1_Dermoscopy_Pt 1 Flashcards
(64 cards)
1
Q
what are the layers of the skin?
A
epidermis, dermis, subcutaneous tissue
2
Q
what are the layers of the EPIDERMIS?
A
- Basal (stratum germinativum) – deepest layer
- Prickle (stratum spinosum)
- Granular (stratum granulosum)
- Stratum lucidum** (**ONLY IN PALMS AND SOLES**) **(*KNOW FOR EXAM, “always a good test question”)
- Horny (stratum corneum) – most superficial layer
3
Q
where in the body is STRATUM LUCIDUM found?
A
This layer of the epidermis is ONLY FOUND in the PALMS AND SOLES
4
Q
what are the functions of the skin?
A
- cold/ heat/ radiation
- pressure/ blows/ abrasion
- action of chemical substances
- invasion by microorganisms
- heat & water loss
- defense against invading microorganisms
- absorption of certain substances
- perspiration
- circ and therm regulation (via derm vasc system)
- pressure/vibration/touch/pain/temp sensory organs
5
Q
what is another name for the basement membrane?
why is it an area of research interest?
A
- Dermal-epidermal interface (basement membrane)
- area of research interest bc pathology here can cause visible skin disease
6
Q
what is the anatomy of the DERMIS layer?
which sublayer has more collagen?
A
- Separated into _papillary and reticular l_ayer
- **the RETICULAR layer has a lot of collagen
- Place where hair and glands begin
7
Q
what are the FUNCTIONS of the DERMIS layer?
A
- Temperature regulation through control of cutaneous blood flow and sweating
- Mechanical protection of underlying structures
8
Q
which skin layer: consists of spongy connective tissue with energy-storing adipocytes
A
Subcutaneous or Subcutis layer:
- Consists of spongy connective tissue with energy-storing adipocytes (fat cells)
9
Q
(T/F) The fat content of the subcutis is the same in all body regions and individuals.
A
- The fat content of the subcutis is NOT the same in all body regions and DIFFERS in men and women
- Zero fat in and around nail tissue
10
Q
what is the fat content in and around the nail tissue?
A
- Zero fat in and around nail tissue
11
Q
when in development does nail begin to develop?
A
between 10th-17th week in utero
is when the nail begins to develop
12
Q
which cells make up the nail plate?
A
- Onychocytes: one of the tightly packed keratinized cells arranged in layers to make up the nail plate.
13
Q
what is the nail plate comprised of, in general terms?
A
the nail plate is formed by mostly nail matrix – w/ some contribution from nail bed, shape contributed from matrix and phalanx
14
Q
what is directly deep to the nail plate?
A
distal phalanx directly underneath nail plate;
there is NO SUBCUTANEOUS tissue
15
Q
compare hair and nails w/ regards to:
- growth
- keratin content
- function
- assoc glands
- where
A
16
Q
what are the key differences between APOCRINE and ECCRINE glands of the skin?
A
17
Q
what is a sebaceous gland?
A
- Apocrine gland associated with hair follicle;
- aka Pilosebaceous unit
18
Q
which glands are where ACNE occurs?
what causes these glands?
A
- Sebaceous glands are where acne occurs
- Sebaceous glands are caused by metabolic, environmental, etc factors
- can become colonized and then infected
19
Q
which glands produce sebum?
what is the normal rate, and what decreases the rate?
A
- sebaceous glands produce sebum
- normal amount is 1mg/10cm2 every 3 hours
- Skin is dry if produces less than that amount
20
Q
how long does it take for keratinocyte to pass from basal to corneal layer?
A
8-10 weeks for epidermal cell turnbover
21
Q
describe the process of epidermal cell turnover
A
- Keratinocytes divide in basal cell layer, differentiate, and progress upwards to the stratum corneum (no nuclei in corneum)
- No cell division detected past the basal layer
22
Q
where is no cell division detected past WHICH SKIN LAYER?
A
No cell division detected past the BASAL layer
23
Q
what are the big 3 of the skin exam?
A
ASK
LOOK
PALPATE
24
Q
What are examples of questions to ASK the patient when preventing for a skin exam?
A
FIRST, NLDOCAT
- Evolution (How did it begin? How did it change?)
- Involution (How did it go away?)
- What other body parts affected
-
History of rashes/skin cancer
- Topical med history (OTC/Rx/Folk/Home, failure or success?)
- Have you seen a dermatologist?
- Have you had a biopsy?
25
what factors should you consider when VISUAL AND TOUCH assessment?
(LOOK AND PALPATE)
* Distribution/location (where on the body?)
* Grouping/configuration
* Shape (primary or secondary lesions)
* Size (cm)
* Color (red, blue/cyanotic, pale)
* Temperature (use backs of hands/fingers to determine if cool or warm)
* Mobility (does it lift up?) and turgor (the speed to which it returns to normal)
* Nails
* The skin around the lesions (especially with wounds)
* Moist or dry (wetness or flakes?)
* **_CHECK THE HANDS!!!_**
26
which configuration is "Blisters on a red base" or "Dew drops on a rose petal"?
