RASH Flashcards
1
Q
– flat lesion ,usually a circumscribed change of colour
A
Macule
2
Q
a broad papule, or confluence of papules, plateau-like lesion that is greater in its diameter than in its depth.
A
Patch
3
Q
– small , solid, elevated lesion
A
Papule
4
Q
– a lesion slightly raised over a larger area
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Plaque
5
Q
– a large , solid , palpable and elevated lesion
A
Nodule –
6
Q
– an elevated lesion ,fluid filled
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Blister
7
Q
– depressed lesion with loss of surface epithelium
A
Ulcer
8
Q
– non raised red-brown non blanchable lesions
A
Petechiae
9
Q
a circumscribed, fluid-containing, epidermal elevation generally considered less than either 5 or 10mm in diameter at the widest point
A
Vesicles-
10
Q
-a rounded or irregularly shaped blister containing serous or seropurulent fluid, equal to or greater than either 5 or 10mm
A
Bulla
11
Q
are flat-topped, palpable lesions of variable size, duration, and configuration that represent dermal collections of edema fluid.
A
Wheals
12
Q
-consist of compressed layers of stratum corneum cells that are retained on the skin surface
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Scale
13
Q
____ involve focal loss of the epidermis, and they heal without scarring.
A
Erosions
14
Q
_______ extend into the dermis and tend to heal with scarring.
A
Ulcers
15
Q
______consist of matted, retained accumulations of blood, serum, pus, and epithelial debris on the surface of a weeping lesion.
A
Crust
16
Q
____________is a thickening of skin with accentuation of normal skin lines that is caused by chronic irritation (rubbing, scratching) or inflammation
A
Lichenification
17
Q
_________ -Ulcerated lesions inflicted by scratching are often linear or angular in configuration
A
Excoriation
18
Q
___ - dermal thickening causing the cutaneous surface to feel thicker and firmer.
A
Induration
19
Q
__________ - refers to a loss of tissue, and can be epidermal, dermal, or subcutaneous. With epidermal atrophy, the skin appears thin, translucent, and wrinkled.
A
Atrophy
20
Q
___________ - softening and turning white of the skin due to being consistently wet.
A
Maceration
21
Q
_______ is a flat lesion; it is not elevated and it is not depressed ,it is a different color than the surrounding normal skin.
White, brown, and red are the most common color changes
appear in many shapes.
A
macule
22
Q
When a macule is larger than 5mm in diameter, it is called
A
a patch.
23
Q
A freckle is an example of a
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a macule
24
Q
A
papule
25
is a small, solid, elevated skin lesion **less than 0.5cm** in diameter.
The top can be **flat, pointed, or rounded**.
seen in many skin diseases, including **acne, fungal infections, and lichen planus.**
papule
26
PUSTULE
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is a small elevation of the skin containing cloudy or **purulent material** usually consisting of **necrotic inflammatory cells.**
These can be either **white or red.**
PUSTULE
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vesicle
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is a small fluid-filled blister
Less than 5 mm in size
vesicle
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BULLA
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- fluid-filled blister more than 5 mm (about 3/16 inch) in diameter with thin walls.
bulla
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are caused by splitting or cracking
Fissures
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An ________ is a discontinuity of the skin exhibiting incomplete loss of the epidermis a lesion that is moist, circumscribed, and usually depressed
erosion
34
An\_\_\_\_\_ is a discontinuity of the skin exhibiting complete loss of the epidermis and often portions of the dermis and even subcutaneous fat.[
ulcer
35
PETECHIAE
36
petechiae
37
one to two mm in size
These are less than 0.5 cm even in the later stages of the disease.
At any stage, they do not have a diameter of more than 3 mm.
PETECHIAE
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purpura
39
A hemorrhagic area in the skin.
The area of bleeding within the skin
is greater than **3 millimeters** in diameter
**Early type** is **red and becomes darker**, then **purple, and brown-yellow as it fades.**
It does not blanch when touched.
Purpura
ex. immune thrombocytopenic purpura and Schonlein-Henoch purpura.
