1. Previous history of skin disease. Any previous skin disease or problem?
* How was this treated?
* Any family history of allergies or allergic skin problem?
* Any known allergies to drugs, plants, animals?
* Any birthmarks, tattoos?
Rationale: Significant familial predisposition: allergies, hay fever, psoriasis, atopic dermatitis (eczema), acne. Identify offending allergen. Use of non-sterile equipment to apply tattoos increase risk of hepatitis.
2. Change in pigmentation. Any change in skin color or pigmentation?
* A generalized color change (all over) or localized?
Rationale: Localized change: hypopigmentation – loss of pigmentation; hyperpigmentation – increase in color. Generalized change suggests systemic illness: pallor, jaundice, cyanosis
3. Change in mole. Any change in mole: color, size, color, shape, sudden appearance of tenderness, bleeding, itching?
* Any “sores” that do not heal?
Rationale: Signs suggest neoplasm in pigmented nevus. Person may be unaware of change in nevus on back or buttock that he or she cannot see.
4. Excessively dryness or moisture. Any change in the feel of your skin: temperature, moisture, texture?
* Any excess dryness? Is this seasonal or constant?
Rationale: Seborrhea – oily, Xerosis – dry
5. Pruritus: Any skin itching? Is this mild (prickling, tingling) or intense (intolerable)?
* Doe it awaken you from sleep?
* Where is the itching? When did it start?
* Any other skin pain or soreness? Where did it start?
Rationale: Pruritus is the most common of skin symptoms; occurs with dry skin, aging, drug reactions, allergy, obstructive jaundice, uremia, lice. Presence or absence of pruritus may be significant for diagnosis. Scratching may cause excoriation of primary lesion.
6. Excessive bruising. Any excess bruising? Where on the body:
* How did this happen?
* How long have you had it?
Rationale: Mutilpe cuts and bruises, bruises in various stages of healing, bruises above knees and elbows, and illogical explanation – consider the possibility of abuse. Frequent falls may be due to dizziness of neurologic or cardiovascular origin. Also, frequent minor trauma may be a side effect of alcoholism or other drug abuse.