Skin Signs Symptoms and tools

• General
  • Overall impression
  • Permission to examine
  • Privacy
  • Patient comfort
  • Adequate exposure
  • Good lighting
  • Total skin examination if indicated
• Specific Inspection
  • Description of rash/lesion/skin problem
  • Type
  • Colour
  • Shape
  • Arrangement/pattern
  • Body site distribution
• Palpation
  • Consistency
  • Deviation in temperature
  • Mobility of lesion or skin
  • Presence of tenderness
  • Plane of lesion in the skin (i.e. subcutaneous/dermal)
• Appendages
  • Hair and nails
  • Mucous membranes

Reporting skin examination findings

A – Asymmetry: (more worrying) Does not just pertain to shape – need to examine by quadrants

B – Border

• BCC nodular well demarcated; other subtypes poorly demarcated
• SCC tend to be well demarcated
• Melanoma – border often both well or poorly demarcated

C – Colour: Blue, grays and scar-like white - suspicious

D – Diameter: Size in mm, indication of growth of lesion

E – Evolution, Elevation, Erythema: Blanching or non-blanching, Growing over time

F – Feel (palpation): Smooth, rough, scaly, firm or soft if raised