Teaching non-dermatologists to examine the skin: a review of the literature and some recommendations

Abstract

An international committee has recently decided on standard definitions of common dermatological terms. However, some inconsistencies remain. Those concerning the definitions of 'plaque' and 'patch' could be resolved by making the lower limit of size of these lesions 0.5 cm, to correlate with the proposed 0.5 cm upper limit of size of a macule and a papule. The practice of describing crust, scale, etc. as secondary lesions should be abandoned. Instead, the type of lesion (e.g. papule, plaque, nodule), and its surface features (e.g. scale, crust, etc.) should be described separately. The concept of smooth/normal as a surface feature should be included. A scheme is recommended for describing skin lesions, which is based on the following features: (i) their site, distribution and arrangement; (ii) lesion morphology, under the following headings: palpation, type, surface, colour, border, size, shape; and (iii) associated features, such as changes affecting the nails, mouth, scalp and genitals.