What's that rash? Key dermatological presentations for the paramedic

After completing this module, the paramedic will be able to:

Despite the many milestones achieved in modern medicine, the pathophysiology of many rashes remains unknown. The anatomy and physiology of the skin offer a foundation from which to draw understanding about what is actually happening within the dermal layers (Marieb and Hoehn, 2015). The integumentary system includes the hair, skin, and nails, each having a variety of functions to protect internal layers, provide a waterproof covering, regulate temperature and provide sensory function. An anatomical understanding of this system is an important, but seemingly overlooked, part of paramedic education. While outside the scope of this introductory CPD article, an awareness of the pathophysical responses within this system would greatly assist the reader.

An accurate evaluation of dermatological complaints can only be made in the context of a thorough history (McKay, 1990). When taking a social history, it is good practice to ask about the patient's occupation, their recent movements and any recent foreign travel—all of which may suggest exposure to known occupational, geographic or parasitic risks. Contact with water, especially hot tubs, may indicate a fungal aetiology, while ingestion of plants or medicated drugs could indicate a systemic reaction. Pay close attention to a patient who complains of an itching sensation but has no presenting rash as further tests are often required—these may be to diagnose potential hepatic issues or malignant conditions.