chapter  10
13 Pages

The skin

ByPeter Kopelman, Dame Jane Dacre

The skin has a significant effect on a patient’s psychological well-being, as dermatological diseases often cause blemishes and abnormalities that, although minor, may be a very large problem to the patient. The structure of the dermatological history is the same as for any other system, but dermatological conditions frequently have a pattern recognition element, and spot diagnoses can be made. The patient may complain of a ‘rash’, ‘spots’, ‘itching’, an ‘ulcer’ or a ‘growth’. It is important to ask them to describe exactly what they are worried about, and also to describe the distribution of the abnormality. An occupational history is very important in skin disease, as several chemicals used in industry can irritate the skin or give rise to allergy. Short-term exposure to the sun can precipitate photosensitive rashes, sometimes associated with drug reactions. Examination of the skin is largely based on inspection.