Intro to Derm Flashcards

Question

Petechiae

Answer 1

small flat red lesions caused by intradermal hemorrhage (< 3 mm), non-blanchable

Answer 2

purplish-red hemorrhagic area in the skin (> 3mm) non-blanchable. Related to clotting disorders, thrombocytopenia

Answer 3

Bruise, bluish-purple, caused by leakage of blood from ruptured vessels (trauma)

Answer 4

Visible and palpable thickening of the epidermis and roughening of the skin with increased visibility of the skin furrows

Answer 5

fine, irregular dilated blood vessels that blanch w pressure

Answer 6

Wetness, white softness to skin (like in pool for a long time)

Answer 7

Like scabies/lice. Go into skin

Answer 8

Serpant-like (can be from parasite)

Answer 9

Shaped like a map

Answer 10

droplet-like

Answer 11

multiple rings within structure (tinnea corpus)

Answer 12

when have skin disease if scratch enough can cause new plaques to form in scratched areas

Answer 13

- Warty/ verrucous/ scaly stuck on appearance - benign - epidermal tumor - Males=females, age>30 - color --> any! - Size varies - Dermatosis papulosa nigra: Seen in African American, smaller/darker papules on cheeks - Stucco keratoses: White papules seen on legs - Sign of Leser-Trelat: Can indicate an internal malignancy (breast, lung, bone marrow, stomach, uterus

Answer 14

- Don't have to be treated if asymptomatic (Benign) - Cryotherapy - Electrodessication and curettage (electric current coagulates top layer. scrape off)

Answer 15

- aka skin tags - Benign - Pedunculated soft tumors - females>males, >age 30 - Neck, axillae, groin most frequently - Normal skin color, pink, tan - size 1-3mm - menopause - obesity-metabolic syndrome - Pregnancy - Many skin tags may indicate a possible correlation with intestinal polyps (familial adenomatous polyposis- internal polyps that can turn into colon cancer)

Answer 16

- Benign - Scissor removal - Electrocaudery - Cryotherapy (don't recommend, causes too much collateral damage)

Answer 17

- Benign - Secondary to injury or disease - Pock mark, ice pick - Hypertrophic, keloid (more likely in those with African ancestry)

Answer 18

Pock mark, ice pick: - Dermabrasion - Synthetic fillers - Chemical peels Hypertrophic, keloid (more likely in those with African ancestry): - Scar massage - Intralesional steroid injection - Pulse dye laser - Silicone products

Answer 19

- Benign - Can be due to trauma - Scar tissue type growth - Seen in adults and less common children - Legs>arms>trunk - Females>males - Firm fibrotic papule - Any color - Dimples with lateral pressure - Size 3-10mm

Answer 20

- Cryotherapy (usually need more than 1 tx) | - Punch biopsy (excision)

Answer 21

``` Benign Hypertrophy of the oil glands Common as we get older, lighter skin individuals (? Oily skin individuals) Seen on the face Lobulated, umbilicated papules Skin color, pink, red (when inflamed) Size 1-4mm ```

Answer 22

Not necessary unless irritating | Electrocautery (tell patient they have a high chance of growing back)

Answer 23

Benign (modified sebaceous hyperplasia but flatter) Onset puberty, mostly women, may be familial and is seen in Down Syndrome Eyelids, axillae, chest, umbilicus, anterior thighs and vulva Yellowish papules and there are many Size 1-2mm

Answer 24

Electrocautery

Answer 25

Benign (Small epidermal cyst, often around eyes) Trauma, certain dermatoses, skin care habits, health conditions, UV exposure, or no known cause Epithelial buds Face, neck, chest White, light-yellow firm papules Size 1-2mm

Answer 26

Retinoids (treat and prevent) Incision and extraction Light electrodessication

Answer 27

``` Benign From epidermis/epithelium of the hair follicle Face, neck, trunk Soft, mobile nodules Cyst contents=not pleasant! Size O.5-5.0 cm ```

Answer 28

Excision | Incision and drainage not effective

Answer 29

``` Benign Occur on scalp Females>males, familial Patients tend to have many Will lose hair Size 0.5-5.0cm ```

Answer 30

Excision | Incision and drainage not effective

Answer 31

(aka mucous or synovial cyst) Benign Dorsal surface of a finger, less often toes Perhaps related to osteoarthritis Single, soft to rubbery nodule Has gelatinous/viscous material within it (filled with jt fluid) Overlying skin normal or can be warty/filiform projections Size 2-5mm

Answer 32

Surgically excised I & D followed by firm compression dressing for weeks Injection of sclerosing solution Triamcinolone injection

Answer 33

Benign Develops over tailbone/near top of gluteal cleft Contains hair and skin debris Asymptomatic or symptomatic Men>women, Caucasians, ages 15-24, +FmHx, hirsute individuals, deep natal cleft Excessive/repetitive trauma to this area will increase risk for development or rupture of existing cyst

Answer 34

