Derm Flashcards
(91 cards)
1
Q
Epidermis
A
Superficial layer
Barrier from environment, waterproof
2
Q
Dermis
A
Blood vessels, hair follicles, sebaceous glands, sweat glands, nails, apocrine glands
-Provides flexibility, strength, and sensation
3
Q
Subcutaneous hypodermis
A
Deepest layer, Subq fat (conserves heat) and connective tissue, fibroblasts, macrophages
4
Q
Layers of Epidermis (5)
A
- Corneum: superficial, shedding skin
- Lucidum: on palms and plantar
- Granulosum: keratinization
- Spinosum: spiny cells, strength and flexibility
- Basale: keratinocytes
5
Q
Types of cells in Epidermis (4)
A
-Keratinocytes, melanocytes, merkels, langerhans
6
Q
Papillary Dermis
A
superficial dermis, loose collagen bundles
7
Q
Reticular dermis
A
Deep dermis, densely packed and thick collagen bundles
8
Q
Eccrine glands
A
- palms, soles, forehead
- No odor
- releases salt and water to cool body
- covers most of body, opens to skin surface
9
Q
Apocrine Glands
A
- axillary/genital regions
- thick colorless fluid
- bacteria react with fluid to cause odor
- Triggered by nervous system: stress, exercise, hormones
- Secretes into the sac of hair follices
10
Q
Vellus hairs
A
short and fine (forehead)
11
Q
Terminal hairs
A
Long/thick (scalp)
12
Q
Bulb of hair
A
- base of follicle
- matrix cells at inferior aspect
- melanocytes within matrix- pigmentation
13
Q
Functions of skin (5)
A
-Protection, fluid loss, vitamin D, sensory info, body temperature regulation
14
Q
Equipment needed for derm exam
A
Light source (daylight is best), tape measure
15
Q
During history taking, consider these aspects…
A
-Recent travel, hx sun exposure, occupation, pregnancy, duration of condition, new medications, new hygiene products, food allergies, comorbid conditions
16
Q
Make sure to check between..
A
Toes, axillae, thighs, between legs, fingers, buttocks, genitals
17
Q
Dermoscopy
A
- Trans illuminating light with magnification
- Requires additional training to be proficient
18
Q
General skin inspection
A
- Symmetry
- Color: pigmentation, cyanosis, jaundice
- Hair: distribution, quantity
- Nails: capillary refil, color, lesions
19
Q
Skin palpation
A
Moisture, temperature, texture, turgor
20
Q
Turgor
A
checks for dehydration, skin should rebound after pinching
21
Q
Checking temperature hand positioning
A
Dorsal side touching patient
22
Q
Checking texture hand positioning
A
Palmar side touching patient
23
Q
Morphology of skin lesion is assessed by?
A
Visual inspection, tactile inspection
24
Q
Characteristics of Skin lesions (5)
A
- Distribution
- Shape/arrangement
- Border
- Pigmentation
- Palpation
25
Distribution (3)
- Localized: one small area
- Generalized: widely distributed on multiple areas at same time (back, face, UE, flexor/extensor regions) one place
- Regional: specific region of body
26
Round/discoid
Coin shaped, no central clearing, umbilicated
-seen with eczema
27
Oval
ovoid
seen in pityriasis rosea
28
Annular
Round, central clearing, active/jagged margins
-tinea infections
29
Dermatomal
Follows nerve pattern
-varicella zoster
30
Target lesion
- Pink macules with target in center
| - Erythema multiforme
31
Linear
Erythematous streaks
-phytophotodermatitis
32
Serpiginous
Cutaneous larva migrans
33
Morbilliform
Measles-like
_erythematous maculopapular
34
Distinct Borders
Well-demarcated, can draw line around area
35
Indistinct
diffuse, poorly defined, rough edges
36
Irregular
Seen with malignant melanoma
-jagged edges, no sort of pattern
37
Raised
Center of lesion is depressed compared to surrounding edge
38
Flesh colored
surrounding skin color
39
Erythematous
variable shades of pink, red, coppery, salmon
40
Violaceous
light violet
41
Other coloration
Tan, brown, black, blue, hyperpigmented, hypopigmented
42
Blanchable
erythematous lesion that loses redness when pressed upon
43
Palpation of lesions look for (7)
- Consistency
- Mobility
- Blanchability
- Tenderness
- Depth
- Temperature
- Fluctuant
44
ABCDEs of melanoma
- Asymmetry
- Borders
- Color variation
- Diameter
- Evolution/elevation
45
Primary lesions
Arise from previously normal skin
