Diagnosis of Steps

General history
1. submit patient's personal data: name, age, address and occupation
2. answer who brought the patient to the doctor (main complaint). For heteroanamnesis ask
the patient's relationship with the introduction.
3. first give the skin abnormalities begin to appear. Exploring more about the onset, the
duration of the abnormality, which is loss or permanent, what is the initial picture, where is
the initial location, how is the development and subsequent distribution.
4. Make friends or not, is there a fever or not
5. apply or not.
6. Ask the forms of this disorder with previous work
7. what is the patient feeling. If any, ask:
- When does this start, does it occur suddenly or not. - Does it appear together or after it.
8. Give whether the patient has experienced the same in the past.
9. Determined the same family history in the context of family or neighborhood
10. Act in contact with patients with the same symptoms, history of contact with insects or
plants.
11. fulfilling medical conditions that have been obtained from a doctor and medication that is
carried out by a patient without a doctor's prescription

EXAMINATION FISIS
SKIN EXAMINATION
1. Examination of the patient in a bright place. And then you will check the patient from head
to foot. Inspection and palpation of existing lesions or skin disorders (using a magnifying
glass). The main points in a good dermatological examination are:
Location and / or distribution of existing disorders: This can be very helpful: for example,
seborrheic dermatitis has a predilection for the face, head, neck, chest, and suprapubis; in
children, eczema is feasible in flexor areas; common acne on the face and upper body; basal
cell carcinoma.
2. Characteristics of individual lesions:
• Characteristic type: macula, papules, nodules, plaque, vesicles, bulls, pustules, ulcers,
urticaria (to find other fluorescent images, arrange search in the reference book)
 • Surface characteristics of lesions: Skuama, Crusta, Hyperkeratosis, Eschoriation,
Maseration and Likenification

 Likenifikasi

MAKULA PUSTUL VESIKEL

BULLA SKUAMA KRUSTA

URTIKA LIKENIFIKASI NODUL

KISTA EKSKORIASI ULKUS

ASSESSMENT OF ULKUS

• Size, shape, edge and boundaries. Exactly the right size, can only compare with peas,
oranges or coins. Lesions can have various forms, such as round, oval, annular, linear or
"irregular"; straight or angular edges may be shaped by external factors.
• Color, there are always benefits for making notes about colors: red, purple, brown, pitch
black and so on
• Surface image. Find out smooth or rough lesions, and to distinguish crusts (dry serum) with
scaling (hyperkeratosis); Some searches on the squad can help, for example, there is silvery
color in psoriasis.
• texture - shallow? Use your fingertips on the surface of the skin; estimate depth and rotation
in or under the skin; lift scales or crusts to see what's under it; an attempt to make the lesion
blanch properly.

3. Examination of the "secondary" location: Look for abnormalities in other places that can
help diagnose. Good examples include:
• Nails have psoriasis
• Fingers and hands on scabies
• The toes of the toes in a fungal infection
• Mouth in lichen planus

4. "Special" examination techniques: Special techniques are needed for examinations such as
skin scraping with potassium hydroxide to check hyphae and spores for examination of fungi
on the skin

Additional checks
• Wood Lamp
• Skin scraping examination
• Skin Scrape Inspection with 10% Potassium Hydroxide + Methylene Blue

Reference:
1. Cox N, Coulson IH. Diagnosis of Skin Disease. In: Burns T, Breathnach S, Cox N,
Griffiths C, editor. Rook Teaching Book on Dermatology. Massachusetts: Blackwell
Publishing; 2004. p. 5.1 - 5.10.
2. WolfK, GoldsmithLA, I.Katz S, A.Gilchrest B.Fitzpatrick's Dermatologyin
GeneralMedicine.WolfK, GilchrestBA, PallerAS, J.LeffelD, editor.NewYork: McGraw;
2008.
3. BudimuljaU. Skin and Cellulite Disease Science. DjuanaA, HamzahM, AisahS, editor.
Jakarta: Faculty of Medicine, University of Indonesia; 2011.