Cutaneous signs: an opportunity for a diagnosis
A wide range of internal diseases and many malignancies have cutaneous signs associated, some of them can be shared between different entities, but others are pathognomonic, that means, are associated with a particular disease, for instance the association between necrolytic migratory erythema and glucagonoma.
A clinical dermatologist is a treasure
A cutaneous lesion is an opportunity to learn more about the patient and the disease. An experienced dermatologist is a treasure in a health center, when he/she is able to discriminate only with the macroscopic and morphological characteristics. Although a cutaneous biopsy is the normal procedure after the inspection, it is not uncommon to get only a descriptive pathological report without a functional correlation.
Deliberate practice is a path of self-learning and improvement
Again, an experienced clinical dermatologist is a diamond in a health center or in a hospital. This experience is the result of a “deliberate practice” through all the years for a motivated physician.
Today, mobile phones are a practical tool to help in the deliberate practice attitude, because they are inside every pocket of every clinician and dermatologist. With the proper respect and collaboration of a patient, a dermatological sign can be shared with other colleagues or to be registered for a future comparison.
Every day in the real clinical practice, doctors have the opportunity to learn from their clinical practice. A dermatologist with a real experience in the clinic is a “rara avis” when we speak about making a diagnosis before a biopsy.
Author: Lorenzo Alonso. Foro Osler
Images obtained under consent of the patient