46
Secondary lesions
Arise from changes in primary lesions usually due to infection, rubbing, crusting, scratching, malignancy
47
Macule
flat, non-palpable circumscribed color change
- <1cm diameter
- freckles
48
Patch
- flat, non-palpable, irregular shape at times
- >1 cm in diameter
- Hypo/hyper pigemented
-cafe au lait
49
Papule
- Palpable, firm, circumscribed, flesh colored, red or brown
- <1cm
-seborrheic keratosis
50
Plaque
- Elevated, firm, palpable, skin colored/pinkish/red, may be scale
- >1 cm
- psoriasis
51
Nodule
- elevated, circumscribed, deeper and firmer than papule
- >1.5 cm
-epidermal inclusion cyst
52
Tumor/Lipoma
- large nodule deep in dermis
- >2cm
-lipoma
53
Wheal
- irregular, raised, comes and goes, superficial edema
| - hives, insect bites
54
Vesicles
- elevated, well circumscribed
- <1 cm
- fluid containing, usually clear
-chickenpox, herpes virus
55
Bullae
- elevated, well circumscribed
- >1 cm
- Serous fluid
-bullous pemphigoid
56
Pustule
-elevated, superficial, well circumscribed
--pus filled
-folliculitis
57
Furuncle
- Boil
- usually staph aureus
-one hair follicle infected
58
Carbuncle
- multiple hair follicles infected with staph aureus
| - may progress to abscess
59
Primary Lesions (10)
- Macule,papule
- Vesicle, bulla, pustule
- Papule, plaque, nodule, tumor, wheal
60
Secondary Lesions (8)
- Crust, scale
- Fissure, erosion, ulcer
- Excoriation, atrophy, lichenification
61
Crust
- dried serums, pus, blood
- adherent
- bacterial
-impetigo
62
Scale
- hyperkeratosis
- accumulation of corneum
- increased proliferation or delayed desquamation
-psoriasis
63
Fissures
- linear cleft, painful
- drying, skin thickening, loss of elasticity
-irritant dermatitis
64
Erosion
- partial or complete loss of epidermis
- moist, oozing, crusted lesion
-SJS, pemphigus foliaceus
65
Ulceration
deeper defect with loss of entire epidermis plus superficial dermis
- loss or entire dermis
- venous stasis ulcer
66
Excoriation
- scratch marks
- liner or rounded
- exogenous injury
-neurotic excoriations
67
Epidermal atrophy
thinning of epidermis, shiny appearance, wrinkling
68
Dermal atrophy
loss of collagen, leads to depression
69
Lichenification
thickening of epidermis
increased visibility of skin markings
lichen simplex chronicus
70
Petichiae
71
Purpura
>0.5 cm
non-blanchable
round, irregular, deep red
72
Ecchymosis
purple lesions of variable size
fades to green yellow
bruising
blood outside vessels due to trauma or bleeding disorder
73
Spider angiomas
fiery red lesions
up to 2cm
blanch with pressure
seen with liver disease, sometimes pregnancy
74
Cherry angiomas
1-6 mm in size, non blanchable
75
Telangiectasias
blanchable, fine, irregular, rosacea, sun damaged skin, BCC
76
Hemangioma
benign vascular neoplasm that represents the most common tumor of infancy
red, irregular lesion secondary to dilation of dermal capillaries
77
Papulosquamous lesions
papules, plaques, and scales
psoriasis
78
Lichen PLanus
5 Ps
Pruritic, polygonal, purple, planar, papules
79
Nodular Lesions
Nevi
Cherry angiomas
Epidermoid cysts
80
Malignant Lesions
SCC- isolated keratotic and eroded papule or nodule
sun exposed areas
BCC: central ulcerations and telangietasias, pearly
81
Vesiculobullous lesions
Vesicles and bullae
Impetigo, herpes, pemphigus
82
Maculopapular lesions
Macules and papules
drug eruptions
viral exanthems
83
Clubbing
rounded, bulbous nail base
feels spongy
- Schamroths sign-diamond space between nails indicates no clubbing
- Lines grow out with the nails
- transverese depressions
84
Beaus line
inflammation of proximal and lateral nail folds
acute <6 weeks
chronic >6 weeks
85
Paronychia
nail grows into dermis
can become infected
86
Onychocryptosis
most white with a distal band of redish brown
no lunula
87
Terry Nails
areas of discoloration caused by trauma
88
Leukonychia
spoon shaped concave nail, iron deficiency
89
Koilonychia Spoon
painless separation of the nail plate from the nail bed
90
Onycholysis
fungal infection, plate of matrix
91
Onychomycosis
small punctate depressions
caused by nail matrix inflammation