``` Incision and drainage Pack the wound if deep with frequent dressing changes in the office Antibiotics generally not needed Pain relief Recurrent cysts=general surgery ```

Answer 35

(pseudocyst- bite inner cheek, bluish soft nodule) Collections of mucin following rupture of a minor salivary gland duct Blue tinted, translucent, soft nodules, asx

Answer 36

Incise and drain

Answer 37

(yellow spots on lips Ectopic sebaceous glands on the oral mucosa Pinhead-sized white-yellow spots on the oral mucosa

Answer 38

Biopsy to rule out other disease processes i.e. squamous cell carcinoma No tx necessary

Answer 39

``` Benign Neoplasm of subcutaneous tissue Solitary or multiple round, lobulated, yellow masses Well circumscribed No overlying skin change Scalp, neck, trunk, UE’s and LE’s ```

Answer 40

(nothing has to be done with them) | Excision (VERY small amount can become cancerous)

Answer 41

Benign Usually follows minor trauma Vascular proliferation (without infection) Fingers, lips, mouth, trunk, toes Red vascular papule, with or without crusts/erosions “Positive band aid sign” Size 1-4mm

Answer 42

(Don't want to leave these. Tend to bleed. Send to pathology) Shave biopsy with cauterization

Answer 43

``` Dilated capillaries in the superficial dermis Occurs 50% of all babies Posterior neck, forehead, eyelids Persistent, faint, red patch Size several centimeters ```

Answer 44

Not necessary on posterior neck | Facial ones do fade over time

Answer 45

Dilated dermal capillaries Face or trunk, less often extremities Pink-purple macules/patches Size can be several centimeters Can be hardly there to severely disfiguring Port wine located over the trigeminal area Think Sturge-Weber Syndrome (malformation of leptomeninges-epilepsy, hemiparesis, glaucoma) Port wine stain involving a limb think: Klippel-Trenaunay Syndrome (underlying venous malformation) Parkes-Weber Syndrome (arteriovenous fistulae seen)

Answer 46

Send to pediatric dermatologist PDL Make up can be used to camouflage

Answer 47

Superficial hemangioma - Most common tumor of infancy - More common in females than males, 3:1 - Soft, bright red to deep purple, compressible nodule or plaques (50% on head, 25% trunk) - Size 1-8 cm - Fast growth first year (80% of their size at 3 months) - Will turn grayish-white - End result: slight atrophy, depigmentation, telangiectasia, scarring - Regression complete by age 5 in 50% of children; 90% by age 9 Deep hemangioma - Same “pattern” as superficial hemangiomas - Lower dermis/subcutaneous fat - Rubbery mass of bluish color with overlying telangiectases - Can be combined with superficial hemangioma - Does not involute as well as superficial type

Answer 48

(for both deep and superficial hemangiomas) Send to pediatric dermatologist Pulse dye laser or continuous wave laser Intralesional and systemic high-dose glucocorticoid Propranolol (worry about hypotension, hypoglycemia, bronchospasm, hyperkalemia) Interferon-alpha Cryosurgery Excision 5 or more hemangiomas evaluate for liver hemangiomas Hemangioma covers face it may be associated with neurologic, ophthalmologic and cardiac abnormities (PHACE Syndrome) The above seen, send to pediatric dermatology

Answer 49

(superficial blood vessels, ok, normal) Dilated capillaries Common as we mature, more so in fairer skin individuals Scalp, face, trunk, extremities Mostly red in color, sometimes dark purple Size 1-3mm

Answer 50

(Should biopsy if just one) Electrocautery Laser/intense pulse light

Answer 51

(superficial blood vessels coming to surface of skin and then branching) Spider angioma: Dilated radiating capillaries surrounding a central arteriole Telangiectases: Small “broken capillaries” Face, forearms, hands Spider angiomas: Under diascopy the radiating telangiectases will blanch; the center will not Red in color Size: up to 1.5cm More often in females Hyperestrogenic states Liver disease Young children Multiple lesions: Hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu Syndrome) Ataxia-telangiectasia Telangiectasia seen in systemic scleroderma, rosacea, sun damaged skin

Answer 52

Electrocautery | Laser surgery

Answer 53

``` Capillary dilation in the papillary dermis Most often on scrotum and vulva Can have many lesions, >100 Red, purple, blue in color Size 2-4mm ```

Answer 54

Not needed | Uncertain of diagnosis --> biopsy it

Answer 55

``` Dilated venule Common in patients >50 y/o ? Related to sun exposure Face, lips, ears most common Dark blue or purple papule Size 3-6mm Will blanch under diascopy ```

