Table 2.

Dermatologic Assessment/History

Skin assessment/history Common Terminology Macule Small flat spot, up to 1 cm Patch Flat spot 1 cm or larger Papules Up to 1 cm Plaques Elevated lesion 1 cm or larger Vesicles Up to 1 cm , filled with serous fluid Bullae 1 cm or larger filled with serous fluid Pustule a vesicle or bulla containing purulent fluid up to 1 cm Filled with pus (yellow proteinaceous fluid filled with neutrophils) Nodule Knot - like lesion larger than 0.5 cm, deeper and firmer than a papule	Perform skin assessment Visually inspect and palpate the skin. Describe the type of lesion, location and distribution Assess for signs and symptoms of infection Take photographs to document lesion and extent of involvement skin condition Take a detailed history When did the skin reaction begin? How long has the skin reaction been present? Does the skin itch? Do you have pain? What did the reaction first look like? Has the skin reaction changed? Does the skin reaction subside and return? Review a list of all medication over 2 month period. Have you changed soap, detergents, lotions, etc., before you noticed the skin reaction? Any history of similar symptoms or a family member with of drug allergies? Have you used or tried anything that seems to make the reaction better or worse? Do you have any other systems i.e. fever, malaise, pain, diarrhea?
Review medications including over the counter and complementary/alternative therapies	Review all medications Include the start date, if /when dose changed and when drug was stopped over the past 2 months. The drug timeline is extremely helpful It is important to assess allergy history including details of type of reaction.
Past medical and surgical history including co morbidities, treatment and nutritional status	Take history including recurrent HSV and infections

Data from Bickley, L.S. & Szilagyi, P.G. (2013) and “Skin Assessment,” by L. Johannsen, 2005, Dermatology Nursing, 17(2), p.166. Copyright 2005 by Jannetti Publications, Inc. Reprinted with permission. Need permission