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Descriptions Of Skin Lesions Flashcards

(75 cards)

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1
Q

What is included in describing skin findings?

A

primary/secondary lesions
number
size
shape
color
texture
location
configuration
“classic features”

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2
Q

Primary Lesions may be:

A

flat
raised
depressed

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3
Q

Types of Primary Lesions

A

macule
patch
papule
plaque
nodule
vesicle
bulla (plural: bullae)
pustule
erosion
ulceration
wheal
ecchymosis
petechiae
purpura

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4
Q

Macule

A

flat (non-palpable)
<1 cm
color change only!
not filled with any material
color can very

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5
Q

What are examples of macules?

A

freckles, hypopigmentation, hyperpigmentation

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6
Q

Patch

A

flat
≥ 1 cm
color change only!
not filled with any material

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7
Q

Papule

A

raised but may have depressed portion (center)
superficial (arising from epidermis)
<1 cm
contents: solid (NO fluid inside)
color can vary
may be dome-shaped, flat topped
distribution can vary: group, dispersed

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8
Q

Plaque

A

raised or depressed
≥ 1 cm
contents: solid (NO fluid inside)
well defined (easy to see)
can form when papules coalesce

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9
Q

coalesce

A

merge together

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10
Q

Nodule

A

raised
≥ 1 cm
solid or fluid contents
larger and deeper than papule (can extend into dermis or subQ)
can result from inflammatory infiltrates, neoplasms, or metabolic deposits

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11
Q

Vesicle

A

raised
<1 cm
fluid contents: clear, serous, hemorrhagic)
dome-shaped or flaccid
top layer often thin
arise from cleavage at superficial level
at superficial level the layers are separating –> think blister!
well defined

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12
Q

serous fluid

A

clear yellow

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13
Q

hemorrhagic fluid

A

blood

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14
Q

what vesicle has erythema surrounding it? (erythema at the base)

A

varicella, chicken pox

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15
Q

Bulla (Bullae: plural)

A

raised
≥ 1 cm
fluid contents (clear, serous, hemorrhagic
arise from cleavage at superficial level
well defined lesions

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16
Q

flaccid bullae

A

sunk back down

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17
Q

tense bullae

A

ready to pop

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18
Q

Pustule

A

raised
<1 cm
fluid (pus)
superficial
sometimes hair follicle is involved

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19
Q

purulent

A

pus

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20
Q

folliculitis

A

small pustules with erythematous halos

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21
Q

pustular psoriasis

A

widespread pustules on an erythematous base

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22
Q

Erosion

A

depressed
any size
no contents (b/c loss of tissue)
focal loss of epidermal tissue (no loss of dermis, superficial)
heal without scarring
seen in inflammatory conditions
may be secondary lesions (bulla popped)

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23
Q

ulceration

A

depressed
any size
no contents (loss of tissue)
loss of epidermis and at least a portion of the dermis
deeper than erosion
leaves a scar
may be secondary lesions

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24
Q

wheal

A

swelling with skin
circumscribed (clear borders)
irregular: size and shape can change
transient (<48 hrs)
produced by cutaneous edema
red to pale in color
frequently itch
THINK HIVES!!!

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25
circumscribed
well-defined and distinct from surrounding parts
26
ecchymosis
bruise multiple colors >3 mm
27
petechiae
deep red/reddish purple 1-3mm (pinpoint) round and flat can occur on mucous membranes too (in mouth)
28
purpura
deep red/reddish purple larger than petechiae can be irregularly shaped may be palpable
29
What 3 primary lesions are due to blood leaving the vessels and do not blanch when pressure applied?
ecchymosis petechiae purpura
30
stratum corneum
dead keratinized cells outer layer of the epidermis
31
secondary lesions
scale crust lichenification erosion ulcer excoriation scar atrophy fissure
32
scale
excessive accumulation of stratum corneum flakes: can be large, tiny, adherent, loose Think psoriasis
33
crust
dried exudate of body fluids
34
serous crust
yellow
35
hemorrhagic curst
red dried blood
36
superficial crust
glistens; "honey-colored"
37
epidermal crust
thick and adherent
38
Impetigo
honey colored crusted plaque erosions thick, crusted plaques
39
lichenification
distinctive skin thickening accentuated skin-fold markings result of chronic scratching/rubbing CHRONIC rather than acute
40
What two lesions can be both primary and secondary?
erosion: bulla that unroofs ulcer: nodule that ulcerates
41
Excoriation
linear, angular erosion may be covered by crust caused by scratching
42
Scar
can change appearance over time skin change secondary to trauma/inflammation (fibrous tissue - collagen being deposited) may be erythematous, hypopigmented, hyperpigmented hair follicles may be destroyed
43
Define atrophy
layers of skin not growing
44
Atrophy
acquired loss of substance ex: loss of epidermis --> shiny quality with "cigarette paper" wrinkling ex: loss of the dermis or subQ --> depressed lesion underlying vessel may be revealed
45
fissure
linear lesion (crack) found in skin or mucosa (anal) result of excessive tension or decreased elasticity
46
Number
solitary or multiple count if possible (less than a dozen)
47
size
measure with ruler use mm or cm
48
how to determine size of oval-shaped lesion
measure the long axis first, then measure perpendicular to the long axis
49
How to determine size of multiple lesions?
note the size ranges
50
possible shapes of lesions
circular oval annular nummular polygonal acruate reticular serpiginous
51
annular
ring-like, with a central clearing color/texture more prominent at the edge
52
nummular
coin-like, no central clearing
53
polygonal
varied, non-geometric shape
54
acruate
arc-shaped; result of incomplete formation of annular lesion
55
reticular
net-like or lacy
56
serpiginous
serpentine or snake-like
57
color
tan, light brown, dark brown erythematous (red); erythematous lesions blanch with pressure skin-colored or flesh-colored
58
what is an important question when talking about color of lesion?
is the color consistent throughout the lesion? is it uniform?
59
demarcation
is the edge of the lesion sharply (well) defined, or does it blend into the surrounding skin?
60
Texture
palpate the lesion to determine texture
61
What are types of textures?
smooth fleshy verrucous/warty scaly (fine, (hyper)keratotic, greasy)
62
fine scaly
dry, but not keratotic
63
(hyper)keratotic Scaly
hard, "crustier"
64
location/distribution
be specific and use anatomical terms
65
location
can also include measured distance from anatomic landmarks
66
What are things to think about for distribution?
photodistributed acral truncal extensor vs. flexor intertriginous generalized vs. localized
67
photodistributed
on sub-exposed areas
68
acral
distal locations (hands, feet, wrists, ankles)
69
truncal
on the trunk
70
intertriginous
in skin folds
71
generalized
all over the body
72
localized
specific location
73
configuration
grouped linear scattered (no pattern) dermatomal
74
classic features
buzz words include descriptions of lesions that are pathognomonic for a particular disease
75
examples of classic features
Christmas tree distribution (back) grouped vesicles on an erythematous stuck-on, verrucous appearance

Dermatology (3 decks)

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