Medical dermatology covers a range of non-cancerous skin conditions and include diseases of hair, nails and mucosal surfaces.
In all these conditions, the aims are to
- Treat appropiately
- Screen for associations
Skin disease diagnosis is the core skill of a dermatologist. It is impossible to devise a treatment plan and to predict prognosis if the diagnosis is unknown.
A clinical diagnosis is often not possible. Sometimes special investigations will be required to confirm the diagnosis:
A sample of skin is removed and sent to the pathologist. The pathologist can identify the processes under the microscope that is invisible to the naked eye.
To determine the cause of an allergic contact dermatitis, a patch test can be performed. A patch test is indicated in all hand and feet eczemas, and in unclassified eczemas that is chronic and recurrent. A basic patch test contains more than 40 allergens that commonly trigger allergic contact dermatitis.
The patient should not use oral corticosteroids while being patched and there should not be an active dermatitis present on the back.
A specific patch test is ordered for each patient. It is applied on the back of the patient on a Monday. The patch is then checked for a bump or blister on a Wednesday and removed. The patient returns on the Friday for another check. If a culprit allergen was identified, it should be avoided in future.
A dermatologist can scrape the skin, nail or scalp to examine under the microscope for superficial fungal infections and scabies.