Content Objective: Rash/Skin Disorders
By the end of the Family Medicine Clerkship, the medical student will be able to:
- Conduct a focused history for a patient presenting with a skin concern including:
- areas of involvement
- associated features (e.g. pruritis, pain, fever)
- travel, medications, exposures
- recent/concurrent illnesses
- Conduct a focused physical exam based on the presenting skin concern. (e.g. oral examination for patient with palm and sole lesions; joint and nail exam in patient with plaques on scalp.)
- Describe skin lesion(s) using appropriate terminology (e.g. macule/patch, papule/plaque, vesicle, bulla, erythematous, ulcer, etc.)
- Apply the ABCDE’s (Asymmetry, Borders, Colour, Diameter, Evolving over time) to identify malignant melanoma.
- Recognize and propose initial management for the following conditions:
- Atopic dermatitis/contact dermatitis
- Infectious causes
- Viral (exanthems, herpes, shingles, molluscum contagiosum, warts)
- Bacterial (impetigo, cellulitis)
- Fungal (tinea, candidal dermatitis)
- Drug-induced reactions
- Drug eruptions
- List the indications for biopsy and/or referral (e.g. treatment failure, uncertain diagnosis, possible malignancy).
- Counsel patients on sun safety.
- Identify risks of long-term topical steroid use.
Mandatory Clinical Encounter
- Skin Conditions 1 Clinical Card, SHARC-FM
- Skin Conditions 2 Clinical Card, SHARC-FM
- Ely JW, Seabury Stone M. The Generalized Rash: Part I Differential Diagnosis. Am Fam Physician 2010 Mar 15;81(6):726-734
- Ely JW, Seabury Stone M. The Generalized Rash: Part II Diagnostic Approach. Am Fam Physician 2010 Mar 15;81(6):735-739
- Genital HSV Infections, Canadian Guidelines on STIs 2014
- Asai Y, et al. Management of acne: Canadian Clinical Practice Guideline. CMAJ 2016; 188(2): 118-126
- Also refer to RxTx
* Where a specific resource is not listed for a particular objective, please refer to recommended general texts/websites. Resources have often been selected from the Clinical Practice Guidelines and Protocols in British Columbia and Alberta’s Towards Optimized Practice Clinical Practice Guidelines. These are often concise summaries of national guidelines.