Skin Analysis, Disorders, and Diseases
What this domain tests
This domain asks you to identify primary and secondary lesions, distinguish cosmetic conditions from medical disease, use Fitzpatrick typing, and recognize when to refer. The exam emphasizes scope of practice: estheticians analyze and treat cosmetic concerns, not diagnose disease.
Core rules
- Primary lesions: macule (flat color change), papule (raised under 1 cm), pustule (pus-filled), nodule (deep, over 1 cm), vesicle (small blister), bulla (large blister), wheal (edema), plaque (raised flat-topped area).
- Secondary lesions: scale, crust, excoriation, fissure, ulcer, scar, atrophy.
- Refer suspicious lesions: asymmetry, irregular border, varied color, diameter over 6 mm, evolving, bleeding, or nonhealing. ABCDE guides melanoma awareness.
- Common cosmetic presentations: acne vulgaris, rosacea with flushing and telangiectasia but no comedones, melasma with symmetric facial pigmentation, and seborrheic dermatitis with greasy scale.
- Fitzpatrick type predicts UV and pigment response and guides energy-based device settings.
Worked example
A client has a pearly papule with telangiectasia and a rolled border near the nose, present for months. Do not extract or treat it. Document the description and refer to a dermatologist. The reasoning: these features suggest basal cell carcinoma; manipulation risks bleeding and delay in diagnosis.
Traps
Do not call every red bump acne. Do not treat active cold sores, impetigo, or undiagnosed rashes. Do not diagnose melanoma; describe and refer. Fitzpatrick typing is not the same as race or ethnicity.