SKILL LABORATORY MODULE

BLOCK
TOPIC
I.

: Dermatomusculoskeletal system
: Dermatological examination

GENERAL OBJECTIVE

After completing a skill practice of dermatological examination (including hair, nail

and mucous membrane), the students will be able to perform dermatological
examination.
II.

SPECIFIC OBJECTIVE

At the end of skill practice, the student will be able to:

1. Perform the physical examination in dermatology
2. Explain about dermatological status
III.

METHODS

1.
2.
3.
4.
IV.

Presentation
Demonstration
Self practice on photographs of skin lesions
Written dermatological status

EQUIPMENT

1. Presentation:
- Audiovisual aids
2. Demonstration and coaching:
- Slide of skin lesions
3. Practice:
- Photographs of skin lesions
- Written dermatological status
V. LEARNING GUIDE:
PHYSICAL EXAMINATION IN DERMATOLOGY

No
.

STEP

Client assessment
1.
2.
3.
4.
5.

Greet the patient respectfully with kindness, introduce your

self
Notice the initial clinical impression: does the patient
appear ill?
Give the patient an adequate explanation about the
examination
The patient is placed in adequate illumination, preferably
natural light or bright overhead fluorescent lighting.
Ask the patient to take off his/her clothes

PERFORMANCE
SCALE

EXAMINATION THE SKIN, HAIR, NAIL, AND MUCOUS MEMBRANE

- Examination of the skin

6.

Distribution of lesion
Examine the entire skin surface and assess the extent of
involvement:
- Localized, regional, generalized or universal?
- Characteristic pattern?
(symmetry/asymmetry, bilateral/unilateral, dermatomal)

7.

Location of lesion
- Determine the location of the lesion from the scalp to the
soles in succession (according to anatomical region)
- Characteristic location: flexural, extensor, intertriginous,
glabrous, palms and soles, exposed area, etc.

8.

Characteristic of lesion
Determine the characteristic of lesion by inspection:
- The number of lesion: soliter or multiple
If multiple: Discrete or confluence
- Shape of individual lesion(s)
(annular, iris, arciform, linear, round, oval, umbilicated,
etc) and arrangement of multiple lesions (herpetiform,
zosteriform, annular, arciform, linear, etc.)
- The size of lesion
(by measuring the lesion :cm X.cm X.cm or
specific size: milier, gutata, nummular)
- The border of lesion (well-defined or ill-defined)
By palpation:
- Elevated, plane or depressed from surrounding skin.
- Dry or wet
- Consistency and feel of lesion (soft, doughy, firm, hard,
mobile or tender).

9.

Type of skin lesions

Determine:
a. Primary skin lesions:
1
1. macule
2. papule
3. pustule
4. plaque
5.
nodule
6.
cyst

7.
8.

wheal
vesicle and bullae

b. Secondary skin lesions:

1. erosion
2. excoriation
3. fissure
4. scar atrophy / hypertrophic
5. ulcer
6. scar
7. scale
8. crust
c. Specific skin lesions:
1. comedone
2. teleangiectasis
3. canaliculi
4. milia
- Examination of the hair
Note the distribution of hair, its texture, and hair loss.

10.

11.

- Examination of the nail

Note the colour, surface, texture, and specific signs of the
nails (pitting nail, splinter hemorrhages, leukonichia,
onychodystrophy, onycholysis, subungual hyperkeratosis,
etc.)

- Examination of the mucous membrane related to chief complaint

12. Inspect the mucous membrane of conjunctivae, oral,
genital, and anal regions for the presence of erythema,
erosion, excoriation, ulcer, etc.
General physical examination in dermatology
13. General physical examination as indicated by clinical
presentation and differential diagnosis, with particular
attention to vital signs, lymphadenopathy, and/or joint.
Description of pyysical examination in dermatology
13. - Conclude the results of skin examination using the
following pattern:
> Dermatological status:
- Distribution
:
- Location
:
- Characteristic of lesion:

- Type of lesion

- Conclude the results of hair, nail, mucous membrane and

general pysical examination.
General status: .

VII.

EVALUATION
1. Self practice on photographed skin lesions
2. OSCE

VIII.

CRITERIA OF PERSONAL PERFORMANCE EVALUATION

SCALE
0
1
2

PERSONAL ACHIEVEMENT
If students are not doing this step
If student are doing this step, but not efficiently
If students are doing this step very well

DESCRIPTION OF DERMATOLOGICAL STATUS

> Dermatological status:
- Distribution
- Location

:
:

- Characteristic of lesion
- Type of lesion

:
:

Results of hair, nail, mucous membrane examination:

DESCRIPTION OF DERMATOLOGICAL STATUS

> Dermatological status:
- Distribution
- Location

:
:

- Characteristic of lesion
- Type of lesion

:
:

Results of hair, nail, mucous membrane examination: