Professional Documents
Culture Documents
Presentation
Common skin lesions: بقع بيضا وال نقط محمرة وال معبية ماية ؟
– Ulcer: depressed skin lesion with missing epidermis and upper layer of dermis
Questions to Ask
– Age of patient
– Season
– Travel history
– Geographic location
– Medications
– Immunization history
– Was there a prodrome? (early symptoms that might indicate the start of disease)
– Has there been any change in the rash (appearance, sensation, etc.)
– Review of systems to rule out inflammatory bowel disease (diarrhea, weight loss, poor appetite,
arthritis, etc.)
– Review of systems for SLE (photosensitivity, malar or discoid rash, cytopenias, renal disease, etc.)
Fever: o,c,d, with thermometer or hands , exclude localizing symptoms of each system.
Differential Diagnosis
Infectious causes
1. Measles:
2. Chickenpox:
3. Rubella:
– Forschemier spots: small, red spots (petechiae) on soft palate in 20% of rubella patients
4. Erythema infectiosum (fifth disease) – human parvovirus B19
– Followed by seizures
6. Scarlet fever
Inflammatory causes
– Erythema marginatum – transient macular lesions with central clearing usually found on extensor
surfaces of proximal extremities and trunk
2. Kawasaki Vasculitis
– Rash
– Cervical lymphadenopath
SOAPBRAINMD:
– Oral (Ulcers)
– Photosensitive rash
– Renal Nephritis
– ANA
– Malar rash
– Discoid rash
– Erythema Nodosum
– Pyderma Gangrenosum
Procedure for Investigation
Physical Examination
– Vital signs
– Meningeal signs
– Neurologic evaluation
– Joint examination
– Skin examination
Laboratory Tests
– Urinalysis
– Serologies – if indicated
– Skin biopsy
بس ممكن نثبتitems
For cases:
For contacts:
Prevention: