Identify the patient and the focused reason for evaluation.
Rotation Ready · Function well from day one
Notice more. Say it clearly.
Prepare to observe, describe, present, reason, and participate appropriately in dermatology clinic and consults—without pretending to know more than you do.
Local expectations vary. Confirm schedule, attire, equipment, documentation, and workflow with your program. DermPrep supports supervised learning; it does not confer independent diagnostic, prescribing, procedural, discharge, or emergency-management authority.
PurposeFunction effectively in clinic and consults.
AudienceStudents, rotators, interns, and advanced learners.
PrerequisiteBasic morphology and focused differential.
Time5, 25, or 60 minutes.
Choose your pathway
Prepare for the rotation you actually have.
Tomorrow Mode is a compressed one-night plan. Rotation Ready is a reusable guide for functioning and improving throughout the rotation.
Quick · 5 minutesArrive oriented
Review morphology, presentation structure, observation targets, and learner boundaries.
Core · 25 minutesCommunicate clearlyPractice description, common patterns, treatment concepts, procedures, and professional expectations.
Deep Dive · 60 minutesReason through consultsAdd consult structure, escalation, pathology and dermoscopy correlation, and audition-level practice.
Before Day One
Five answers you should have.
- Know: the morphology sequence and a concise presentation framework.
- Bring: only what the program recommends; arrive with a way to take notes that respects privacy.
- Notice: how clinicians describe, choose a biopsy site, explain treatment, communicate uncertainty, and plan follow-up.
- Say: what you see, your focused differential, what supports the leader, and what you want to clarify.
- Avoid: interrupting care, overstating certainty, copying documentation blindly, or implying competency you do not have.
Mobile first-day checklist
Useful anywhere. Adapt locally.
0 of 8 complete
Presentation Lab · Core feature
Describe before you diagnose.
Location → number → primary lesion → color → configuration → surface → distribution.
Practice vignette
A patient presents with several itchy areas on both antecubital fossae.
On examination, there are multiple poorly demarcated erythematous plaques with fine scale and excoriations, distributed symmetrically in the flexures.
Weak: “The patient has a red rash on both arms.”
Your attending-ready version
Complete the seven fields to build a precise description.
Why this is stronger
It creates a shared visual representation without prematurely naming a disease. It also gives the attending the information needed to test your differential.
What is still missing?
Timeline, symptoms, triggers, exposures, treatment response, other involved sites, medication history, systemic findings, and relevant personal history.
What might come next?
“What is your focused differential, and which feature supports your leading consideration?”
Give only history that changes morphology, differential, urgency, or management.
Use the morphology sequence and distribution.
Leader, important alternative, and dangerous mimic when relevant.
Name the discriminating feature and acknowledge uncertainty.
Clarify examination, testing, biopsy, treatment concept, or escalation with your supervisor.
Active observation
Watch for the decision behind the action.
Do not shadow passively. Ask what clinical question each observation, test, procedure, or follow-up plan answers.
Morphology and distribution
Notice the precise nouns and modifiers used—and which absent findings matter.
Focused differential
Listen for the clue that moves one diagnosis above a close alternative.
Biopsy-site reasoning
Observe how the clinical question, lesion age, morphology, and intended studies influence site selection.
Context before class
Notice how severity, body site, age, comorbidity, prior treatment, safety, monitoring, access, and preference shape choices.
Calibrated uncertainty
Listen for how clinicians explain what is likely, what remains uncertain, and what would change the plan.
Longitudinal reasoning
Notice what response is expected, what is monitored, and when the diagnosis is reopened.
Common patterns worth recognizing
Focus on morphology, not a memorized list.
Acneiform
Comedones, inflammatory papules, pustules, nodules, distribution, scarring, and medication context help distinguish acne from acneiform eruptions.
Eczematous
Pruritic erythema, scale, crust, vesiculation or lichenification vary by stage; distribution, exposures, and age help narrow the process.
Psoriasiform
Well-demarcated plaques with scale and characteristic sites may support psoriasis, while nails, scalp, folds, and joints add context.
Annular and fungal pattern
An active scaly edge, central change, exposure, prior corticosteroid use, and fungal evaluation when needed can separate dermatophyte infection from mimics.
Skin lesion evaluation
Symmetry, border, color, evolution, symptoms, palpation, dermoscopy, and the full examination guide whether a lesion needs further evaluation.
Treatment concepts to recognize
Class, purpose, safety, monitoring.
Anti-inflammatory class used across many dermatoses; potency, site, duration, age, adverse effects, and diagnosis matter.
Normalize follicular keratinization and support acne treatment; irritation, photosensitivity counseling, and pregnancy considerations require supervision.
Match the agent and route to the suspected organism, site, extent, resistance considerations, and diagnostic confidence.
Mechanism, indication, contraindications, infection risk, laboratory or clinical monitoring, vaccination considerations, and current labeling matter.
Basic procedures · Recognize and observe
Ask three questions: What is happening? Why is it being done? What should I watch for?
Observe how the suspected diagnosis and desired tissue depth shape technique and specimen handling.
Notice site, punch size, depth, closure, and whether additional studies change specimen needs.
Connect lesion selection with expected tissue injury, counseling, healing, pigmentary change, and follow-up.
