- 1.
Many outpatient visits are for dermatologic complaints
- 2.
The patienťs chief complaint can be divided into two diagnostic skin diseases: growths and rashes
Skin diseases are common and a significant number of outpatient visits are for dermatologic complaints. A minority of these patients are seen by dermatologists; most of the remainder are seen by primary care physicians and physician extenders. In a survey of the family practice clinic at the Pennsylvania State University College of Medicine, we found that dermatologic disorders constituted 8.5% of diagnoses. The incidence is higher in a pediatric practice, in which as many as 30% of children are seen for skin-related conditions.
Although thousands of skin disorders have been described, only a small number account for most patient visits. The primary goal of this text is to familiarize the reader with these common diseases. Some uncommon and rare skin disorders are covered briefly in this book to expand the readers’ differential diagnosis.
Our diagnostic approach divides skin diseases into two large groups: growths and rashes. This grouping is based on both the patienťs presenting complaint (often a concern about either a skin growth or a symptom from a rash) and the pathophysiologic process (a growth represents a neoplastic change and a rash is an inflammatory reaction in the skin). Furthermore, the correlation between the clinical appearance of the disorder and the pathophysiologic processes responsible for the disease facilitates making the diagnosis and selecting the proper treatment.
Growths and rashes are then subdivided according to the component of skin that is affected. Growths are divided into: epidermal, pigmented, and dermal proliferative processes. Rashes are divided into those with and those without an epidermal component. We also have chapters dedicated to ulcers, disorders of the hair, nails, mucous membranes, and skin signs of systemic disease. A self-assessment chapter at the end of the text provides the learner an opportunity to reinforce diagnostic and treatment principles.
