Rashes and skin lesions
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Dermatologic problems result from a number of mechanisms, including inflammatory, infectious, immunologic, and environmental (traumatic and exposure induced). At times, the mechanism may be readily identified, such as the infectious bacterial etiology in impetigo. However, some dermatologic lesions may be classified in more than one way. Most insect bites, for example, involve both environmental (the bite) and inflammatory (the response) mechanisms. Awareness of the potential mechanism of any skin disorder is most helpful in identifying the risk a person may have for other illnesses. For example, people with eczema are also frequently at risk for other atopic conditions, notably asthma and allergic rhinitis. Thousands of skin disorders have been described, but only a small number account for the majority of patient visits. Evaluation of rashes and skin lesions depends on a carefully focused history and physical examination. The
provider needs to be familiar with the characteristics of various skin lesions; anatomy, physiology, and pathophysiology of the skin; clinical appearance of the basic lesion; arrangement and distribution of the lesion; and associated pathological conditions. It is also important to know common symptoms associated with specific lesions such as itching or fever. It is necessary to quickly identify life-threatening diseases and those that are highly contagious. Ultimately, competence in dermatologic assessment involves recognition through repetition.