Answer 56

Electrosurgery Laser Rarely, excision

Answer 57

aka birthmark/mole Localized benign tumors of melanocytes Classified by age of onset - Acquired versus congenital Classified by arrangement of these tumors within skin layers - Junctional, compound, intradermal More common in lighter skinned individuals

Answer 58

``` Benign proliferations of normal skin components Occur from scalp to soles Can be macular or papular Tan to brown Size 1-6mm ``` Junctional - Arise from dermo-epidermal junction - Macular - Common in childhood - Face, arms, legs, trunk, palms and soles Compound - Collection of melanocytic cells in the epidermis and dermis - The “in between stage” of junctional and intradermal nevi - Less pigmented than junctional nevi - More papular Intradermal or Dermal - Nevus is totally within the dermis - No color - Papular

Answer 59

Shave biopsy Punch biopsy/removal Elliptical excision Dermascope can help aid in deciding to remove lesion or monitor Will remove if it looks unusual or has a history of repetitive trauma, any symptoms or h/o change Large numbers of nevi can be a genetic risk factor for melanoma Total body skin checks are a must! Sun protection measures need to be taught Teach ABCDE method to monitor moles

Answer 60

These present differently than your typical nevus More common in fair skin individuals Can occur on any part of the body Borders are notched, irregular, ill-defined Can have a macular appearance +/- center that is papular Color ranges from tan, brown, black, red, pink Size 5-15mm Those with many of these lesions=higher risk for melanoma (10 or more have 12 times the risk for melanoma vs. general population) This risk increases if there is a +FMHx for melanoma

Answer 61

``` Biopsy if it resembles no other Total body skin check by a dermatology provider Teach sun protection measures Teach the ABCDE’s Discouraged intentional tanning ```

Answer 62

``` Asymmetry Border irregularity Color variegation Diameter, >6mm Evolution ```

Answer 63

``` Minimize sun exposure Sun protective clothing Sun protectant lotion >30 SPF Hats ```

Answer 64

``` Deeper in the dermis and subcutaneous fat Noted at birth/ first few years of life Occur anywhere Evenly pigmented papules/plaques Can have a pebbly surface Can be associated with hair follicles Tan, brown, array of colors ``` These lesions have malignant potential 1.5cm have less than 0.5% risk 1.6-20cm have a 3.3-6.0% risk >20cm have a 10% risk

Answer 65

Have to monitor on a regular basis by derm If it looks abnormal = biopsy Any changes = biopsy Educate about sun protection measures

Answer 66

(Single giant nevus) Increase number of basal melanocytes (no nevus cells in dermis) Melanosomes increased in keratinocytes Increased number of testosterone receptors Back, shoulder, submammary Large, focal, brown, hair-bearing verrucous plaque or brown patch at onset >10 cm

Answer 67

None needed unless for cosmetic reasons

Answer 68

``` ("Frog spawn nevus") Late infancy or early childhood Trunk, UE’s, LE’s Tan to light brown patches with 1-2mm brown-dark brown macules and/or papules “sprinkled” throughout Size few centimeters to >15cm ```

Answer 69

None | Cosmetic reason: surgical excision, laser

Answer 70

Scalp, face, neck Pebbly, velvety, or warty surface Can be flat at birth Yellow to orange in color Size 1-3cm Associated with basal cell and squamous cell carcinomas Large lesions can be associated with “neurocutaneous syndrome” of epilepsy, mental retardation, eye and skeletal defects

Answer 71

Excise-refer to dermatology

Answer 72

Immunologic phenomena Pre-existing melanocytic nevus that is encircled by depigmentation Can occur to any melanocytic nevus on any part of the body Perhaps the ”calling card” for future development of vitiligo Can be seen in metastatic melanoma (halo forms around mets and the primary lesion)

Answer 73

Need to evaluate skin for vitiligo and suspicious nevi Biopsy Refer to dermatology for monitoring/ rule out melanoma

Answer 74

``` Due to melanocytes in the dermis Face, scalp, back, hands, feet Macules or papules, round and oval in shape Blue, blue-gray, blue-black Size <10mm ```

Answer 75

Excise, send to derm

Answer 76

``` Most often occurs in pre-adolescence Rare in >40 y/o Dome-shaped, hairless papule Face, scalp Pink, tan, brown Size <10mm Microscopically looks close to melanoma ```

Answer 77

Excision | Send to dermatology for skin evaluation

Answer 78

Increase in melanin with giant melanosomes Tan to brown patches Common in African Americans>Hispanics>Caucasians Males=Females Present at birth or within 2-3 years Associated with neurofibromatosis and other syndromes (tuberous sclerosis, ataxia telangiectasia)

Answer 79

None if there is no suspicion of another disorder

Intro to Derm Flashcards

(108 cards)