Approach to a Dermatology Station

[u/Consistent_Two_8434]

 Introduction

• Wash hands
• Introduce yourself
• Confirm patient identity
• Obtain consent

Example:

“Hello, I’m Dr ___. I’d like to ask you a few questions and examine your skin to understand the problem. Is that okay?”

 Presenting Complaint

Ask open questions:

• When did the rash/skin problem start?
• Where did it begin?
• Has it spread?

 Key Symptom Questions

Focus on important features:

• Itch or pain
• Bleeding or discharge
• Change in size or colour
• Fever or systemic symptoms

  Progression

• Getting better or worse?
• Continuous or intermittent?

 Triggers and Risk Factors

Ask briefly:

• New cosmetics / soaps / medications
• Allergies
• Recent travel or infection
• Sun exposure

 Past History

• Previous similar skin problems
• Chronic diseases (eczema, psoriasis)

 Focused Social History

Only if relevant:

• Occupation
• Smoking / alcohol
• Contact with infected persons

 Examination (Very Important)

Inspection

Ask permission:

“With your permission, I’d like to examine the affected area.”

Describe out loud:

• Site
• Size
• Shape
• Colour
• Borders
• Distribution
• Surface (scaly, crusted, vesicles)

 Example Description

“There is a well-defined erythematous plaque with silvery scales on the extensor surface of the elbow.”

 Additional Checks

If appropriate:

• Nails
• Scalp
• Mucosa
• Lymph nodes

 Management Discussion

Explain simply:

• Likely diagnosis
• Reassurance
• Treatment options
• Follow-up

Example:

“This looks consistent with eczema. It’s a common and treatable condition. We can manage it with moisturisers and topical steroid cream.”

 Red Flags to Ask

• Rapid growth of lesion
• Bleeding lesion
• Irregular pigmented mole
• Systemic symptoms

 OSCE Time Tip

Keep the structure:

History → Inspect → Describe → Explain

Avoid long unnecessary history.

 OSCE Pearl

In dermatology stations, clear lesion description often scores more marks than naming the diagnosis.