Integumental: History
  1. Skin lesions
  2. Past medical, surgical history
  3. Family, social, drug history
Skin lesions
  • SOCRATES
  • Site: covered vs. sun exposed.
  • Site: symmetrical vs. asymmetrical.
  • Site: where originated, if spread, when it moved.
  • Site: arrangement pattern.
  • Character: colour, shape, depression/elevation, edges.
  • Character: changes in properties.
  • Character: itchiness, pain.
  • Character: scaling, crusting.
  • Character: discharge, bleeding.
  • See Skin Lesion Terminology Reference.
Past medical, surgical history
  • Similar condition in the past.
  • DM (lower limb ulcerations).
  • Asthma, hayfever (eczema).
  • Strep (erythema nodosum).
  • Rash dz's: psoriasis, RA, herpes, etc.
Family history
  • Similar condition in a relative, what age.
  • Skin problems in the family.
  • Allergies in the family.
Social history
  • Smoking: ever smoked, how many per day, for how long, type [cigarette, pipe, chew].
  • Passive smoking in the home, workplace.
  • Alcohol (aspiration).
  • Occupation type.
  • Occupation details:
    Tasks done at work.
    Chemicals, plants contacted.
    How long of exposure.
    Protection used.
    Illness in fellow workers. 
  • Pets at home (allergy).
  • Stress levels (allopecia, etc).
  • Who is with you there at home.
Drug history
  • Drugs currently, formerly on:
    Steroids (thinning, bruising, ulceration).
    Chemotherapy (allopecia).
    Dyes (hives).
  • OTCs:
    Salves.
    Shampoos.
  • Ventilators.
  • Recreational drugs:
    IV drugs.
  • Allergies:
    Chemicals.
    Latex.
  • Allergies to drugs, esp. rashes:
    Drugs.
    Dyes.

Integumental Exam