40
Ecchymoses
41
A **macular red or purple hemorrhage** in skin or mucous membrane **more than 2 mm in diameter.**
Ecchymosis
Note: Ex. Dissiminated intravascular coagulopathy
42
\_\_\_\_\_\_\_\_\_\_\_\_\_ typically presents in **term neonates aged 3 days to 2 weeks**
The pustules from below the stratum corneum or deeper in the epidermis and represents **collection of eosinophils** that also accumulate around the upper portion of **pilosebaceous follicle**
It is a is a **benign self-limited eruption** occurring **primarily in healthy newborns** in the early neonatal period.
It is characterized by **macular erythema, papules, vesicles, and pustules, and it resolves without permanent sequelae**
Erythema toxicum neonatorum (ETN)
43
\_\_\_\_\_\_\_\_ – a superficial epidermal inclusion cysts that contain **laminated keratinized material**
Lesion is **firm papule**, 1-2mm in diameter and **pearly opalescent white**
Milia
44
inflammation of the upper layers of the skin, causing **itching, blisters, redness, swelling, and often oozing, scabbing, and scaling**
Known causes include **contact with a particular substance, certain drugs, constant scratching, and fungal infection**
DERMITITIS
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skin inflammation caused by direct contact with a particular substance
rash is confined to a specific area, and often has clearly defined boundaries
CONTACT DERMATITIS
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CONTACT DERMATITIS
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CONTACT DERMATITIS
48
–
◦accounts for 80% of all cases of contact dermatitis
◦ occurs when a **chemical substance causes direct damage to the skin**
◦ **symptoms are more painful than itchy**
◦ Typical irritating substances are acids, alkalis (such as drain cleaners), solvents (such as acetone in nail polish remover), strong soaps, and plants (such as poinsettias and peppers)
Irritant Contact Dermatitis
◦Example diaper dermatitis
49
–
◦is a reaction by the body's immune system to a substance contacting the skin.
◦substances found in plants such as poison ivy, rubber (latex), antibiotics, fragrances, preservatives, and some metals (such as nickel and cobalt)
◦ People may use (or be exposed to) substances for years without a problem, then suddenly develop an allergic reaction.
Allergic Contact Dermatitis
50
–
◦results only after a person touches certain substances and then exposes the skin to sunlight
◦Such substances include sunscreens, aftershave lotions, certain perfumes, antibiotics, coal tar
**Photoallergic or Phototoxic Contact Dermatitis **
51
Photoallergic or Phototoxic Contact Dermatitis
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\_\_\_\_\_\_ can be used to determine the cause of dermatitis (small patches containing substances that commonly cause dermatitis are placed on the skin for 1 to 2 days to see whether a rash develops beneath one of them)
Patch testing
53
chronic, itchy inflammation of the **upper layers of the skin**
**Infants may develop red, oozing, crusted rashe**s on the f**ace, scalp, diaper area, hands, arms, feet, or legs**
ATOPIC DERMATITIS
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ATOPIC DERMATITIS
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Diagnosis – typical pattern of rash
(+) family history of allergy
(+) history of asthma, food allergy
Cows milk allegy
Atophic march
ATOPIC DERMATITIS
Treatment
◦Avoiding contact with substances known to irritate the skin or foods that the person is sensitive to skin should be kept moist
◦emoillients
◦Specific treatments include applying a corticosteroid ointment or cream, immune system-modulating drug such as tacrolimus
◦For severe cases, the immune system can be suppressed with cyclosporine
56
is chronic inflammation that causes **yellow, greasy scales** to form on the **scalp and face** and **occasionally on other areas.**
The cause is unknown.
occurs most often in infants, usually **within the first 3 months of life**
**more common among males**, often familial, and is **worse in cold weather**
Seborrheic Dermatitis
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Seborrheic dermatitis
58
usually begins gradually, causing dry or greasy scaling of the scalp with itching but without hair loss.
In more severe cases, **yellowish to reddish scaly pimples** appear along the hairline, behind the ears, in the ear canal, on the eyebrows, on the bridge of the nose, around the nose, on the chest, and on the upper back.
