Dermatology - Classifications

Question 1

Bulla

Answer 1

A superficial, well circumscribed raised fluid filled lesion greater than 0.5 cm in diameter ex. bullous pemphigoid, pemphigus, dermititis herpetiformis

Question 2

burrow

Answer 2

a subcutaneous linear track made by a parasite ex. scabies

Question 3

crust

Answer 3

a slightly raised lesion with irregular border and variable color resulting from dried blood, serum, or other exudate ex. scab from an abrasion, impetigo

Question 4

ecchymosis

Answer 4

a flat non blanching red-purple-blue lesion that results from extravasation of RBCs into the skin. Non-palpable >5 mm ex. trauma, long term steroid use

Question 5

erosion

Answer 5

• Loss of superficial layers of upper epidermis by wearing away from friction or pressure
• Heals without scarring
• Red, oozes
  ex. rupture of herpes simplex blister

Question 6

excoriation

Answer 6

Skin abrasions, usually superficial, due to scratching of the skin ex. scratching assoc with pruritis

Question 7

fissures

Answer 7

Sharply-defined, linear or wedge-shaped tears in the epidermis with abrupt walls
ex. cracks seen in athlete’s foot

Question 8

keloid

Answer 8

irregular raised lesion resulting from hypertrophied scar tissue ex. seen with burns, African Americans are more prone

Question 9

lichenification

Answer 9

a thickening of the skin with an increase in skin markings resulting from chronic irritation and rubbing ex. atopic dematitis

Question 10

macule

Answer 10

a circumscribed nonpalpable discoloration of the skin less than 1 cm in diameter ex. freckles, rubella, petechiae

Question 11

Nodule

Answer 11

A palpable, solid lesion, > 1 cm in diameter. Usually found in dermal or subcutaneous tissue; may be above, level with, or below the skin surface ex. erythema nodosum, gouty tophi

Question 12

papule

Answer 12

a solid elevated lesion less than 1 cm in diameter

ex. acne, warts, insect bites

Question 13

patch

Answer 13

A circumscribed area of discoloration, > 1 cm, without elevation or depression
ex. vitiligo

Question 14

petechiae

Answer 14

a flat non blanching red-purple-blue lesion that results from extravasation of RBCs into the skin.
Non-palpable <3 mm
ex. DIC, ITP, SLE, meningococcemia

Question 15

Plaque

Answer 15

A well-circumscribed, elevated, superficial, solid lesion, > 1 cm in diameter. May be formed from confluent papules
ex. psoriasis, discoid lupus erythematosus, actinic keratosis

Question 16

purpura

Answer 16

1. Non-blanching, violaceous (red/purple) discoloration of the skin
2. Due to blood that has extravasated outside of vessel walls
3. palpable or non-palpable
   ex. henoch-schonlein purpura, TTP</p>

Question 17

pustule

Answer 17

A small (< 1 cm in diameter), circumscribed superficial elevation of the skin that is filled with purulent material.  Can also be described as filled with pus
ex. acne, impetigo

Question 18

scales

Answer 18

Visible shedding of the stratum corneum (epidermal layer)

ex. psoriasis, dandruff

Question 19

scar

Answer 19

Final stage of healing which involved the deeper dermis

Question 20

telangiectasia

Answer 20

dilation of capillaries resulting in red, irregular, clustered lines that blanch.
Ex. scleroderma, osler-weber-rendu disease, cirrhosis

Question 21

tumor

Answer 21

a solid palpable circumscribed lesion greater than 2 cm in diameter
ex. lipoma

Question 22

ulcer

Answer 22

Localized defect of irregular size and shape, loss of epidermis and some dermis; scars
ex. decubitis ulcers, primary lesion of syphilis, venous stasis ulcer

Question 23

Vesicle

Answer 23

A small, superficial, circumscribed elevation of the skin, < 0.5 cm, contains serous fluid
ex. herpes simplex, varicella

Question 24

Wheal

Answer 24

Transient, circumscribed, elevated papules or plaques, often with erythematous borders and pale centers
ex. uticaria, allergic reaction to injections or insect bites

Question 25

Discrete

Answer 25

Each lesion is easily separated from others

Question 26

Confluent

Answer 26

Edges of the lesions blend into one another

Question 27

Isolated

Answer 27

just one lesion in the area

Question 28

Scattered

Answer 28

Lesions are discrete, multiple and distributed in no discernible pattern

Question 29

Grouped

Answer 29

Lesions appear close together with normal skin between groups

Question 30

Dermatomal

Answer 30

Distributed in one spinal nerve or spinal nerve equivalent branch

Question 31

Annular

Answer 31

ring like shape

Question 32

polycyclic

Answer 32

shape made up of tangential rings

Question 33

Arcuate

Answer 33

arc shaped

Question 34

Serpiginous

Answer 34

Shape like a snake

Question 35

Iris/Target

Answer 35

Shaped like a bulls eye

Question 36

Reticulate

Answer 36

Net like pattern

Question 37

Glaborus

Answer 37

Shiny and smooth surface; bald

Question 38

Atrophy

Answer 38

Thinning or depression of skin due to reduction of underlying tissue

Question 39

Sclerosis

Answer 39

Hardening or induration of the skin caused by an increase in collagen, other connective tissue components (mucin), edema, cellular infiltration

Question 40

Necrosis

Answer 40

Death of skin tissue

Question 41

Comedone

Answer 41

Darkened plug of sebum and keratin; occludes pilosebaceous follicles Open: blackhead Closed: whitehead

Question 42

Cyst

Answer 42

Encapsulated, raised lesion filled with solid or liquid material; often fluctuant

Question 43

Elliptical excision technique

Answer 43

Anesthetize area after marking; excise in elliptical shape with length 3x longer than width; undermine edges for easier suture closure without puckers

Question 44

Shave biopsy/excision technique

Answer 44

Anesthetize the area making a wheal surrounding the lesion; excise in a scooping manner to get underlying dermis/SC, ensuring entire lesion is excised

Question 45

Punch biopsy

Answer 45

anesthetize the area; place punch 90 degrees from skin and rotate with downward pressure until SC is reached; lift gently and cut bottom

Question 46

KOH

Answer 46

Scrape the edge of scaly lesion onto glass slide; add 1-2 drops of KOH onto slide; +/- heat for few seconds; look for spores/hyphae/budding yeast to confirm fungal infection

Question 47

Tzanck smear

Answer 47

Unroof an intact vesicle at the base and collect fluid onto slide or swab. Multinucleated giant cells confirm herpes/varicella infection

Question 48

Diascopy/Dermoscopy

Answer 48

Dermatoscope to skin to note algorithmic patterns when magnified to identify suspicious lesions

Question 49

Wood's light

Answer 49

``` Shine light onto skin areas to confirm; Coral/pink-erythrasma Pale blue-Pseudomonas Yellow/green-Microsporum Green/gold-tinea versicolor White-vitiligo ```