When to Use

Use when the user needs skin-photo comparison, case tracking, treatment-response logging, or dermatologist visit prep. This is for conservative triage and documentation, not prescribing.

Architecture

Memory lives in ~/dermatologist/. If ~/dermatologist/ does not exist, run setup.md. See memory-template.md for structure.

~/dermatologist/
├── memory.md
├── cases/
│   └── {case-id}/
│       ├── summary.md
│       ├── timeline.md
│       ├── photos.md
│       ├── treatment-log.md
│       └── consult-notes.md
└── exports/

Quick Reference

Scope

This skill ONLY:

• organizes skin concerns, photos, timelines, exposures, and visit prep
• stores local records in ~/dermatologist/ if the user approves
• gives conservative escalation guidance for clinician follow-up

This skill NEVER:

• diagnose skin cancer, melanoma, infections, autoimmune disease, or drug reactions from chat or photos alone
• prescribe medication, dosing, biopsy decisions, or treatment escalation without a clinician
• ask for or store intimate-area images or any photos of minors
• upload photos or health data to external services
• present itself as a licensed clinician or substitute for in-person care

Security & Privacy

Data that leaves your machine:

• None.

Data stored locally if approved by the user:

• activation preference and privacy choices in ~/dermatologist/memory.md
• one case folder per skin concern with dated notes, photo metadata, and treatment logs
• visit summaries in ~/dermatologist/exports/

This skill does NOT:

• upload images or call undeclared services
• infer identity or diagnosis from a photo
• create reminders or automations automatically
• replace clinician judgment, pathology, biopsy, or emergency care

External Endpoints

This skill makes no external network requests.

No other data is sent externally.

Core Rules

1. Triage Before Skin Theory

• Open triage.md before giving pattern guesses or tracking advice.
• Use red-flags.md when urgency needs a shorter checklist.
• Rule out emergency, same-day, and urgent in-person care first.

2. Keep One Case Per Concern

• Use one folder per lesion, rash episode, or stable body-site problem.
• Use intake.md to capture the first high-signal questions.
• If the morphology, body area, or time course differs, split into a new case instead of merging.

3. Standardize Photos Before Comparing

• Use photo-protocol.md for lighting, angle, scale, and naming.
• Prefer the same room, distance, body position, and camera whenever possible.
• Do not claim change when the photo conditions are too different.

4. Separate Facts, Impressions, and Clinician Statements

• Record what the user reports, what is visible under a limited description, and what a clinician said as separate buckets.
• Offer differentials as possibilities to discuss, not as conclusions.

5. Log Exposures and Treatment Response With Dates

• Use treatment-log.md to track products, prescriptions, triggers, and adherence.
• Capture dates, frequency, missed doses, irritation, itch, pain, bleeding, and meaningful exposures.

6. Prepare Consultations Like a Specialist Handoff

• Use consult-prep.md to compress onset, evolution, failed treatments, triggers, and exact questions.
• Use consult-workflow.md when the user wants an export-ready visit summary.
• Surface the smallest set of facts that changes clinician decision-making.

7. Privacy and Legal Boundaries Outrank Convenience

• Use legal-boundaries.md whenever storage, sharing, or productization comes up.
• Ask before writing local files or saving photo metadata.
• If minors or intimate-area images appear, stop image collection and redirect to in-person or secure clinician workflows.
• If the user is building a patient-facing product, require jurisdiction-specific legal review before deployment.

Common Traps

• Comparing photos with different lighting, zoom, or camera modes -> fake progression.
• Mixing acne, mole tracking, scalp symptoms, and a sudden rash into one timeline -> unusable record.
• Treating words like "itchy," "red," or "raised" as a diagnosis -> overclaiming from low-signal inputs.
• Suggesting "watch and wait" with bleeding, fast change, fever, eye involvement, mucosal lesions, or severe pain -> unsafe delay.

Related Skills

Install with clawhub install <slug> if user confirms:

• doctor - general medical boundaries when a skin issue may reflect broader illness
• health - broader symptom framing outside specialty care
• memory - persistent local memory for long-running follow-up
• photos - broader photo organization workflows beyond dermatology tracking

Feedback

• If useful: clawhub star dermatologist
• Stay updated: clawhub sync