SEBORRHEIC DERMATITIS
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In infants **younger than 1 month of age**, seborrheic dermatitis may produce a **thick, yellow, crusted scalp rash (cradle cap) and sometimes yellow scaling behind the ears and red pimples on the face.**
seborrheic dermatitis
60
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_is characterized by **joined patches** of **erythema and scaling** mainly seen on the convex surfaces, with the skin folds spared
Generic rash or irritant diaper dermatitis (IDD)
61
DIAPER DERMATITIS
62
Some insects inject formic acid which can cause an immediate skin reaction often resulting in redness and swelling in the injured area
Itching, painful and may stimulate a dangerous allergic reaction called anaphylaxis for at-risk patients
INSECT BITES AND STINGS
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inflammation on the lower legs from pooling of blood and fluid
It tends to occur in people who have varicose (dilated, twisted) veins and swelling (edema).
STATIS DERMATITIS
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STASIS DERMATITIS
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Characterized by itchy blisters on the palms and sides of the fingers and sometimes on the soles of the feet.
Also called dyshidrosis, which means "abnormal sweating"
Unknown cause
fungal infection, contact dermatitis, or stress may be a factor as well as some ingested substances such as nickel, chromium, and cobalt.
The blisters are often scaly, red, and oozing.
Pompholyx comes and goes in attacks that last 2 to 3 weeks.
POMPHOLYX
66
POMPHOLYX
Wet compresses with potassium permanganate or aluminum acetate (Burow's solution) may help the blisters resolve.
Strong topical corticosteroids, tacrolimus
phototherapy
67
is an itchy rash that is often worsened with bathing or at night.
It is spread by close bodily contact such as sleeping together or sharing of clothing.
Mites can survive for several days in clothes, bedding, and dust
SCABIES
68
What is the etiololic agent of scabies?
It is caused by a mite (Sarcoptes scabiei) that burrows beneath the top layer of skin.
69
SCABIES
70
is a viral infection of the skin or occasionally of the **mucous membranes**
Caused by a **DNA poxvirus**
most common in **children aged one to ten years old**.[
Their lesions are **flesh-colored, dome-shaped, and pearly in appearance.**
They are often **1–5 millimeters in diameter, with a dimpled center.**
Molluscum contagiosum
71
MOLLUSCUM CONTAGIOSUM
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MOLLUSCUM CONTAGIOSUM
73
Very common superficial infection of the skin.
It can be divided into **non-bullous and bullous forms**.
\>The **non-bullous types represent about 70%.**
◦The infecting organism is usually **Staphylococcus aureus or a beta-haemolytic streptococcus**
◦Usually the predisposing factor is a breach of the skin
\>**bullous impetigo** may affect intact skin and is almost invariably caused by S. aureus.
It i**s more common in hot areas** where sweating can macerate the skin
IMPETIGO
74
usually start as **tiny pustules** that evolve rapidly into **honey-coloured crusted plaques**
◦Usually on exposed areas of the face and extremities where bites, abrasions, lacerations, scratches, burns or trauma have occurred.
◦It spreads rapidly.
◦There is little or no surrounding erythema or edema.
◦ Regional lymph nodes are often enlarged.
NON-BULLOUS LESION
75
have a thin roof and tend to rupture spontaneously.
◦They are usually on the face, trunk, extremities, buttocks, or perineal regions.
◦They are more likely to occur on top of other disease
◦There is little erythema
◦Usually no regional lymphadenopathy
BULLOUS TYPE OF LESION
76
This is a variant of Bullous type
superficial, intraepidermal, vesiculopustular infection (and the **most common skin infection in children**).
Impetigo contagiosa
77
Impetigo contagiosa
78
\_\_\_\_\_\_\_is a toxin-mediated erythroderma and involves the sloughing off of the epidermal layer of the skin.
Bullous impetigo
79
This term is usually applied to infection occurring in pre-existing wounds.
Impetigo can also present as folliculitis, which is considered to be **impetigo of the hair follicles** caused by **S. aureus.**
Common impetigo
80
COMMON IMPETIGO
81
is a deeper, ulcerated impetigo infection, often occurring with lymphadenitis.
