Physical Assessment for Dermatitis

Key Assessment Components

A comprehensive skin examination is essential for a patient with worsening dermatitis, with particular attention to signs of secondary infection or systemic spread, according to the American Heart Association 1, 2
Assess the extent of the rash, noting percentage of body surface area (BSA) involved, to determine severity and treatment approach, as recommended by the American College of Cardiology 1, 3
Check for signs of secondary bacterial infection: increased warmth, tenderness, purulent drainage, honey-colored crusting, or surrounding cellulitis, as advised by the American Society of Clinical Oncology 4
Evaluate for characteristic manifestations: erythema, papules, vesicles, bullae, and assess the degree of itching, according to the American Heart Association 1

Mild (Grade 1): <10% BSA involvement, minimal symptoms, as defined by the American Society of Clinical Oncology 4
Moderate (Grade 2): 10-30% BSA involvement or significant symptoms limiting instrumental activities of daily living, as classified by the American Society of Clinical Oncology 4
Severe (Grade 3): >30% BSA involvement or severe symptoms limiting self-care, as categorized by the American Society of Clinical Oncology 4

Document any treatments already attempted and their effectiveness, as recommended by the American Heart Association 1, 2
Consider that worsening after two weeks could indicate continued exposure to the allergen or complications develop, according to the American College of Cardiology 1

Remember that the "angry back syndrome" can occur when multiple areas are affected, potentially leading to false positive reactions to other substances, as noted by the British Association of Dermatologists 5