Scaly skin Assessment Questionnaire

Why: to determine if acute or chronic.

Why: may assist in helping determine the cause e.g. scaliness between the toes may suggest athlete's foot (fungal infection); dry scaly cracked skin on legs of elderly especially in winter suggest asteatotic eczema; on heels suggest keratoderma climactericum; hands and wrists may suggest scabies; in flexures such as front of elbow and behind knee suggest atopic dermatitis (eczema); on scalp may suggest psoriasis vulgaris.

Why: may suggest scabies, tinea or other fungal skin infection.

Why: may suggest atopic dermatitis.

Why: e.g. cosmetics, soaps, clothes detergent, foods - may suggest atopic dermatitis (eczema) or contact dermatitis.

Why: may suggest atopic dermatitis (eczema) or psoriasis.

Why: e.g. asthma, hay fever - may suggest atopic dermatitis (eczema), ichthyosis is also commonly associated with allergic tendencies such as eczema, allergic rhinitis and asthma.

Why: some medical conditions are associated with thickened scaly skin patches including polycystic kidney disease, hypothyroidism (myxoedema), scleroderma, peripheral vascular disease, acromegaly, anorexia nervosa and discoid lupus erythematosus; cystic fibrosis, celiac disease, nephrotic syndrome and cirrhosis of the liver may cause Vitamin A deficiency and rough scaly skin.

Why: e.g. diuretics may predispose to asteatotic eczema; isotretinoin for severe acne may cause dry scaly skin.

Why: e.g. atopic dermatitis (eczema), ichthyosis, psoriasis.

Why: Vitamin A deficiency may cause rough scaly skin. Dietary deficiency of Vitamin A is often due to failure to incorporate green leafy vegetables into the diet, usually exclusively in developing countries and may also cause night blindness and dry eyes; Pellagra is deficiency in niacin and causes diarrhea, dementia and dermatitis (scaly red thickened skin). It is now rare and found only in people who virtually only eat maize (e.g. in parts of Africa).

Why: may suggest asteatotic eczema, tinea, scabies, dyshidrotic eczematous dermatitis (pompholyx), atopic dermatitis, contact dermatitis, lichen sclerosis, ichthyosis.

Why: may suggest psoriasis or tinea Nails affected? - may suggest psoriasis or tinea.

Why: e.g. itchy, red, dry, scaling, cracked skin. The typical distribution changes as the person grows older. In infants the rash is usually on the cheeks of the face, the folds of the neck and scalp. It may then spread to the limbs and groin. During childhood a drier ad thicker rash develops in front of the elbow, behind the knees and on the hands and feet, which may be dry, itchy, cracked and painful. Rarely does eczema have an adult onset.

Why: e.g. may range from faint redness to severe swelling, symptoms are often worse in area around the eyes, genitals and on hairy skin, symptoms are least on hairless skin such as palms and soles. Allergic contact dermatitis is usually confined to the site of exposure to the allergen.

Why: e.g. red lesions that enlarge and develop a silvery scale. The commonest sites are the backs of the elbows and knees, then the scalp, sacral areas, genital and nails.

Why: e.g. husky voice, tiredness, weight gain, constipation, cold intolerance, loss of hair, puffiness of face and eyes, and cool dry thickened skin.

Why: e.g. refusal to maintain normal body weight, loss of more than 25% of original body weight, intense fear of becoming fat, preoccupation with calorie counting, avoidance of all carbohydrate, fainting. May also have dry scaly skin and increased soft downy body hair.

Why: e.g. tiredness, weakness, increased sweating, heat intolerance, weight gain, enlarging hands and feet, enlarged facial features, headaches, decreased vision, voice change and dry coarse scaly skin.

Why: e.g. night blindness is the earliest symptoms of vitamin A deficiency. Later symptoms include dry eyes, eye pain (due to ulcer formation) and blindness. May also have rough scaly skin.

Why: e.g. difficulty with swallowing, heartburn, hand swelling and/or thickening and tightening of the skin of the fingers, Raynaud's phenomenon.