Observe identity checks, allergy and medication history, dose awareness, injection technique, and patient communication.
Recognize closure goals, tension, wound-care instructions, warning signs, and local follow-up practices.
Define the fungal question, sample the correct site, and interpret microscopy with the clinical picture.
Observation and conceptual preparation do not establish procedural competency. Follow local policy and supervision.
Professional expectations
Be prepared, useful, honest, and coachable.
Program culture and workflow vary. Ask rather than assume.
Review the next day’s setting, common vocabulary, and your knowledge gaps.
Confirm local arrival expectations and account for check-in and travel.
Observe before inserting yourself; ask which task is helpful and appropriate.
Say what you know, what you do not know, and how you would close the gap.
Write down one concrete change and demonstrate it on the next patient.
Prioritize privacy, consent, comfort, inclusive language, and uninterrupted care.
What not to do
- Diagnose before describing or ignore distribution.
- Give an unranked differential to hide uncertainty.
- Skip medication review, systemic symptoms, or urgency-changing findings.
- Pretend to know an answer or overstate certainty.
- Interrupt patient care to display knowledge.
- Photograph, copy, or store patient information outside approved systems.
- Imply procedural or prescribing competency you have not earned.
Consult Mode
Start with the consult question.
What problem is the primary team asking dermatology to help solve?
Consult question, urgency, timeline, and decision the team needs.
Evolution, symptoms, medications, exposures, prior treatment, systemic findings, and relevant history.
Morphology, distribution, complete-skin-examination concepts, mucosa, scalp, nails, palms and soles, folds, and other sites when relevant.
Common, important, dangerous, and rare-but-characteristic diagnoses—without zebra inflation.
Testing, biopsy concepts, treatment reasoning, escalation, communication, and follow-up under supervision.
Educational consult-note framework
Adapt to local policy and supervision.
Do not paste a generic template into a medical record. Use the local format and ensure every statement is patient-specific and verified.
- Summary: focused consult question and clinical context.
- Pertinent history: facts that change the differential or urgency.
- Skin examination: morphology and distribution with relevant additional sites.
- Differential: ranked reasoning with discriminating clues.
- Recommendations: supervised next considerations, communication, and follow-up.
When to escalate promptly
Do not let a desire to name the rash delay the team.
Promptly involve the supervising clinical team for toxic appearance, rapidly progressive eruption, skin pain, extensive blistering or detachment, mucosal involvement, purpura with systemic symptoms, suspected invasive infection, major medication reaction, or another urgent concern. Morphology alone may be insufficient.
Communication across levels
Change the language, not the meaning.
Patient-friendly
“The skin is inflamed in a pattern that can have several causes. We will use the history and examination—and testing if needed—to narrow it down and discuss the safest next step.”
Say it like this
Instead of: “It is definitely psoriasis.”
Try: “The morphology and distribution are most consistent with psoriasis. I would also examine the scalp and nails, ask about joint symptoms, and keep an important mimic in mind.”
What would you say?
Consult scenario: A hospitalized patient develops a rapidly spreading eruption after several medication changes.
“I would first clarify the consult question and medication timeline, describe the morphology and distribution, assess mucosa, skin pain, systemic symptoms, and progression, and promptly update my supervising team if red flags are present. I would avoid committing to a diagnosis before the full evaluation.”
What changes your mind?
Select a finding, then revise the differential or urgency.
Rapid-fire sets
Practice what you may be asked to explain.
Each prompt tests a defined rotation skill—not random trivia.
Morphology · Question 1 of 5
What should come before the diagnosis in a skin presentation?
Questions you may be asked
What is the primary lesion?
Name the lesion before the disease. If mixed lesions are present, identify the dominant and secondary changes.
Why is that your leading diagnosis?
Give one or two features that support it, then state the closest alternative and the discriminating clue.
What question would a biopsy answer?
Connect the clinical differential to the desired tissue, lesion site, timing, and studies; do not answer only with a procedure name.
What do you need to know before discussing treatment?
Clarify diagnosis, severity, site, age, comorbidity, prior treatment, contraindications, safety, monitoring, access, and patient context.
Morphology, focused differential, treatment and procedure concepts, red flags, and your role.
Present concisely, show your reasoning, calibrate certainty, and ask a focused question.
Observe deliberately, examine relevant additional sites, protect privacy, seek feedback, and apply it.
30-second recap
- Prepare for the setting and confirm local expectations.
- Describe before diagnosing.
- Rank the differential and defend the leader with a discriminating feature.
- Ask what question a test, biopsy, or treatment is meant to answer.
- Communicate uncertainty honestly and escalate red flags promptly.
- Leave each day with one feedback action and one knowledge gap to close.
Next best actions
Use the rotation to drive your learning loop.
Also connects to Visual Diagnosis, Derm Conditions, Treatments, Procedures, Dermpath & Dermoscopy, and the Glossary.
Sources & page information
- American Academy of Dermatology. Basic Dermatology Curriculum.
- American Academy of Dermatology. Clinical guidelines and current disease-specific guidance.
- DermNet. Terminology in dermatology.
- DermNet. Principles of dermatological practice.
- Centers for Disease Control and Prevention. Clinical Overview of Ringworm.
- U.S. Food and Drug Administration. Drug Safety Communications.