Macules and papules

Blog #8

by Nishani

During our clerkship years, the rest of my classmates and I received a few hours of experience in a dermatology clinic to cover the learning objectives required for our dermatology block.  The experience also included working through several cases online and reading a dermatology handbook.  Although the teaching resources were very helpful, at the time, I knew the practical experience provided hardly enough time for me to get a good sense of dermatology and feel comfortable assessing skin lesions.  How often are we asked by patients and in many cases, friends and family members, to take a look at a “rash” and make a diagnosis on the spot?  I was always amazed at the rapid diagnostic capabilities of dermatologists when looking at skin conditions.  I recognize that the very refined diagnostic skills of dermatologists take time to develop after years of training the eyes to carefully examine numerous skin lesions and their various presentations.  Today, I had a chance to see these skills in action in the dermatology clinic.  I, myself, became more comfortable looking at skin lesions and appreciating some of the features that make them identifiable.  For instance, after seeing several examples of sebhorreic and actinic keratoses, I became more confident in identifying these lesions on patients.  I learned that being able to touch a skin lesion and assess what it "feels like" adds so much more information, but receives little recognition. Many times, we are expected to learn dermatology through pictures.  Although there are certainly a number of great visual resources available to study dermatology, I do not think they can replace the value of seeing the real thing. My personal goal is to gain more practice in a dermatology setting so that I can become more proficient in my "spot diagnosis" skills.