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Dermatology is a specialty in which visual inspection may allow for rapid diagnosis. Some authors suggest a brief examination before a lengthy history because some of the classic skin diseases with obvious morphologies allow a “doorway diagnosis” to be established. The tools the physician needs are readily available and include a magnifying glass, glass slide (for diascopy), flashlight, alcohol pad to remove scale or makeup, scalpel, and at times a Wood’s lamp. Universal precautions should always be used.

The ability to describe lesions accurately is an important skill, as is the ability to recognize specific patterns. These abilities aid clinicians in their approach to the patient with a cutaneous eruption both in developing a differential diagnosis and while communicating with other physicians. The classic dermatologic lesions are defined in Table 18–1.

TABLE 18–1.Dermatologic Diagnostic Descriptions of Lesions of the Skin

The skin shields the internal organs from harmful xenobiotics in the environment and maintains internal organ integrity. The adult skin covers an average surface area of 2 m2. Despite its outwardly simple structure and function, the skin is extraordinarily complex. The skin can be affected by xenobiotic exposures that occur through many routes. Dermal exposures themselves are important because they account for approximately 1% of the fatalities reported to the American Association of Poison Control Centers (AAPCC) (Chap. 136). The clinician must obtain essential information as to the dose, ...

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