Skin biopsy pathology report

:Patient Data # :Name: - Serial Number .. :Telephone Number:. -Doctor Name :Date:Personal History # ..:Age:.. :Marital StatusSex:. Occupation -

:History Of The lesion # : Onset:. Duration :Site ..:pattern of SpreadAssociated Symptoms&it's quality&intensity
itching pain , Constitutional symptoms: Provocative factors: *heat: *cold: *dietary history : *season: *pregnancy: :*others :Previous episodes .:Previous treatment: *topical:. *systemic :Travel history burning bleeding or discharge ,

:Examination # : Type of lesion:ColorMargin: *well defined :Palpation: *Consistency: Tenderness: Number: *Solitary: * * ill defined *Mobility :*Temperature *Multiple=herpetiform -

Arrangement: *Grouped: =annular =linear =reticulated =arciform serpiginous =others= :Disseminated* Distribution: =Extent: *single *localized *regional generalized *universal * Pattern: *symmetric *exposed areas *sites of = pressure intertriginous areas *follicular localization * *random dermatomal *Blaschko lines *

:past Medical History # operations: -illness(hospitalization): :(-medications(past&present

Atopic History: *asthma Habits: *smoking *eczema *drug abuse

*hay fever *alcohol intake -

:Review of Systems #

:Family History #
Topography / distribution/ sites involved

Differential diagnosis: 1234Pathological/final diagnosis