Derm Terms Flashcards
(81 cards)
1
Q
What things should we keep in mind when doing a derm history?
A
- when and where the lesions began - how they spread - how they changed - are they pruritic (itchy)? painful? - is this the first episode? - contactants, environmental exposures, travel hx
2
Q
What’s the system frequently used in a derm description?
A
TAD type arrangement distribution
3
Q
What is the main determinant of a derm dx?
A
primary lesions
4
Q
How are basic types of lesions categorized?
A
- raised vs. flat
- small (gen 5mm) v. large
- clear-fluid filled v. pus-filled
5
Q
macule (defn)
A
- A circumscribed, flat lesion
- differs in color from the surrounding skin
6
Q
What are some things that can produce a macule?
A
- vasodilation (e.g. erythema)
- blood pigments (e.g. ecchymosis)
- excess melanin (e.g. melasma)
- deficient melanin (e.g. vitiligo)
- exogenous pigment (e.g. tattoo)
7
Q
plaque (defn)
A
- A raised lesion with MORE LATERAL dimension (surface area) than height (elevation above the skin)
- sometimes the result of clustering of papules
- has the feel of a “thickened” area of skin
- usually 2 cm or more
- e.g. psoriasis
8
Q
patch (defn)
A
- any portion of skin markedly different in appearance or character from its surroundings.
- Some dermatologists restrict its use to large macules (>5mm); others use it to refer to relatively thin, but large plaques.
- Most feel that accurate description can almost always be better served by the more precise terminology, e.g. large macule, or thin plaque.
9
Q
papule (defn)
A
- SOLID, circumscribed ELEVATED lesion <5mm (small)
- can involve epidermis, dermis, or both
10
Q
What is a papule often caused by?
A
- accumulation of inflammatory cells
- proliferation of neoplastic cells or
- deposit of metabolic by-products
11
Q
What is an example of a papule that predominantly involves epidermis?
A
warts
12
Q
What is an example of a papule that involves both dermis and epidermis?
A
lichen planus
13
Q
nodule (defn)
A
- similar to a papule (i.e. solid, circumscribed, elevated lesion) but BIGGER - 5mm-5cm
- may be seen as elevation or can be palpated
14
Q
Which layers can a papule involve?
A
epidermis, dermis, or both
15
Q
Which layers can a nodule involve?
A
- epidermis and dermis
- dermis and subQ fat
- subQ fat alone
16
Q
What may a nodule consist of?
A
- edema
- inflammation
- granulomas
- neoplastic cells
17
Q
tumor (defn)
A
- solid mass >5 cm
- usually extends deeply into skin
- may be inflamm, non-inflamm, benign or malignant
** careful with using this term so as not to scare your patients!!
18
Q
vesicle (defn)
A
- SMALL (<5mm), circumscribed, RAISED lesion that contains FLUID (ex: pompholyx or many early-onset herpes blisters)
19
Q
bulla (pl bullae) (defn)
A
- LARGER (>5mm) vesicle (i.e. RAISED, FLUID-FILLED)
- aka blister
20
Q
What are some examples of bullae?
A
- acute contact dermatitis
- friction blister
21
Q
pustule (defn)
A
- yellow-white PUS-filled VESICLE
- usually within follicle
- NO surrounding capsule (unlike a cyst)
- usu roof is nothing more than bit of epidermis still hanging on (whereas with a cyst there is a true circumferential wall)
22
Q
What is the difference between a pustule and a cyst?
A
- pustule: no surrounding capsule, roof is a little epidermis still hanging on
- cyst: has a capsule, true circumferential wall
23
Q
What should we keep in mind when using the term maculopapular?
A
- true maculopapular rash is relatively rare
- NO such thing as a maculopapule (can’t have a single lesion that is both macule and papule but could see both types of lesions present)
- ex of a more precise description: predominantly brown macules and rare round pink papules)
24
Q
telangiectasia
A
- a MACULE
- linear, punctate, or sometimes arborizing THIN blood vessel
25
wheal
aka hive
- can be papule OR plaque
- TRANSIENT, PINK ELEVATION of the skin
- often surrounded by a red flare
- pores looked stretched like surface of orange ("peau d' orange") b/c of edema fluid
26
What is a synonym for wheal?
hive
27
comedo (pl comedones)
- a PAPULE
- plugged, dilated pore
- often called blackhead ("open" comedo) or whitehead ("closed" comedo)
28
open comedo
blackhead
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closed comedo
whitehead
30
cyst
- a NODULE (5mm-5cm) or TUMOR (\>5cm)
- semisolid or fluid-filled mass
- surrounded by a capsule
- usually located deeply
31
abscess
- a NODULE (5mm-5cm)
- localized collection of PUS in a cavity formed by disintegration or necrosis of tissue
32
What things should we pay attention to when describing primary lesions?
