Intro to Dermatology Flashcards
(56 cards)
1
Q
What is the initial approach to a dermatological complaint?
A
- Examined first before history taken
- Diagnostic accuracy > when objective examination is approached without preconcieved ideas
2
Q
What is a general skin exam? Focused? Detailed?
A
- General: examine all skin surfaces- undress patient when applicable
- Focused: exam in area of concern
- Detailed: examine the individual lesions
3
Q
What are components of the skin exam in addition to the skin itself?
A
- Mucous membranes
- Genital and anal region
- Hair and nails
- Lymph nodes
4
Q
When seeing a lesion what are you looking for?
A
- Type of lesion
- Color
- Margination
- Consistency
- Shape
- Arrangement
- Distribution
5
Q
What is a macule?
A
- Flat, nonpalpable lesions usually <10 cm in diameter
- Represent change in color and are not raised or depressed compared to skin surface
- Patch is large macule
6
Q
What is a papule
A
- Elevated lesion usually <5 mm in diameter that can be felt or palpated
- Examples = nevi, warts
7
Q
What is a plaque?
A
- Palpable lesion >10 mm in diameter that are elevated or depressed compared to skin surface
- May be flate topped or rounded ie psoriasis and granuloma annulare
8
Q
What is a nodule?
A
- Firm lesion that extends into dermis or subcutaneous tissue > 5 mm
- EX: cysts, lipomas, fibromas
9
Q
What is a vesicle?
A
- Small, clear, fluid-filled blisters <10 mm in diameter
- Vesicles are characteristic of herpes infections, acute allergic contact dermatitis, and some autoimmune blistering disorders
10
Q
What is a bulla?
A
- Clear fluid-filled blisters >10 mm in diameter
- May be caused by burns, bites, irritant, or allergic contact dermatitis, and drug reactions
- Classic autoimmune bullous diseases - pemphigus vulgaris and bullous pemphigoid
11
Q
What is a pustule?
A
- Vesicle that contains pus
- Common in bacterial infections and folliculitis and may arise in some inflammatory disorders including pustular psoriasis
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12
Q
What is urticaria?
A
- Wheals or hives characterized by elevated lesions caused by localized edema
- Wheals are pruritic and red
- Wheals = common manifestation of hypersensitivity to drugs, stings or bites, autoimmunity, physical stimuli ie temp, pressure, sunlight
- Typically lasts <24 hr
13
Q
What is a scale?
A
- Heaped up accumulation of horny epithelium
- Occur in disorders such as psoriasis, seb derm, fungal infections
14
Q
What is a crust?
A
- Dried serum, blood, or pus
- Can occur in inflammatory or infectious skin diseases
15
Q
What are erosions?
A
- Open areas of skin that result from loss of part or all of the epidermis
- Can be traumatic or occur with inflammatory or infectious skin disease
16
Q
What is an excoriation?
A
Linear erosion caused by scratching, rubbing, or picking
17
Q
What is an ulcer?
A
- Due to loss of epidermis and at least part of dermis
18
Q
What are causes of ulcers?
A
- Venous stasis dermatitis
- Physical trauma with or without vascular compromise
- Infections
- Vasculitis
19
Q
What is petechiae?
A
- Nonblanchable punctate foci of hemorrhage
20
Q
What are causes of petechiae?
A
- Platelet abnormalities (thrombocytopenia, platelet dysfunction)
- Vasculitis
- Infections (meningococcemia, rocky mountain spotted fever, rickettsioses)
21
Q
What is purpura?
A
Larger area of hemorrhage that may be palpable
22
Q
What are causes of purpura?
A
- Leukocytoclastic vasculitis has palpable purpura
- Coagulopathy
- Ecchymoses
23
Q
What is atrophy?
A
- Thinning of the skin, which may appear dry and wrinkled, resembling cigarette paper
24
Q
What can cause atrophy?
A
- Chronic sun exposure
- Aging
- Inflammatory and neoplastic skin diseases, ie cutaneous T cell lymphoma and lupus erythematosus
- Long term topical corticosteroid use
25
What are scars?
