Dermatologic Physical Examination

Abstract

The four components of the dermatologic physical examination are (1) primary lesions, (2) secondary lesions, (3) distribution, and (4) configuration. Because primary and secondary lesions are rather constant with most dermatitides, they should be relied on heavily to lead to the correct diagnosis. The two other basic components of the physical exam, distribution and configuration, are used for support and confirmation. Some skin disorders lack a distinct distribution or configuration. Occasionally, however, these latter components can be so characteristic for certain diseases that they are by themselves diagnostic. When the distribution and configuration are confusing or fail to support a diagnosis, it is wise to rely most heavily on the information and clues from the primary and secondary lesions.