Clinical Examination and Approach to the Patient in Dermatology

Abstract

Diagnosis of cutaneous lesions requires both history taking and physical examination. History taking must specify the circumstances of the onset and the course of the disease, as well as treatments applied and their effects. The starting date of the disorder and its initial location must be specified, as well as the ways in which the lesions spread and eventually change. The main cutaneous functional symptoms are pain and pruritus. The context in which lesions have appeared is often essential: associated extracutaneous signs, medications, comorbidities, immunodeficiencies, etc. Thus full history taking is often crucial, gathering all past history. Finally, given the large number of skin diseases related to the environment, targeted history taking should be carried out regarding lifestyle, professional and domestic backgrounds, and products that may have been applied and manipulated, in order not to miss, for example, the diagnosis of a contact dermatitis. Dermatological physical examination requires training. It is necessary to know how to recognize the primary lesions of the skin, their arrangement and/or configuration, and their distribution.