Dermatology

Core Generalist#

Knowledge#

CG.K.1#

Describe the basic structure of skin in health and disease

CG.K.2#

Describe a lesion, rash, ulcer, skin nail or mucous membrane change using conventional dermatological nomenclature including colour, exudates, pattern, size, shape, change in sensation, inflammation, location, distribution, symmetry, tenderness, consistency, temperature, moisture, texture, turgor, and fragility

CG.K.3#

Identify and be able to distinguish between:

  • Non-melanocytic

    • benign: seborrheic keratosis, skin tags, haemangioma, dermatofibroma, pyogenic granuloma, naeviprem
    • alignant: solar keratosis
    • malignant: basal cell carcinoma, squamous cell carcinoma, Bowen’s disease, keratoacanthoma

  • Melanocytic: melanocytic naevi, malignant melanoma

CG.K.4#

Identify sun damaged skin and distinguish between benign non-actinic lesions and:

  • ephelides
  • solar lentigines
  • solar elastosis
  • solar keratoses
  • sun related skin malignancies

CG.K.5#

Discuss indications and contraindications for treatment of dermatological conditions using common pharmacological agents, including"

  • topical corticosteroids
  • moisturisers and emollients
  • antibacterials
  • antifungals
  • antivirals
  • antipsoriatic agents
  • acne therapies
  • immune stimulant
  • topical cytotoxic

Skills#

CG.S.1#

Undertake a relevant dermatological history, including;

  • history of the presenting complaint including time course, distribution, associated symptoms such as pain, itch or fever, possible triggers and response to previous therapies
  • medications: current and previous, including topical and complementary therapies
  • past medical history, including previous skin conditions and cancers
  • family history, particularly of skin conditions and cancers
  • domestic and international travel in the last year
  • occupation
  • hobbies for example gardening, crafts
  • skin, nail and hair care routines including frequency and temperature of showers and baths, types of cosmetics, soaps, oils, and products used
  • clothing and jewellery
  • lifetime and current sun exposure
  • hair and nail care products and routines
  • tattoos
  • skin slashing, cutting

CG.S.2#

Perform a dermatological examination, including:

  • mucous membranes: eyelids, nose, mouth, buccal, pharyngeal, sub-lingual, tongue
  • hair: texture, colour, quantity, distribution, brittleness, hair loss including pattern, facial hair distribution, quantity, texture, hirsutism in females
  • scalp: scales, crusts, or lesions
  • nails: length, colour, configuration, symmetry, hygiene, thickness, deformities, hyperpigmented bands, pitting, and splinter haemorrhages
  • skin of the head, face, neck, arms, hands, chest and abdomen, legs, back, back of legs, feet, including soles and between the toes, buttocks, and genital area

CG.S.3#

Undertake the following procedures to assist in diagnosis:

  • specialised equipment for further examination of the skin, including magnifying lamp, Woods light
  • examine skin lesions with a dermoscope
  • collect skin scrapings and clippings for mycology
  • skin biopsy: excision, shave, curettage, punch and incisional
  • use telederm to seek assistance with diagnosis and treatment

CG.S.4#

Undertake initial assessment and triage patients with acute or life-threatening dermatological conditions, including:

  • staphylococcal toxic shock syndrome
  • angioedema
  • exfoliative erythroderma
  • necrotising fasciitis
  • meningococcemia
  • Stevens-Johnson Syndrome
  • toxic epidermal necrolysis
  • malignant melanoma

CG.S.5#

Arrange and interpret results of patch testing, bacteriology, mycology, virology and polymerase chain reaction (PCR) nucleic acid amplification test (NAAT), including details such as transport delays and sampling errors

CG.S.6#

Diagnose and manage common skin conditions

CG.S.7#

Perform the following therapeutic procedures:

  • cauterisation or freezing of skin lesions
  • excisions of skin lesions
  • select a vehicle for topical treatment
  • supervise the choice and application of dressings for ulcers
  • apply wet wraps/dressings for eczema

CG.S.8#

Incise and drain or excise cystic structures eg carbuncle, epidermal cyst, collections, foreign bodies

CG.S.9#

Perform and provide instruction for wound care

Attributes#

At.2#

Adaptability

At.15#

Reflection

At.14#

Receptivity

Dermatology presentations and conditions#

  • Skin infections

    • Viral: warts, molluscum contagiosum, herpes simplex, herpes zoster, HIV
    • Bacterial: erysipelas/cellulitis, staphylococcal infections, folliculitis, pitted keratolysis, erythrasma, syphilis, impetigo
    • Fungal: candidiasis, tinea, pityriasis versicolor
    • Insects: scabies, lice, flea bites

  • Cutaneous manifestations of systemic disease, including:

    • systemic malignancy
    • metabolic diseases
    • endocrine disorders e.g. diabetes, thyroid, Cushings, Addison’s
    • gastrointestinal disorders
    • Paget’s disease
    • extra-mammary Paget’s disease
    • autoimmune and or connective tissue diseases eg systemic lupus erythematosus, polymyositis, systemic sclerosis, CREST syndrome, sarcoid, raynauds, scleroderma, bullous pemphigoid, epidermolysis bullosa

  • Rashes related to pregnancy, including:

    • pruritis gravidarum
    • prurigo of pregnancy
    • pruritic urticarial papules and plaques of pregnancy
    • pruritic folliculitis of pregnancy

  • Dermatological conditions associated with hair, including:

    • hair loss – diffuse, localised
    • alopecia areata
    • alopecia totalis
    • trichotillomania
    • traction alopecia
    • scalp ringworm
    • lichen simplex
    • psoriasis
    • excessive hair growth, aetiology, differences: hirsutism, hypertrichosis

  • Dermatological conditions associated with nails, including:

    • nail pitting
    • nail ridging
    • nail discolouration
    • nail plate thickening; tinea, onychogryphosis
    • other nail conditions; avulsion, ingrown, subungual haematoma

  • Nail changes that occur due to:

    • psoriasis
    • dermatitis
    • paronychia

  • Types of ‘nappy rash’, including:

    • irritant dermatitis
    • candida
    • seborrheic dermatitis

  • Facial rashes, including:

    • rosacea
    • seborrheic, perioral, contact dermatitis
    • fungal infection
    • systemic and discoid lupus
    • erythematosus
    • acne
    • chloasma

  • Rashes on the hands and other areas of body including:

    • contact irritant dermatitis
    • contact allergic dermatitis
    • endogenous eczema
    • fungal infection
    • psoriasis

  • Mucous membrane conditions; ulcers, tumours, leukoplakia

  • Chronic ulcers; venous and arterial ulcers, pressure sores

  • Dermatitis conditions; atopy, eczema, contact dermatitis, venous insufficiency dermatitis, xerosis

Last updated on by acrrmbot