Definition
• Skin lesions that display a spec distribution & pattern
Approach
• Nature of rash: D-I-M-P-L-E-S mnemonic
• ROS, PMH, h/o skin lesions, travel, exposures (pets or hobbies), sick contacts, immunizations, sexual hx, menstrual hx, new medication hx (including OTC)
• Physical exam: Assess for fever, hypotension, tachycardia, AMS; Nikolsky sign?
• Distribution of rash: Central/peripheral, flexor/extensor surface, dermatomal, intertriginous, follicular, acral, localized/grouped/regional/generalized, sun-exposed, mucosal
• Shape or configuration: Annular (ring-shaped), round/nummular/discoid (coin-shaped), targetoid, arcuate (arc-shaped), linear, serpiginous, reticular (net-like/lacey), whorled (marble-like), polycyclic (coalescing circular/ring-shaped lesions)
• Characterize rash based on morphology (see table)
