Derma - Cutaneous Infestation Flashcards by Sam James

Initial manifestation of skin disorders

Primary lesions

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Flat Primary lesions

Macule
Patch
Erythema
Erythroderma

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Non-palpable
Color change
<1 cm

Macule

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Tinea versicolor

Macule

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An-an / Tinea versicolor

Macule

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Large macule

> 1 cm

Patch

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Vitiligo

Patch

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Melasma

Patch

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Blanchable

Dilation of BV in dermis (redness)

Erythema

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Blanchable redness

Scaling and desquamation

Erythroderma

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Raised primarylesions

Papule
Plaque
Nodule
Wheal/ Hives 
Tumor
Cyst
Comedo
Horn

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< 1 cm, raised solid

Papule

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Raised solid lesiosn, capped by scales

Papulosquamous

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Molluscum contagiosum

Raised

Papule

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Lichen nitidus

Raised

Papule

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> 1 cm
Plateau like elevated lesion
Maceration, erosion, scale on surface
Epidermal only

Plaque

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Similar papules
> 1cm
Rounded surface

Nodule

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Histoid leprosy

Raised

Nodule

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Nummular eczema

Raised

Plaque

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Erythematous, edematous papule/plaque

Wheal

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Prototype lesion of urticaria

Wheal

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Oval, arcuate contour, pink to red edematous papule, surrounded a flare of macular erythema

Wheal

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Is wheal evanescent

Yes

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Solid, raised growth
>5 cm
Elevated or deep-seated, pedunculated

Tumor

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Encapsulated with liquid/ semisolid contents

Cyst

Hair follicle infundibulum dilated and plugged with keratin and lipids

Comedo

Conical mass of cornified cells

Horn

Viral pathogen associated with corn

SCCA | HPV

Fluid filled primary lesions

``` Vesicle Bullae Pustule Furuncle Abscess ```

Fluid filled | < 1cm

Vesicle

Vesicles are rounded, acuminate, umbilicated

Eczema herpeticum

Vesicles are discrete, irregularly scattered, grouped

Herpes zoster

Linea vesicles

Allergic contact dermatitis from urushiol

Dishydrotic eczema | Primary lesion

Vesicle

Fluid filled > 1cm Rounded, or irregularly shaped blisters

Bullae

Bullae diagnostic maneuvers

Nikolsky’s sign | Asboe-Hansen sign

Diagnostic maneuver of putting lateral pressure and having the epithelium shear off

Nikolsky;s sign

Extension of a blister to adjacent unblistered skin when pressure is put on top of blister

Asboe-Hansen sign

Bullae that has irregular vegetations on the base

Pemphigus vegetans

Hemorrhagic bullae | Enumerate

Pemphigus Herpes zoster Severe bullous drug rxn Lichen sclerosus

<1 cm or > 1cm Contains pus Usually have inflammatory areola (nipple?)

Pustule

Healing of pustule

No scarring

Infected pustule

Folliculitis

Sterile pustule

Pustular psoriasis

Sycosis barbae | Primary lesion

Pustule

Deep necrotizing folliculitis with suppuration > 1cm Inflammated follicle centered nodule with central necrotic plug and overyling pustule

Furuncle

Localized accumulation of pus in dermis and subcutaneous layer

Abscess

Dilated superficial BV

Telangiectasia

Occur subsequent to primary lesions

Secondary lesions

Depressed secondary lesions

``` Erosion Ulcer Atrophy Poikiloderma Striae Burrow Sclerosis ```

Partial loss of epidermis | Initially appears as vesicle or bullae

Erosion

Bullae of impetigo | Secondary lesion

Erosion

Full thickness loss of epidermis and some dermis

Ulcer

Healing erosin

No scarring

Ulcer healing

With scarring

Ecthyma Secondary lesion

Ulcer

Dystrophic epidermolysis bullosa | Secondary lesion

Ulcer

Depression of the surface due to thinning of the epidermis or dermis

Atrophy

Acne pits Secondary lesion

Atrophy

Triad of poikiloderma

Pigmentation Atrophy Telangiectasia Mottled appearance

Linear depression of the skin

Striae

Thread-like tunnel through the outer portion of epidermis by parasites

Burrow

Hardening/ induration of skin

Sclerosis

Change inskin due to trauma/ inflammation New connectve tissue that replaced the lost substance in the dermis or deeper Secondary lesion

