A comprehensive clinical examination is the basis for selecting further diagnostic steps:
- General physical examination – including blood pressure, pulse, body weight, height; further:
- Inspection (viewing) of the skin, mucous membranes, and sclera (white part of the eye) [inconspicuous plaques, usually skin-colored, that develop into a raised hard tumor due to an inflammatory reaction; this tumor is usually yellow-brown in color; it is slightly vulnerable but not painful; also possible are ulceration (ulceration), exophytic growth (“growing beyond a surface”), and discharge of corneal masses]
- Inspection and palpation (palpation) of the regional lymph node stations (cervical, axillary, supraclavicular, inguinal).
- Dermatological examination [due topossible causes:
- Actinic keratosis (precancerous lesion; risk factor for squamous cell carcinoma).
- Chronic degenerative skin diseases
- Chronic inflammatory skin diseases
- Chronic infection with the papillomavirus (HPV infection).
- Skin atrophy
- Lichen sclerosus et atrophicus – chronic inflammatory disease of the connective tissue, which is probably one of the autoimmune diseases.
- Lupus vulgaris – chronic skin tuberculosis.
- Recurrent mechanical injuries of the skin
- Tight atrophic scars as in burn scars.
- Sclerosing scars – hardened scars.
- Lower leg ulcers (lower leg ulcers)]
[due todifferential diagnoses:
- Actinic keratosis – cornification disorder of the skin caused by radiation – especially UV radiation (precancerous (cancer precursor): risk factor for squamous cell carcinoma).
- Arsenic keratosis – changes in the skin caused by chronic exposure to arsenic; this includes yellowish discoloration and roughness and dryness).
- Seborrheic keratosis (synonyms: seborrheic wart, age wart, verruca seborrhoica) – most common benign (benign) tumor of the skin. Initial cells of hyperplasia (proliferation) are keratinocytes.
- Verruca vulgaris (“common wart”)]
- If necessary, gynecological examination [due topossible cause: vulvar dystrophy (disease of the female genital organ, which is mainly accompanied by pruritus (itching) and burning)]
- Health check (as an additional follow-up measure).
Square brackets [ ] indicate possible pathological (pathological) physical findings.