* Areas of fibrosis that replace normal skin after injury
* Some become hypertrophic or thickened and raised
* Keloid = hypertrophic scars extending past wound margin
26
What is a telangiectasia?
* Foci of small, permanently dilated blood vessels that may occur in areas of sun damage, rosacea, systemic diseases, or inherited diseases, or after long term therapy with topical fluorinated corticosteroids
27
What is a cyst?
* Cavity containing liquid or solid or semisolid materials
* Either superficial or deep
* Appears superficial and often dome shaped
* May be skin colored, yellow, red or blue
28
What are the ABCDEs of melanoma?
A: asymmetry
B: border
C: color
D: diameter (larger than a pencil eraser 1/4 inch or 6 mm)
E: evolution (evolve in size, shape, color, elevation, crusting, itching)
29
What does asymmetry mean?
Do the 2 sides match?
Is it grouped or scattered?
30
What is under border?
Well defined or ill defined?
Regular or irregular?
31
What is considered a concern for color?
Multiple colors
32
How can the distribution/diameter of a skin lesion be described?
* Localized
* Generalized
* Linear
* Dermatomal
* Extensor
* Flexor
* Intertriginous
* Confluent
* Morbilliform
Is the diameter >6 mm? HIGH RISK
33
How is elevation/enlargement described?
Is it elevated? Is the elevaation regular or irregular?
Has the lesion grown or changed? How quickly?
34
What is annular?
Ring shape
35
What is nummular?
Looks like coins
36
What is polycyclic?
Incomplete rings coalescing
37
What is arcuate?
Arc shaped
38
What is reticular?
Lacy or net like
39
What is geographic?
Large and vary greatly with borders
40
What is serpiginous?
Wavy pattern
41
What is targetoid?
Resembles a target
42
What is whorled?
Marble like
43
How can you describe the extent of a lesion?
Isolated, localized, generalized, universal
44
How can you describe the pattern of a lesion?
Symmetric, exposed areas, sites of pressure, intertriginous area, follicular localization
45
What are constitutional symptoms of acute illness?
* Headaches
* Chills
* Fever
* Weakness
46
What are constitutional symptoms of a chronic illness?
* Fatigue
* Weakness
* Anorexia
* Weight loss
* Malaise
47
What is I on the FItzpatrick skin type scale?
* Pale skin, light or red hair, prone to freckles
* Burns very easily and rarely tans
* At greatest risk of developing skin cancer an needs to protect preferably with clothing
48
What is II on the Fitzpatrick skin type scale?
* Fair skin, light hair, blue or brown eyes
* Some have dark hair but still fair skin
* Usually burn but may gradually tan
* At the greatest risk of developing skin cancer. Need to protect skin, preferably with clothing
49
What is III on the Fitzpatrick skin type scale?
* Light olive skin with dark hair and brown or green eyes. Burns with long exposure to the sun but generally tans quite easily
* Should protect themselves against strong sunshine
50
What is IV on the Fitzpatrick skin type scale?
* Brown eyes and dark hair
* Burns with very lengthy exposures but always tans easily
* Should protect themselves in strong sunshine
51
What is V on the Fitzpatrick skin type scale?
* Naturally brown skin, brown eyes and dark hair
* Burns only with excessive exposure to the sun. Skin easily darkens further
* Protect themselves when outdoors in the sun for a long time
52
What is VI on the Fitzpatrick skin type scale?
* Black skin with dark brown eyes and black hair
* Burns only with extreme exposure to the sun
* Skin very easily darkens further
* Protect themselves when outdoors in the sun for a long time
53
What is dermoscopy?
Hand lens with built in lighting and magnification
54
What is diascopy?
Firmly pressing a glass slide over lesion to determine capillary dilation or blood extravasation
55
What is a Woods lamp?
UV long wave light (black light)
56
How can a biopsy be performed?
Shave/punch/excisional
