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1. The type of skin lesion
D 2. The colorI
A 3. Margination
G
N Skin 4. ConsistencyO Lesions
S 5. Shape
IS 6. Arrangement
7. Distribution of lesion
DERMATOLOGIC DIAGNOSIS
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DIAGNOSTIC PROCESS
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Type of skin lesions
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Macule : Flat, circumscribed skindiscoloration that lacks surface elevation
or depression
Examples : caf au lait, Vitiligo, Freckle,
Junctional nevi, Ink tattoo
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Macular depigmentation
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Multiple hyperpigmented patches and
plaques, cutaneous T-cell lymphoma
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Papule : Elevated, solid lesion < 0.5 cm in
diameterExamples : Acrochordon (skin tag), Basal
cell carcinoma, Molluscum contagiosum
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Skin-colored papule with overlying
telangiectasias, trichoepithelioma
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10/65Hyperpigmented macule, papule, lichenification
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Nodule : Elevated, solid lesion > 0.5 cm in
diameter; a large, deeper papule
Example : Rheumatoid nodule, Tendonxanthoma, Erythema nodusum, Lipoma,
Metastatic carcinoma
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Eritema nodusum : nodul kemerahan, nyeri +
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Urtikaria : urtika
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Multiple wheals and dermatographism ,
urticarial vasculitis
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Vesicle / Bulla
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Herpes simpleks : vesikula bergerombol, krusta
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Pustule : papule that containspurulent material.
Examples : Folliculitis, Impetigo,
Acne, Pustular psoriasis
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Cyst : Nodule that contains fluid orsemisolid material.
Examples : Acne, Epidermal inclusion,Trichilemmal cyst
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Crust : A collection of cellular debris,dried serum, and blood; a scab.
Antecedent primary lesion is usuallya vesicle, bulla, or pustule.
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Dermatitis atopik : pergelangan tangan kanan-kiri, makula
eritema, papulae, likenifikasi, ekskoriasi, krusta
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Erosion : A partial focal loss ofepidermis; heals without scarring
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Erosion
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Ulcer : A full-thickness, focal loss of
epidermis and dermis; heals withscarring
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Penile ulcer with a purulent base, chancroid
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Scar : A collection of new connective
tissue; may be hypertrophic or atrophic.
Scar implies dermoepidermal damage
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Scar
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Scalp plaque with scarring alopecia
hyperpigmentation and depigmentation, discoid
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Evaluation of arrangement patterns
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Evaluation of arrangement, patterns,
and distribution
Number : single or multiple lesions Arrangement : multiple lesion may be :
1. grouped : herpetiform, linear, etc
2. disseminated : scattered discrete lesions
Confluence : yes or no
Distribution :
1. Extent : isolated, localized, generalized, etc
2. Pattern : symmetric, exposed areas, etc
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Outline of Dermatologic Diagnosis
1. History
2. Physical examination
3. Special Clinical and Laboratory
Aids to Dermatologic Diagnosis
History
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History1. Constitutional symptoms
2. History of skin lesions3. General history of present illness as
indicated by clinical situation, with
particular attention to constitutional andprodromal symptoms
4. Past medical history
5. Family medical history6. Social history
7. Sexual history
Physical Examination
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Physical Examination
1. Appearance
2. Vital Signs3. Skin : Learning to Read
Dermatologic diagnosis :
1. type of skin lesion 5. shape
2. the color 6. arrangement
3. margination 7. distribution
4. consistency
4. Type of skin lesions
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The entire mucocutaneous surface, as well as
the hair and nails, should be examinedwhenever reasonable
Morphologic characteristic derived from cell
type in skin must be carefully scrutinized
Diseases have characteristic morphology and
distribution
Common pitfalls in dermatologic diagnosisexist and can be avoided
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