Treatments used Topical including cleansers and moisturizer Oral medications:
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1 Discipline: Dermatology Extended Topic: Acne & Rosacea : Onset: Location: Face Chest Back Menses if female: Regular Irregular PCOS Treatments used Topical including cleansers and moisturizer Oral medications: Flushing: Drug exposure: Alcohol Steroids use BCP Medications: Allergies: Examination Location Face Back Chest Neck Masculine Features Pigmentation Excoriation Comedones Scarring Inflammatory papules Nodules Cysts If Rosacea: Facial redness Telangiectasia Scaling Eye involvement Diagnosis: Acne: Grade DDX: Rosacea Seborrhoea L.E. Acne Investigations
2 DHEAS, Free testosterone Cholesterol, TG, B-HCG Treatment Accutane discussion of side effects Treatment to start after consent and blood work. Others: (amount and repeats) Topical Oral medication & side effects: : especially Accutane
3 Discipline: Dermatology Extended Topic: Actinic Keratosis & Skin Cancer History Complaint Previous history of A Ks Skin Cancer: Location: When: History of sun burn Occupation Past Medical History Medications Family History of skin cancer or melanoma Referral Examination: Number of lesions Skin Type: Location: Diagnosis: Investigation Biopsy Sunsceen with SPF of 30 or more, Hat and protective clothing Treatment: Cryotherapy Topical creams: Efudex Zyclara Aldara Other modalities Excision
4 Discipline: Dermatology Extended Topic: Alopecia : Gender: Onset: History of loss: gradual History of pregnancy Surgery Family history of hair loss: Stressful life events Diet restrictions Infections Hair care habits: Chemical straitening Hot comb Pulling Traction History of Iron deficiency Thyroid disease Acne Hirsutism Hx of chemotherapy Other diseases Medications: Examination: Scarring or non-scarring alopecia Areas of involvement Solitary or multiple areas Hair regrowth Inflammation, scaling, follicular atrophy, telangiectasia Pull test Evidence of Acne Evidence of Hirsutism Diagnosis: Investigations Medications (amount, concentration, repeats)
5 Discipline: Dermatology Extended Topic: Collagen Vascular Diseases Duration of eruption Photosensitivity: Previous treatments: History of Fatigue arthritis Pain and tingling in extremities Medications: Oral contraceptive medications Others: Allergies: Examination: Eruption locations: Scalp Face Cheeks Nose Ears Lips V neck Outer arms and hands Nail folds Differential Diagnosis: Investigations: ANA Complements Other Biopsy Treatment (amount and repeats)
6 Discipline: Dermatology Extended Topic: Eczema of onset Frequency Triggers: Areas of involvement History of atopy, asthma Family history of atopy, Asthma Past treatments: Medications: Including OTC and Herbal medications Examination: Description: Locations: Differential Diagnosis: Investigations: (e.g. Patch testing Biopsy or blood tests) Medications (Dose including repeats) Skin care advice After care instructions Photos
7 Discipline: Dermatology Extended Topic: Fillers Reason for treatment rational: Previous treatment and types of fillers areas of treatment Allergic reaction to fillers History of body dysmorphic disorder Medications including herbal medications Immune suppression medication ASA Anticoagulants Vitamin E Alcohol intake Last filler laser peels treatments Loss of volume Location Areas of proposed treatment Signs of infections Diagnosis: Consent to treatment Photos Type of fillers Amount injected Lot number
8 Discipline: Dermatology Extended Topic: Laser Previous treatment Type of lasers used History of herpes infection or Accutane use Medications: Examination: Consent Type of peel Name of peel How long applied for: Neutralization applied Material applied after neutralization After care instructions Photos
9 Discipline: Dermatology Extended Topic: Peels Reason for seeking peels Previous treatments and peels: Hx of Herpes virus Medications Examination: Acne Melasma Sun damage Aging skin Skin type Consent Type of peel Name of peel How long applied for: Neutralization applied Material applied after neutralization After care instructions Photos
10 Discipline: Dermatology Extended Topic: Lesions & Melanoma Lesion: Location Change in size, colour or shape Time that lesion has been changing Medications Allergies History of Sun exposure: Grew up in tropical area Burn without tan Burn then tan Tan Blistering sunburns Used tanning bed - How frequent; How long Past medical history: Breast cancer BRCA genes testing Pancreatic cancer Family history: Melanoma Dysplastic nevi Breast cancer Examination: Describe the concerning lesion: asymmetry; border; colour; diameter; location Number of nevi Extent of sun damage Dermoscopy Lymphadenopathy Diagnosis: Biopsy of lesion same day or next visit Photography recommended Patient Education o ABCDE changes o Sunscreen use with SPF 30 or more, Protective clothing Referral for o Plastics o Cancer centre
11 Discipline: Dermatology Extended Topic: Psoriasis of patient of onset Current treatments used Hx of arthritis Family history of psoriasis or psoriatic arthritis Co-morbidities: PSA Diabetes mellitus CVD Depression Inflammatory bowel disease. Hx of Hepatitis Quality of life impact Current medications Allergies Alcohol intake Areas of involvement: a. Scalp face b. trunk c. arms d. legs e. nails i. Inverse psoriasis areas ii. Body surface areas: Discussion S/E Treatment: (Include amount and repeats) o Topical o Phototherapy o Oral treatment o Biologics:
12 Discipline: Dermatology Extended Topic: Urticaria : Onset Previous history of hives Frequency of eruption: History of Angioedema Triggers: Rubbing Cold Heat Duration of each episode Parts of the body that are usually affected Time of worse symptoms Seasonal variation Cyclical (menses, pregnancy) Medication history History of rashes with drugs or Foods Family Contacts Hobbies History of infections Treatments used and response: Exertion Pressure Sun exposure Showering Vibration Pet exposure Dermatographism Treatment: (amounts and repeats)
13 Discipline: Dermatology Extended Topic: Warts History: Onset Location Treatment(s) used PM H Diabetes mellitus Immune compromising disease Others Medications Examination Location Diagnosis: Topical: Cryotherapy Cantharidin Cantharidin + P+SA Salicylic acid compound Podophyllin / Podophyllotoxin Surgery: ED+C Excision Laser Systemic:
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