![]() Typically, access is provided across an institutional network to a range of IP addresses. If you are a member of an institution with an active account, you may be able to access content in one of the following ways: Get help with access Institutional accessĪccess to content on Oxford Academic is often provided through institutional subscriptions and purchases. Drug-induced skin disease is important, and a full history of drugs taken for other disorders is essential. Many patients will already have tried topical treatment before presentation, either self medicated or physician prescribed, and the response to these, whether beneficial or adverse, may be helpful in diagnosis. Occupation, travel or residence abroad, leisure activities, and hobbies may indicate exposure to the sun, irritant or sensitizing chemicals, or infections. If more than one household member is affected this may indicate heredity or contagion. ![]() The history should include an enquiry into general health, both past and present, and of skin disease, including specific enquiry about the personal and family history of psoriasis and the atopic disorders eczema, asthma, and hay fever. ![]() The site of onset may also give a clue to the diagnosis and cause of a rash. The rapidity of fluctuation is helpful urticaria and eczema are both intensely itchy, but are distinguished by the fluctuation of the individual lesions of urticaria over hours, rather than days or weeks as in eczemas or psoriasis. Neoplasms are likely to be relatively asymptomatic and persistent, whereas inflammatory disorders may itch, scale, or ooze, and frequently fluctuate. These should include a description of the events surrounding the onset of skin lesions: when and where the eruption started and how it progressed. There are certain key points in the history of skin disease that should be specifically elicited, and these are summarized in Box 23.2.1.
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