Dermatological Complaints

Introduction

Unlike internal medicine, most dermatological complaints presenting in a community pharmacy can be seen (and felt).

This presents the community pharmacist an excellent opportunity to base the differential diagnosis by

Questioning

Physical examination

It is worth remembering that many patients will be embarrassed by the appearance of the skin conditions.
Examples of notable findings include:

Dry, flaky scalp with reddened areas may indicate dandruff, psoriasis or dermatitis.
White patches on the tongue or throughout the mouth can indicate oral candidiasis ("thrush").
Xanthomas are deposits of cholesterol in the skin of patients who have very high cholesterol levels and indicate a need for referral.
Nails that are very thick, lifting up from the nail bed or are discoloured can be a sign of a fungal infection.
Bluish or purplish discolouration of the lips or finger, also known as cyanosis, is a sign of hypoxia.
Palmar erythema (redness of the palms) and spider veins can be signs of liver injury.

NOTE: Some patients only provide photos of their skin conditions, which can be unhelpful for diagnosis if the image resolution is poor.

Apart from general community pharmacy references, few useful resources on dermatological conditions include:

Dermatology is a medical field which relies heavily on visual examination.

Hence, to familiar with a skin condition (instead of reading through the plain words description), it may be a good idea to Google image the skin condition.
However, many skin conditions can look similar. Hence, it is important to consult with a qualified healthcare professional for an accurate diagnosis.

Inspection should be performed in a well-lit room with either natural light or the ability to use a penlight to determine how raised a lesion is.

When performing palpation, gloves are important both for patient comfort and practitioner safety.