The Dermatological Exam
The dermatologic examination involves thorough examination for rashes or skin lesions affecting the hands, face, scalp, trunk, abdomen, pelvis, arms and legs. The morphology of these lesions can aid in identifying their cause.
Classification of Lesions
Inspection of Lesions
Size
Using a ruler
Shape
Annular, discoid, target lesions
Colour
Flesh, hypo/hyperpigmented, erythema, purpura
Border
Well-demarcated / poorly defined, regular / irregular
Elevation
Raised / even / depressed
Number of Lesions
Distribution
Localised / generalised, flexor / extensor surfaces, pressure areas, dermatomal
Arrangement
Discrete / confluent lesions, clusters, linear
Palpation of Lesions
Head-to-Toe Exam
The Hands
Clubbing, xanthomata, hyperkeratosis
Fingernails
Colour, pitting, ridging, nail plate
The Arms
Erythema, scratch marks, nodules
The Neck
Cervical lymph nodes
The Scalp
Oily, dry, erythematous, excoriated
Hair
Follicles, alopecia, hirsutism, hypertrichosis
The Face
Eyes, nose, mouth, ears
The Chest
Including axillae and underneath breasts
The Abdomen
Including inspection under skin folds
The Back
Intergluteal cleft, perianal area
The Legs
Scratch marks, erythema
The Feet
Clubbing
Toenails
Colour, pitting, ridging, nail plate