Dermatology

Overview

Dermatology is the management of disorders of the skin, mucous membranes, and adnexal

structures, including inflammatory, infectious, neoplastic, metabolic, congenital, and structural

disorders. Competence in medical and surgical interventions and dermatopathology are

important facets.

The general internist should have a general knowledge of the major diseases and tumors of the

skin. He or she should be proficient at examining the skin; describing findings; and recognizing

skin signs of systemic diseases, normal findings (including benign growths of the skin), and

common skin malignancies. The general internist should be able to diagnose and manage a

variety of common skin conditions and make referrals where appropriate.

Common Clinical Presentations

· Abnormalities of pigmentation

· Eruptions (eczematous, follicular, papulosquamous, vascular, vesiculobullous)

· Hair loss

· Hirsutism

· Intertrigo

· Leg ulcer

· Mucous membrane ulceration

· Nail infections and deformities

· Pigmented lesion

· Pruritus

· Purpura

· Skin papule or nodule

· Verrucous lesion

Procedure Skills

· Application of chemical destructive agents for skin lesions e.g.,

warts and molluscum, condyloma

· Incision, drainage, and aspiration of fluctuant lesions for diagnosis or therapy

· Scraping of skin (for potassium hydroxide, mite examination)

· Skin biopsy

· Cryotherapy

Primary Interpretation of Tests

· Microscopic examination for scabies, nits, etc.

· Tzanck smear

Ordering and Understanding Tests

· Dark-field microscopy

· Fungal culture

· Skin biopsy