The astute clinician uses the appearance of the eruption and its accompanying symptoms to arrive at an accurate diagnosis. A symptom, such as itch or pain, is something that the patient reports. In contrast, a sign is elicited by the physician during examination. Pain is a symptom; tenderness to palpation is a sign.
This chapter will focus on the morphologic patterns skin lesions may have primarily or acquire over the course of time. The latter are called secondary characteristics and are not as helpful diagnostically as those present at the onset of the condition. Examples of each primary and secondary lesion are included, as well as other findings that are utilized to narrow the differential diagnosis such as the configuration, grouping, and color.
Finally, examples throughout will emphasize that the astute clinician should utilize all observable findings, inducing those of the hair, nails, and mucous membranes.