Diagnostic Hints What to Do When Youre Uncertain

Did you consider:

1. Drug eruption?

2. Factitial?

3. Lupus erythematosus?

4. Mycosis fungoides?

5. Occupational or hobbies?

6. Sarcoidosis?

7. Scabies?

8. Syphilis?

9. Systemic illness?

Did you think of these broad categories?

1. Infectious: E.g., bacterial, fungal, parasitic, spirochetal, viral

2. Neoplastic

3. Inflammatory/autoimmune

4. Allergic: E.g., contact dermatitis

5. Drug reaction

6. Metabolic

7. Genetic

Did you examine for or enquire about:

1. Focus of infection?

2. Foreign travel?

3. Mucosal clues?

4. Nail clues?

5. Over-the-counter, herbal, or natural medicines?

7. Scalp clues?

8. Tinea pedis?

1. Biopsy?

2. Culture?

3. Envision the lesion at another site?

4. Order blood studies?

5. Order imaging studies?

6. Patch test?

7. Perform a KOH?

8. Really listen to the patient?

Diagnostic Hints Courtesy of Dr. Walter B. Shelley.

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