How to Approach a Patient With a Rash or

Concerning Skin LesionGrand Strand Advanced Practice Nurse Association

September 19, 2014

M. Holly B. Glover, M.D.Grand Strand Dermatology

Myrtle Beach, SC

Disclosures

• I have no financial disclosures nor any conflicts of interest.

Learning Objectives

• Introduction to skin anatomy• Introduction to dermatology terminology• Common skin rashes– Recognition and treatment

• Common skin lesions– Recognition and treatment

Epidermis

• Epidermis: Major physical barrier of the skin– Made up of 4

distinct cell layers, each with different cell structure and function

1

2

3

4

Epidermis Epidermis: Made

up of several different cell types Keratinocyte: major

cell that keratinizes to form hard, outer layer

Melanocyte: pigment-producing cell

Langerhans cell: immune cell of skin

Dermis and Hypodermis• Dermis: tough,

support structure• Hypodermis or

subcutaneous fat: insulates the body and cushions deep tissues

• Both contain nerves, blood vessels, hair follicles and sweat glands

Terminology of Skin Lesions

Macule Patch

Vitiligo Tinea corporis

Papule Plaque

Verruca vulgaris Psoriasis

Bullae

Herpes zoster Bullous pemphigoid

Vesicle

Pustule Nodule

Acne vulgaris Keloid

Erosion Ulcer

Basal cell carcinomaPemphigus vulgaris

COMMON RASHESIN DERMATOLOGY

Recognition DiagnosisTreatmentWhen to Refer

Eczema

• Numerous different types:– Atopic dermatitis – Dyshidrotic eczema– Xerotic eczema– Nummular eczema– Allergic contact dermatitis– Irritant contact dermatitis– Stasis dermatitis

Atopic Dermatitis