The History

The emergency physician should determine the chief complaint and obtain a brief history (discomfort, duration, rate of progression, and location of lesions). The secondary history should include issues relating to the lesion—morphology, evolutionary nature, rate of progression, and distribution. Associated systemic complaints and mucosal systems must be identified. Ask about exposures to medications (over-the-counter, prescription, and illicit), immunizations, toxins, chemicals, foods, animals, insects, plants, and ill contacts. Sexual history, if appropriate, as well as medical and family histories, should be reviewed. Asking about medication use, sun exposure, or particular food ingestion may also yield helpful information.

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