1. Dermatology Terminology
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2. Learning Outcomes
To be able to accurately describe lesions and rashes to colleagues.
To be able to write a clear dermatology referral.
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3. Ask The Right Questions
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4. Symptoms - Does it itch? Department of Dermatology © 2013 Scabies
Psoriasis
Eczema
Bowens
Tinea corporis
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5. Symptoms - Is it painful?
Also notice the pattern of the rash.
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6. Intermittent or constant?
Urticaria is rarely visible when patients visit the doctor but can be diagnosed by history.
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7. Is it anywhere else?
Patient may focus on an acute eruption and ignore a chronic long-standing problem, which may be related.
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8. How did it start?
In Pityriasis Rosea, a solitary patch appears for several days followed by large numbers all over the torso. The original herald patch is important.
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9. Foreign travel? Leishmaniasis – North Africa / Mediterranean.
Cutaneous larva migrans – tropical beaches.
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10. Associated symptoms Some skin disorders follow a prior illness.
Sore throats caused by Streptococcus precede guttate psoriasis.
Drug eruptions are common with antibiotics.
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11. Examining the patient 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.
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12. Rashes are composed of multiple (primary) lesions, arranged in particular patterns and affecting particular body sites.
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13. Key terminology to describe lesions
Example
Small macule/ large patch:
Pustule:
Papule:
Vesicle:
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14. Lesion terminology (2) Nodule: Bulla (blister): Plaque: Lesion Example
Telangiectasia:
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15. Lesion terminology (3) Colour Crusting / scaling Shape / patterns
Erythema (red)
Pigmented (brown)
Crusting / scaling
Shape / patterns
Annular / discoid / serpiginous
Well defined / ill defined
Erythrodermic psoriasis
Tinea corporis
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16. Secondary changes Scar: Necrosis: Excoriation: Lesion Example
Lichenification:
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17. Your go (1)
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18. Your go (2)
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19. Your go (3)
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20. Your go (4)
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21. Your go (5)
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22. Your go (6)
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23. Conclusion As always, patient history very important Check occupation
Key lesion terminology
For rash describe individual (primary) lesions and distribution
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24. GROUP WORK 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

25. ACNE - Case 1
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.

26. ACNE - Case 2
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?

27. ECZEMA - Case 1
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.

28. ECZEMA - Case 2
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.

29. PSORIASIS
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?