Medical Health Encyclopedia

The health care provider will perform a physical examination and ask questions such as the following:

• Type of rash
  • Does it look like pinpoint red spots?
  • Does it look like small red areas?
  • Does it look like bruises?
  • Has it occurred more than once without known cause (recurrent)?
  • Does it look like hives (red welts that come and go on different parts of the body and are very itchy)?
  • Does it look like blisters? Are they filled with yellow or honey-colored fluid?
  • Does it look like ulcerations (craters in the skin)?
  • Does it look like dry, tough skin growth (keratosis)? Is it associated with overexposure to sunlight (actinic keratosis)?
  • Is the rash scaling or crusting?
  • Does it look like small, solid, red, elevated bumps (papule)?
  • Does it look like both a macule (flat area) and papule (small bump)?
  • Is it a slightly elevated flat lesion (plaque)?
• Location
  • Is it in the diaper area only?
  • Is it on the rectum?
  • Is it on the scalp or face?
  • Is it on the trunk?
  • Is it on the lower extremities (legs or feet)?
  • Is it over the muscles that straighten the leg (extensor surfaces)?
  • Is it on the upper extremities (arms or hands)?
  • Is it over the muscles used to straighten the arm (extensor surfaces)
  • Is it on the genitals?
• Distribution
  • Is the rash spreading to other areas?
  • Does the amount of skin area affected increase over time?
  • Is the number of skin lesions increasing over time?
  • Do the spots come and go, or do they always stay in the same place?
  • Is it at the site of a skin injury such as a cut or scrape?
  • Is it at a site of chronically damaged skin, such as a burn?
  • Do lesions affect one side of the body (unilateral) or both sides (bilateral)?
  • Did the rash begin on hands or feet?
  • Have the sores gradually increased in size over months to years?
  • Are the lesions on exposed skin?
    • On sun exposed areas only?
    • Did the lesions begin at the site of an exposure?
• Quality or color
  • Is the skin darkening (hyperpigmentation) or thickening?
  • Is the skin red (erythematous) or is it flesh colored?
• Shapes and borders
  • Do the lesions have sharp, distinct borders?
  • Do the lesions have a bulls eye shape (irisated)?
• Time pattern
  • Did the rash begin suddenly (within hours) or slowly and gradually?
  • How long did the rash last?
  • Are there short-lasting episodes of rashes (transient)?
  • Does the same type of rash occur repeatedly (recurrent)? How often does the rash occur?
  • Did symptoms begin at birth or in infancy? What age?
  • Has the rash been long-standing (chronic)?
  • Did symptoms begin after a fever occurred and was relieved?
  • During which months does the rash usually occur?
  • Did you have a vesicle (blister) that appeared after a number of weeks? How many?
• Aggravating factors
  • Is it worse after taking a bath or other exposure to water?
  • Is it worse when you are stressed?
  • Does it occur after cold exposure?
  • Is it worse after you use skin softening or smoothing agents (emollients)?
  • Is it worse after an exposure to the sun?
• Does the rash get better after you use skin softening or smoothing agents?
• Changes over time
  • Did you have red cheeks followed within 2 days by a red spotty rash?
  • Was the rash of a brief duration and then went away (evanescent)?
  • Did the lesion change from a vesicle to an ulcer?
  • Did the lesion change from an hard bump (nodule) to a "beefy" red ulcer?
• Cther
  • What other symptoms are also present?
    • Is there fever?
    • Is there itching?
    • Is there pain?
    • Is there drainage? What kind?
  • What laundry detergent do you use? How long have you used it?
  • What kind of soap do you use? How long have you used it?
  • Do you put anything on the skin (creams, lotions, oils, perfumes)?
  • Is your child taking any medications? How long has the child taken them?
  • Has your child eaten any new foods recently?
  • Has your child been in contact with grasses/weeds/trees recently?
  • Has your child had a recent illness?
  • Does your child have any allergies?
  • Do allergies run in your family?
  • Do any skin problems run in your family?
  • Does asthma run in your family?