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A 23-year-old young woman comes to your office with a rash. The rash started as red, round, pruritic bumps on the abdomen approximately 1 week before presentation and has spread. More recently, 1.5-cm round scaly patches and plaques have developed on the trunk and extremities.
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- What additional questions regarding personal and family history would you ask?
- What types of social or occupational exposures may be relevant to this case?
- What specific questions about the location of the eruption may help in making a diagnosis?
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Dermatologists are not the only physicians who assess and treat patients with skin disorders. The results of the National Ambulatory Medical Care Survey (1990–1994)1 showed that US dermatologists saw only 40% of patients with diseases of the skin, hair, or nails. In the primary care setting, 25% of all visits were found to involve skin disorders. Data from both the United States and Canada reveal a continued undersupply of dermatologists, resulting in the need for nondermatology physicians and physician extenders to provide primary care of skin disease.2,3 These data support the importance of a fundamental understanding of the skin to all healthcare professionals.
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As the body's most accessible organ, the skin is too important to be ignored. A close inspection of the skin can afford important insight into the presence and nature of cutaneous and internal disease.
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