Physical Exam & Dermatologic Diagnosis - DEMO
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Diagnosis, Exam and Distribution
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Distribution Examples
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Primary Lesions
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Primary Lesion Examples
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Secondary Lesions
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Dermatologic Procedure Videos #9–#14: Cryosurgery
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Secondary Lesion Examples
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Description of Lesions
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Lesion Examples by Description
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Morphologic Variation, Time Course and Age
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Immune Status
Put what you've learnt to the test. Identify, diagnose, and treat these real world patients.
About
Physical Exam & Dermatologic Diagnosis
DURATION
1hr 20mins
Updated April 1, 2021
ACTIVITIES
11 Videos
2 Quizzes
credit hours
2.25 contact hours
Course Outline
- Key elements of a dermatologic exam
- Specific vocabulary of lesion morphology
- Systematic evaluation & search for lesion morphology & pattern recognition
- Search for “primary” & “secondary” lesions with pattern recognition will lead to correct diagnosis
- Identify how factors (immune status, skin type) affect lesion morphology
- Time course of development of skin problem can change exam findings, namely the clinical horizon
Instructor
33,000 Mohs surgery cases for skin cancer | Director for accredited ACGME procedural dermatology fellowships
Course Quizzes
Put what you've learned to the test - take the Physical Exam & Dermatologic Diagnosis quizzes below.
Quick Facts
Dermatologic exam based on objective, observable exam findings as follows:
Distribution - where is rash anatomically
- unilateral vs. bilateral
- sun exposed
- flexural, extensor
- diffuse
- acral
- generalized
- dermatomal
Primary Lesions - must correctly identify to make a correct diagnosis or be in disease group.
- Macule: lesions are visible only and have no palpable quality
- Plaque: an elevated lesion that is palpable
- Papule: raised bump measures < 1cm or <0.5cm; different descriptors (e.g. flat-topped, polygonal, follicular, perifollicular, compressible, verrucous, umbilicated
- Nodule: larger papule 0.5cm-2.0cm
- Tumor: palpable lesion >2.0cm
- Wheal: edema in skin producing a peau d’orange
- Vesicle: any fluid-filled lesion < 0.5cm in diameter
- Bullae: fluid-filled blister >0.5cm in diameter
- Pustule: vesicle containing pus
- Cyst: a collection of fluid or solid debris within a defined sac
- Telangiectasia: a superficial blood vessel that has enlarged enough to be visible
- Comedone: noninflammatory acne lesion due to obstruction of the pilosebaceous opening
Secondary Lesions - changes that occur to or are associated with primary lesions.
- scale
- crust
- excoriation
- erosion
- pigmentation change
- scarring
- fissuring
- atrophy
- lichenification
- erythema
- burrow
Descriptions of Lesions - specific visual clues that describe unique clinical exam findings often associated with particular skin lesions or diseases.
- targetoid / serpiginous / nummular / linear / follicular
- exophytic/endophytic
- indurated
- umbilicated
- fluctuant
- pedunculated
- herpetiform
- color
Morphologic Variation - factors that can affect the morphologic appearance of lesions.
- Time course and clinical horizon, depending upon when in the timeline of skin disease development the patient presents. Patients who present before essential, key elements of a skin disease develop (i.e. below the clinical horizon) are more difficult to diagnose.
