Pre PACES Podcast #73 Dermatology in PACES
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Nov 5, 2023 Dr Naomi Jones, ST6 dermatology registrar skilled in clinical dermatology and systemic skin signs. She walks through a practical skin exam and concise history tips. Learn why lesion distribution and descriptive terms matter. Hear clear pointers on rashes, vasculitis, dermatomyositis, nail and lower-leg clues. Short, practical and packed with clinically useful signposts.
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Use Distribution To Narrow Differentials
- Do use distribution to narrow differentials: dermatomal suggests shingles, extensor surfaces suggest psoriasis, and widespread with mucosal involvement suggests drug eruption.
- Naomi Jones advises always describing whether lesions are localized or generalized and their morphology.
Describe Lesions With Precise Dermatology Terms
- Do use precise lesion terminology: macule <1 cm, patch >1 cm, papule <1 cm raised, nodule >1 cm, plaque >1 cm thick, vesicle/bulla/pustule for fluid-filled lesions.
- Naomi Jones recommends describing erosions vs ulcers to indicate epidermal-only loss versus full-thickness loss.
Skin Findings Can Mirror Internal Disease
- Insight: Cutaneous findings can directly mirror internal disease and offer accessible diagnostic tissue, exemplified by sarcoid where skin granulomas reflect pulmonary disease.
- Naomi Jones highlights lupus pernio as a stable cutaneous sign prompting skin punch biopsy instead of lung biopsy.