Patient Presentations Related to the Integumentary System

The guide to clinical presentations in this category may include, but is not limited to, the following ways in which patients present for osteopathic medical care:

acne and related conditions – rosacea, acne vulgaris, acneform skin lesions • bites, human, animal, and other vectors – tick bites, lice infestation (pediculosis) • burns, chemical, thermal, and electrical • dermatitis, allergic, contact, atopic (e.g., eczema), irritant, perioral, stasis, seborrheic; dermatoses and pruritus in pregnancy • fungal infections – candidiasis, tinea capitis, tinea corporis • hair-related conditions – folliculitis, hirsutism/hypertrichosis, hydradenitis suppurativa, alopecia (areata, universalis, traction) • nail plate/ungual conditions, acute and chronic – nail trauma and infections (e.g., paronychia); discoloration; nail fold and bed deformities, primary, or secondary to systemic disease (e.g., koilonychia, onychosis, Beau lines, clubbing, splinter hemorrhages, Muehrcke lines, Terry nails) • newborns, normal dermatologic manifestations (e.g., cradle cap/seborrheic dermatitis, milia, erythema toxicum, vascular birthmarks) • rashes – impetigo, vesicobullous lesions • skin lesions, immunologic (e.g., related to foods, medications, aeroallergens, autoimmune disease immunodeficiency, infection), nonimmunologic (e.g., related to physical stimuli) • skin/cutaneous lesions and dermatologic disorders, congenital and acquired – keratosis; wheals; vesicles; bullae; pemphigus (vulgaris, bullous); verrucae (warts); macules; papules; psoriasis; papulosquamous lesions; pustules; plaques; lichen planus and lichen sclerosus et atrophicus; pruritus with or without primary skin lesions (e.g., manifestations of systemic disease); carcinomas, cutaneous – basal cell, squamous cell, melanoma • skin/cutaneous pigmentation lesions and disorders, congenital and acquired – vitiligo; solar lentigo; overexposure to ultraviolet (UV) radiation; phototoxic drug eruptions; nevi; acanthosis nigricans; discoid lupus erythematosus; vascular lesions (e.g., petechiae, purpura) • sweat gland-related conditions – bromhidrosis, hyper/hypohidrosis; miliaria • systemic diseases – disseminated gonorrhea, secondary syphilis; lupus; Kawasaki disease; Raynaud syndrome (e.g., primary, secondary); Stevens-Johnson syndrome; cutaneous manifestations of internal malignancies • trauma, skin – abrasions, lacerations, contusions, stab wounds, surgical wounds, high-pressure injection injuries • ulcers, skin – traumatic, neurologic, infectious (cellulitis and cutaneous abscesses, furuncles, carbuncles), metabolic, drug-related • urticaria, acute and chronic • viral infections – varicella, herpes, enteroviruses, pityriasis rosea

CONSTITUTIONAL SIGNS AND SYMPTOMS
fatigue • fever • generalized weakness • involuntary weight loss • malaise • night sweats • pallor

PHYSICAL EXAM FINDINGS
Auspitz sign • Nikolsky sign • visual inspection (including temperature, color, moisture, tenderness)

LABORATORY TEST FINDINGS AND DIAGNOSTIC IMAGING
microscopic evaluations, fungal cultures, skin biopsies, Wood lamp