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Begin with a detailed patient history. Ask if any other family member has the same problem and if it was present from birth or developed after skin lesions or a rash. Were the lesions painful? Does the patient have any medical problems or a history of burns, physical injury, or physical contact with chemicals? Is he taking prescription or over-the-counter drugs? Find out if he has noticed other skin changes—such as erythema, scaling, ulceration, or hyperpigmentation—or if sun exposure causes unusually severe burning.
Next, examine the patient’s skin, noting erythema, scaling, ulceration, areas of hyperpigmentation, and other findings.
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
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