Skin Analysis, Conditions, and Disorders
This domain tests structured observation: Fitzpatrick phototype, skin type versus condition, primary and secondary lesions, and when to treat, modify, or refer. The exam rewards scope discipline.
Analysis framework
- Fitzpatrick I-VI estimates sunburn and pigment response; it guides UV protection and peel or laser risk, not skin type alone.
- Skin type: dry, oily, combination, normal, sensitive. Condition: dehydration, acne, rosacea, hyperpigmentation, aging, sensitivity.
- Primary lesions: macule, papule, pustule, vesicle, bulla, nodule, wheal, cyst. Secondary: scale, crust, fissure, erosion, ulcer, scar, excoriation.
- Red flags for referral: asymmetry, irregular border, multiple colors, diameter change, evolving mole; spreading infection; severe pain; sudden pigmentation; honey-colored crust; fever.
Worked example
A client has central facial erythema, small papules, and visible telangiectasia, and says spicy food and heat trigger flushing. This pattern suggests rosacea, not acne. Avoid steam, vigorous massage, strong acids, and extractions on inflamed areas; use gentle cleansing, barrier support, and sunscreen; refer for diagnosis.
Traps
Diagnosing instead of describing; treating active infection; extracting inflamed pustules; mistaking dehydration for dry skin; using Fitzpatrick type as a diagnosis; ignoring a changing mole because it is just pigmentation; treating rosacea with aggressive exfoliation.