- color - size - shape - # - depth - tenderness - temperature - consistency
33
ex of shapes used to describe lesions
- round - oval - umblicated - dome-shaped - flat-topped - polygonal - iris/target - acuminate - filiform - serpiginous
34
acuminate (defn)
pointed
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filiform
threadlike
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serpiginous
snake-like
37
ex of consistencies used to describe lesions
- hard - firm - soft - fluctuant - boggy
38
What might each of the following consistencies suggest? - hard - firm - soft - fluctuant - boggy
- hard: Calcium, bone, foreign body, dermatofibroma
- firm: dense dermal process (most common consistency)
- soft: skin tag, lipoma
- fluctuant: abscess
- boggy: kerion
39
secondary lesion
- primary lesion altered by scratching (excoriations) or that has simply evolved (ex: most open area - erosion - left behind when blister breaks)
- provide important dx clues
40
common and important secondary features include:
- scales - atrophy - burrow - fissure - erosion - ulcer - excoriation - fibrosis - oozing - crust - lichenification - scar - poikiloderma - sclerosis - sinus
41
scales
- excessive accumulation of loosely adherent keratin, a flat plate or flake of stratum corneum
- usually seen in papules & plaques, or when eruptions resolve
42
Furfuraceous/Branny
Scales that are fine & loose \* Characteristic of tinea versicolor and pityriasis rosea
43
Ichthyotic
- Scales that are large & polygonal \* Characteristic of a group of inherited and acquired disorders of keratinization, termed the ichthyoses
44
Silvery/Micaceous
- Scales characteristic of parakeratosis, especially psoriasis; parakeratosis refers to nuclei retention in stratum corneum \* Characteristic of psoriasis
45
Greasy
- Scales that are yellowish and moist \* Characteristic of seborrheic dermatitis
46
Collarette
- A fine peripherally-attached & centrally-detached scale at the edge of an inflammatory lesion \* Usually seen when a vesicle or a pustule is resolving
47
Desquamation
- Superficial shedding or peeling of the epidermis \* Seen with resolution of a primary dermatosis, e.g. an exanthematous drug eruption
48
atrophy
- Thinning of the skin
- appreciated best by palpation
- Characterized by loss of normal skin markings
- May affect epidermis, dermis OR subcutaneous fat
- May be fine wrinkles & increased translucency unless sclerosis is associated.
49
burrow
a small tunnel in the skin that houses a parasite such as scabies mite.
50
fissure
a crack in the epidermis
51
erosion
- SUPERFICIAL loss of epidermis - NOT associated with scarring - often accompanies vesicles, bullae or pustules
52
ulcer
- a DEEP erosion resulting from loss of epidermis AND PART OF DERMIS - often heals with a scar
53
excoriation
- LINEAR erosion caused BY SCRATCHING - may be superficial OR deep
54
fibrosis
formation of excessive fibrous tissue
55
oozing
- accumulation of moist sebum, serum, cellular & bacterial debris over a damaged epidermis - often overlies erosion and is seen in vesicles, bullae, and pustules
56
crust
- accumulation of dried sebum, serum, cellular & bacterial debris over a damaged epidermis - often overlies erosion and is seen in vesicles, bullae, and pustules
57
lichenification
- Thickened skin with accentuated surface markings caused by chronic rubbing, and scratching - can resemble the bark of a tree
58
Scar
Replacement by fibrous tissue of another tissue that has been destroyed by injury or disease.
59
3 major types of scars
- hypertrophic: elevated with excess growth of fibrous tissue - atrophic: thin & wrinkled - cribriform: scar is perforated with multiple small pits
60
Poikiloderma
association of HYPERpigmentation, HYPOpigmentation, atrophy, AND telangiectasia ALL in one skin lesion - seen in some cutaneous lymphomas.
61
Sclerosis
- diffuse or circumscribed induration of the subcutaneous tissues - may involve dermis when overlying epidermis may be atrophic
62
Sinus
- a tract leading from a suppurative cavity to the skin surface or between cystic or abscess cavities
63
Koebnerization
- skin lesions appearing on lines of trauma - may result from either a linear exposure or irritation
64
ex of derm dx with linear arrangement
- contact dermatitis - dermatitis artefacta - psoriasis - lichen planes - warts
65
linear arrangement can be due to . . .
- exogenous agents (Koebernization) - internal anatomic of dev structures - embryonal dev lines in the skin - blood or lymphatic vessels
66
annular arrangements can be due to . . .
- centrifugal extension of infection from point of inoculation (Lyme disease, tinea corporis) - neoplastic process that leaves central scarring (basal cell carcinoma) - allergic process with refractory state in central area (annular urticaria)
67
grouped arrangements can be due to . . .
- exogenous origin (ex: insect bite) - nerve distribution (ex: herpes zoster) - inoculation (plantar warts)
68
distributions of lesions on the body may be . . .
- Symmetrical: affecting mirror-image portions of the body
- Dermatomal: unilateral, along the course of a sensory nerve
- Photodistributed: affecting sites that routinely receive solar radiation
- Intertriginous: affecting warm, moist opposed sites
- Flexors: affecting antecubital & popliteal fossae, skin folds
- Extensors: affecting extensor aspects on limbs, including elbows and knees.
- Random: no apparent pattern
- Localized: clustered in an area such as scalp or groin
- Generalized: diffuse, widespread
69
Intertriginous distribution
affecting warm, moist opposed sites
70
factors that impact distribution include
* exogenous chemicals or microbes
* UV exposure
* blood supply
* variation in epidermal appendages
* variation in horny layer thickness
* variation in microenvironment
* variation in vessel permeability
71
Agminate
clustered
72
Annular
ring shaped with active edge and clear center
73
Arcuate
arc shaped or incomplete circle
74
Guttate
small droplet-like
75
Herpetiform
closely grouped vesicles (herpes-like)
76
Nummular
coin-shaped
77
Pedunculated
on a stalk
78
Reticulate(d)
resembling a net
79
Retiform
arranged like a net
80
Vermiculate
worm-like
81
zosteriform
similar to shingles, following along a nerve dermatome
