Ochsendorf Falk, Meister Laura
Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland.
Hautarzt. 2017 Mar;68(3):229-242. doi: 10.1007/s00105-017-3939-y.
The dermatologic examination follows a clear structure. After a short history is taken, the whole skin is inspected. The description, which is ideally provided in writing, forces one to look at the skin more closely. The description should include an accurate description of the location, the distribution, the form, and the type of lesion. The article contains tables with internationally approved definitions to describe skin changes. The analysis of these findings allows one to deduce pathophysiologic mechanisms occurring in the skin and to deduce hypotheses, i. e., suspected and differential diagnoses. These are confirmed or excluded by further diagnostic measures. The expert comes to a diagnosis very quickly by a pattern-recognition process, whereby novices must still develop this kind of thinking. Experts can minimize cognitive bias by reflective analytical reasoning and reorganization of knowledge.
皮肤科检查遵循明确的结构。在简要了解病史后，对整个皮肤进行检查。理想情况下应以书面形式提供描述，这会促使人们更仔细地观察皮肤。描述应包括对病变的位置、分布、形态和类型的准确描述。本文包含用于描述皮肤变化的具有国际认可定义的表格。对这些发现的分析使人们能够推断皮肤中发生的病理生理机制并推断假设，即疑似诊断和鉴别诊断。通过进一步的诊断措施来证实或排除这些假设。专家通过模式识别过程能非常迅速地做出诊断，而新手仍必须培养这种思维方式。专家可以通过反思性分析推理和知识重组来尽量减少认知偏差。
