A Rash of Rashes

So, I don't think I even made it through a whole year of medical school before the questions started coming. I don't know why, but everyone I know is really eager to have their own personal physician, pro-bono of course (because you know those $20 co-pays are real wallet busters). Everyone, also, wants to know if I can prescribe narcotics and if I can take a look at some rash on their body.

With respect to the narcotics: I usually just laugh those questions off nervously as I hope that the questioner isn't serious but I'm not so sure as I see the glint in the eyes. Then I conjure up images in my mind of the DEA busting down my door and the Board of Medicine revoking my license in perpetuity, heh...

But the rashes, oh the rashes, how I hate rashes.

First off, let's just talk about me and rashes for a second. Dermatology is a field of medicine that I am not particularly fond of. Its subject may be the largest organ but it is also the most boring organ. Diagnosis is usually done by sight and nothing else, sometimes biopsies are taken. It is freaking disgusting at times (play around here at your own risk). My greatest fear in medicine is to be asked to describe a rash using proper medical terminology: macule, papule, plaque, patch, scale, ulcer, bulla, vesicle, and so forth.

Next, we have my ambushed encounters with rashes. "Hey, William, you're a doctor type person! what do you think THIS is?" They say this as they strip off clothing to give me a good view of the lesion in question. As I carefully inspect the rash, feeling for texture and raised edges, I put my best pensive face on and I think to myself, "Yup! He's got a rash all right." In my most confident voice I tell my patient, "Well, it's really hard to tell in this setting what exactly we're looking at... I would probably due a skin scraping and KOH test but it could be an atopic dermatitis [a big word for eczema], contact dermatitis [allergy], or some form of tinea [fungus/ringworm]. Try an over the counter antifungal/cortisone cream for a couple weeks and see if that works... if not, maybe you should go see a doctor."

Don't get me wrong, I think it is pretty awesome that I have the respect of my friends such that they want to come to me for medical advice. But the fact of the matter is, I don't know everything there is to know about all fields of medicine and especially not dermatology. So, bring me your sick, bring me your ill but DON'T, just DON'T bring me your rashes.