Herpetiform configuration,
often assoc w/ VIRAL distribution
27
geographic distribution usually indicates what condition?
psoriasis
28
what is the following configuration?
* **wood grain**
* usually malignant, and VERY RARE
29
what is the pigmentation of a new scar?
* **_New scar_** _is usually_ **_darker than skin color (hyperpigmented)_** _and gets_ **_lighter as it progresses_**
30
how would you describe a **blue lesion?**
## Footnote
**red lesion?**
* cyanic is blue
* erythematous is red
31
how do you describe: reddish brown, scaly papules on the palms and soles?
COPPER PENNY LESIONS;
32
**plane lesion:**
define
lesions that are FLUSH WITH SKIN;
eg. macule and patch
33
what is a "flat, non palpable lesion smaller than 1 cm"
macule
34
what is a "flat, non-palpable lesion LARGER THAN 1 CM"?
Patch
| (aka macule \> 1 cm)
35
what is: a "circumscribed, solid elevations with NO visible fluid from a pinhead size to 1cm"
PAPULE,
an elevated lesion \< 1 cm
36
what is a "circumscribed, solid elevation with NO visible fluid that is LARGER THAN 1 CM in diameter"?
**nodule**,
elevation; aka papule \> 1 cm
37
what is the following derm condition?
"TOASTED SKIN SYNDROME";
* Multiple macules, with both hypopigmentation and hyperpigmentation
* From infrared radiation
38
what is: "an elevated mass 2cm or more in diameter"
tumor
39
what is: "an elevated confluence of papules or a broad papule, 1cm or more in diameter"
plaque;
| (more geographic than dome shaped)
40
what is: "edematous elevations of various sizes that DO NOT last more than 24 hours"
wheals or hives;
## Footnote
*these are not permanent; "when doing an injection, raise a wheal"*
41
which skin elevation involves "**dermal hardening and thickening"?**
INDURATION
42
define: **heat urticaria**
hives after exercising
43
what is: a "**circumscribed fluid-filled elevations 1mm to 1cm in size,** can be serous, purulent, sero-sanguinous filled"
VESICLE, or small blister
44
what is a: "circumscribed fluid filled elevations LARGER THAN 1 CM in size, can be serous, purulent, sero-sanguinous filled"
Bulla, or big blister
45
what is: a "circumscribed fluid filled elevations 1mm to 1cm in size, with **purulent material in them**"
\*does not have to be a sign of infection, does not have to be bacteria-filled
PUSTULE;
aka a vesicle w/ purulent material
46
what is: "dry or greasy skin flakes"?
SCALE
47
what is: "a **_horny projection from skin**_ (_**calluses and warts_**)"
KERATOSIS
48
what is: "a heap of dried plasma, WBC, RBC"
CRUST,
| (crust = scab, if dried fluid)
49
what is "tissue necrosis"?
what is "dried fluid"\>
* ESCHAR is tissue necrosis (right)
* CRUST is dried fluid (left)
50
what is: "a depression below skin level; loss of part or all EPIDERMIS (burn)"
EROSION
(there is NO SCAR with loss of epidermis)
51
what is: "a depression below the skin level with **LOSS OF EPIDERMIS AND PART DERMIS**"
ULCER:
* If you lose part of dermis, **_you will scar_**
52
what are the 3 types of skin **openings**?
(meaning there's a break WITHOUT LOSS OF EPIDERMIS)
* fissure
* burrow
* cyst
53
what is: "an opening in which a linear cleft through the epidermis which may go into the dermis (think chapped lips)"
FISSURE
54
what is: "an opening with **_narrow, elevated tortuous tunnel produced by a parasite_**"
BURROW;
such as from CLM (cutaneous larva migrans)
55
what is: "an opening, **circumscribed** lesion with a **wall AND a lumen**, may contain fluid or solid matter"
CYST
* Elevations that have lumen (opening) and also a wall
* Usually start as ingrown hair or some foreign body
* Have to remove wall by excising it to fully remove it
56
what is: "a punctate or linear abrasion produced by mechanical means usually to epidermis"
EXCORIATION
57
what is: "an appearance of surface softening due to constant wetting"
MACERATION
58
what is: "flat topped thickening of skin induced by scratching, skin lines are accentuated"
LICHENIFICATION
59
what is: "a **_depression in the skin resulting from thinning_** of the epidermis or dermis"
ATROPHY
60
what is: "dilated superficial blood vessels, blanch with pressure"
TELANGIECTASIA
61
what is: "**_greater than 5mm_**, less than 1cm.
**_Do not blanch with pressure**_, _**extravasation of blood cells into dermis"_**
PURPURA
62
what is: "**_less than 5mm.**_ _**Do not bland with pressure**_, _**extravasation of blood cells into dermis"_**
PETECHIAE
63
what are the 3 zones of a target lesion?
* bull’s eye dark center,
* pale zone,
* rim of erythema (most common is erythema multiforme)
64
what are the differences between a hypertrophic scar and a keloid scar?
