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Derma guide 1 Derma Guide Brought to you by JI Francis Castell ?? For Chief Complaint write only the primary lesion see below Example Papules For HPI only the pertinent Dermatological history including meds and consult Remember to write whether or - for p

Derma Guide Brought to you by JI Francis Castell ?? For Chief Complaint write only the primary lesion see below Example Papules For HPI only the pertinent Dermatological history including meds and consult Remember to write whether or - for pruritus If considering viral or - for fever For Previous Treatment include the medications procedures listed in the HPI plus soap shampoo facial wash and other dermatological products the patient used especially Chinese ointments ? Example Loratadine mg tab OD in the AM x days Katialis prn x week Safeguard soap For Past Med Hx and Family Med Hx include HPN BA DM Allergy ? Example HPN - DM - BA Allergy to seafoods For Physical Examination include the following Number distribution ?? few multiple or solitary localized or di ?use generalized Shape optional ??annular guttate etc ? Border ??well de ?ned or ill-de ?ned Color ??hypopigmented hyperpigmented depigmented skin-colored erythematous Primary lesion a Macules ??variously sized circumscribed solid changes in color without elevation or depression aka small at spots b Patches ??a large macule cm or more c Papules ?? circumscribed solid elevations with no visible uid varying in size from pinhead to pea d Plaques ??a broad papule or con uence of papules cm or more e Nodules ??larger and deeper papule arising in dermis f Tumors ??soft or ?rm freely movable or ?xed masses g Wheals Hives ??evanescent edematous at elevations of various sized almost always with itching h Vesicles Blisters ??circumscribed epidermal elevations - mm with a clear uid i Bullae ??rounded or irregularly shaped blister containing serous or seropurulent uid larger than cm Cj Pustules Pimples ??small elevations containing pus usually with in ammatory areola Secondary lesion a Scales exfoliations ??dry greasy laminated masses of keratin b Excoriations abrasions scratch marks ??punctuate or linear abrasions produced by mechanical means such as scratching usually involving only the epidermis c Fissures Cracks Cleft ??linear cleft through the epidermis rarely into the dermis Occur mostly when the skin is thickened inelastic from in ammation dryness d Crusts Scabs ??dried serum pus or blood usually mixed with epithelial debris e Erosions ??loss of all or portions of the epidermis alone f Ulcers ??loss of both dermis epidermis g Scars ??new formations of connective tissue that replace loss of substances in the dermis or deeper parts Measurement in centimeters Location ? Example Multiple well de ?ned erythematous to skin-colored papules and plaques with excoriations measuring x cm to x cm on the lateral aspect of the left leg C