structures Regional lymph nodes Local tissues Always examine the whole patient!

8. Lumps: Composition 1 Consistence: Stony hard Rubbery Spongy Soft Fluctuation Fluid thrill Translucency

9. Lumps: Composition 2 Resonance Pulsatility Compressibility Bruits

10. Ulcer: History When first noticed? What made patient notice the ulcer? Symptoms of the ulcer? Change since first noticed? Any other previous ulcers? Does patient know the cause?

11. Ulcer: Examination 1 Position Shape (Draw) Size Colour Tenderness Temperature

12. Ulcer: Examination 2 Base Edge: Sloping Punched-out Undermined Rolled Everted Depth (mm and anatomically)

14. Ulcer: Examination 3 Discharge (?offensive) Relations Lymph nodes State of local tissues: Blood Supply Innervation Skin signs Always examine the whole patient!