Scar

Raised Secondary lesion

Scar

Surface change Secondary lesion

``` Fissure Scales/exfoliation Crusts/scabs Excoriation/ scratch marks Lichenificaton Keratoderma ```

Linear tear in the epidermis/ dermis due to abnormal skin keratin Increase tension Decrease elasticity

Fissure

Fissure common in these sites

Palms/soles

Dry/greasy laminated mass of keratin

Scales/ exfoliation

Cradle cap | Yellowish greasy

Seborrheic dermatitis

Scale | Silvery white

Psoriasis

Fine, delicate, branny scales

Tinea versicolor

Coarse scales

Eczema, ichthyosis

Large sheets of desquamated epidermis

TEN toxic epidermal necrolysis SSSS Scarlet fever

pemphigus Secondary lesion

Bullae

Herpes zoster Secondary lesion

Bullae

Lichen sclerosus Secondary lesion

Bullae

Hardened serum, pus, blood mixed with epithelial cells & bacterial debris Pus: yellow green Blood: reddish black Serum: yellow brown

Crusts/scabs

Impetigo contagiosa Secondary lesion

Golden yelow crusts/scabs

Third degree burns Secondary lesion

Crusts/scabs

Late syphillis Secondary lesion

Crusts

Lamellated, elevated, brown black green masses | Ostaceous crusts/rupia

Crusts

Punctate or linear abrasion due to mechanical means

Excoriation/ scratch marks

Thickening of skin | Accentuated skin fold markings

Lichenification

Chronic eczema Secondary lesion

Lichenification

Lichen simplex chronicus Secondary lesion

Lichenification

Excessive hyperkeratosis of stratum corneum

Keratoderma

Yellowish thickening of skin | Palms and soles

Keratoderma

is a skin condition characterized as the thickening of the outer layer of the skin (hyperkeratosis) of the palms and soles of the feet; this usually occurs with at the start of menopause.

Haxthausen’s disease/ | Keratoderma climactericum

Erythematous plaques with silver white scales on elbows

Psoriasis

Grouped vesicles on an erythematous base

HSV 1

Umbilicated papule

Molluscum contagiosum

Hypopigmented patch and macules

Tinea versicolor

Annular plaque/ patch with erythematous border with scaling

Tinea corporis

Arrangement of lesions | HSV-1 arthropod bites

Grouped/ herpetiform

Breakfast-lunch-and-dinner sign

Arthropod bites

Small lesions arranged around a large one

Corymbose arrangement

Arrangement of lesions | Scabies

Scattered

Arrangement of lesions | Pityriasus rosea

Scattered

Shape of skin lesions

``` Annular Round/ nummular Arcuate Umbilicated Targetoid Linear Reticular Serpiginous Whorled Polycyclic ```

Arrangment of lesions

Individual Grouped/herpetiform Scattered Corymbose arrangement

Distribution of lesions

``` Zosteriform Blaschkoid Lymphangitic Photodistributed Sun protected Truncal Acral Extensor Flexor Localized Intertriginous Generalized Bilateral symmetric Universal ``` Extend Pattern Characteristic location

3 major characteristic of lesions

Color Consistency Anatomic components of skin affected

Proper way of reporting dermatologic lesions

``` Color Shape Type of primary lesion Secondary lesion Location ```

Hair loss

Alopecia

Violaceous to purple | Polygonal lesions

Lichenoid

Small, firm, white papules | Filled with keratin

Milia

Rash that looks like measles. Macular lesions that are red 2-10 mm Confluent in places

Morbilliform

Most common symptom of inflammatory skin diseases

Pruritus

Elderly skin associated with

Xerosis and aged skin

Single 2-4 mm macule Becomes vesicular or pustular Ruptures forming honey colored crusts Direct extension coalesced macules / patches

Impetigo contagiosa

Tzanck to detect

Virus

Dark field to detec

Spirochetes

Ink burrow to detect

Parasites (scabies mite)

Ring-shaped lesions | Erythematous elevated border with central clearing

Annular

Coin shaped

Round , nummular

Arc shape

Arcuate

Depression inc enter

Umbilicated

Target like with 3 distinc zones

Targetoid

Band-like | Koebner phenomenon

Linear

Net like | Lacy

Reticular

Snake like | Wavy

Serpiginous

2 distinct colors interspersed in a wavy pattern

Whorled

Coalescing rings/ incomplete rings

Polycyclic

Shape | Tinea corporis

Annular

Shape | Nummular eczema

Round

Shape | Granuloma annulate

Annular

Discoid lupus Shape

Round

Molluscum contagiosum | Shape

Umbilicated

Shape | Erythema multiforme

Targetoid

Shape | Lichen plannus

Linear

Shape Livedo reticularis

Reticular

Cutis marmorata Shape

Reticular

Cutaneous larva migrans | Shape

Serpiginous

Hypomelanosis of Ito | Shape

Whorled

Urticaria

Polycyclic

Subacute lupus erythematosus

Polycyclic

Derma - Cutaneous Infestation Flashcards

(137 cards)