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lnvolvement of hands, inctuding nail folds and fingcr wcbs

If symmctrical

Extensor. e.g. psoriasis (J]

Flexor, e.g. eczema ■

Morphology of individual lesions with the aid of a hand lens (see opposite)

Eye involvement

e.g. Conjunctivitis/blepharitis in rosacea

General medical examination if indicated

lnvolvement of face

Central

Hairline

Cheeks and

nasal bridge butterfly'

Sparing of light-protected

sites and behind ears

Orał involvement

^ Orał lichen planus with lip involvement

Joint involvement

e.g. Psoriatic arthritis

A Erosive psoriatic arthropathy (large arrows) and fixed flexion deformities (smali arrows)

Individual lesions

Discrete Grouped Confluent Reticulate (lace-like) Linear lnvolvement of axillae and groin

e.g. hidradenitis suppurativa

Fine pitting of nails in ^ alopecia areata

Nail involvement

Distribution of rash

(Examine the fully undressed patient in bright. uniform light) Symmetricai, e.g. psoriasis Asymmetrical. e.g. granuloma

annulare Proximal. e.g. acne Distal, e.g. leg uicer Facial. e.g. seborrhoeic dermatitis Localised. e.g. morphoea Widespread, e.g. erythroderma

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