The infection is caused by **group A streptococci or Staphylococcus aureus.**
ECTHYMA
82
ECTHYMA
83
\_\_\_\_\_\_\_\_\_\_ is a distinctive dermatological eruption featuring iris or target lesions.
The **minor form** is an **acute, self-limiting disease** that affects the skin but **mucous membranes little**
The major form has more involvement of both skin and mucosa and is a potentially life-threatening condition.
Erythema multiforme (EM)
NOTE :
It is considered by some as being part of a spectrum of disease which includes, in order of severity, EM,Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN).
84
A common cause of erythema multiforme (EM) is **\_\_\_\_\_\_\_\_\_\_\_**
Other infections have also been implicated, ranging from viruses (for example, measles, mumps, adenoviruses and influenza) to bacterial infections (for example, pneumonia, syphilis and typhoid).
It is associated with a number of infections, including streptococcus, tuberculosis and BCG immunization
**herpes simplex infection**
85
there may be no prodrome or a mild upper respiratory tract infection.
◦The rash starts abruptly, usually within 3 days. It starts on the extremities, being symmetrical and spreading centrally.
Involvement of the mucosa may be marked in \_\_\_\_\_.
EM major
86
Erythema Multiforme
87
The **iris or target lesion** is the **classical feature of the disease.**
Initially, there is a **dull red macule or urticarial plaque** that **enlarges slightly up to 2 cm over 24-48 hours.** In the middle, a small papule, vesicle, or bulla develops, flattens, and then may clear.
The intermediate ring forms and becomes raised, pale, and edematous.
The **periphery slowly becomes violaceous** and forms a typical concentric target lesion.
Some lesions are atypical targets with only 2 concentric rings. Polycyclic or arcuate lesions may occur.
**Köbner's phenomenon** may occur.
This is where a lesion occurs along the line of trauma and it is typical of psoriasis and lichen planus
ERYTHEMA MULTIFORME
88
\_\_\_\_\_\_\_\_\_is a disorder of the **pilosebaceous follicles** found in the face and upper trunk.
At puberty, androgens increase the production of sebum from enlarged sebaceous glands that become blocked and infected with ______________ causing an inflammatory reaction.
Comedones (follicles impacted and distended by incompletely desquamated keratinocytes and sebum) may be open (blackheads) or closed (whiteheads). Inflammation leads to papules, pustules and nodules.
Acne vulgaris Propionibacterium acnes (P. acnes)
89
\_\_\_\_\_\_\_\_\_\_\_\_\_ infections are fungal infections caused by dermatophytes - a group of fungi that invade and grow in **dead keratin.**
Several species commonly invade human keratin and these belong to: **Epidermophyton, Microsporum and Trichophyton genera.**
They tend to grow outwards on skin producing a ring like pattern, hence the term 'ringworm'.
Dermatophytosis (tinea)
90
Itching, rash and nail discolouration are the most common symptoms of tinea infection.
Hair loss occurs with tinea capitis (mainly a disease of children).
Complications such as secondary infection (cellulitis and impetigo) can lead to symptoms.
It occurs in immunocompromised patients.
TINEA
91
\_\_\_\_\_\_\_\_\_\_
◦It affects particularly the web of the toe where skin may be macerated and erythematous.
◦It commonly affects plantar surface of the foot.
◦ Erythema, vesicles and pustules can occur.
Tinea pedis:
92
\_\_\_\_\_\_\_\_\_
Usually occurs in **men.**
Often tolerated for some time before presentation.
Typically erythematous with central clearing and raised edge
Tinea cruris:
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TINEA CRURIS
94
\_\_\_\_\_\_
◦The skin lesions have **annular scaly plaques with raised edges.**
◦There may be vesicles and pustules.
◦Typically lesions are on exposed skin of trunk, arms and legs (see Differential diagnosis).
◦More unusually the lesions can appear as overlapping concentric circles (tinea imbricate) or even herpetiform subcorneal vesicles or pustules (bullous
Tinea corporis:
95
Tinea Corporis
96
\_\_\_\_\_\_\_\_\_\_
Usually with tinea pedis.
Typically **just affects one hand.**
**Scaling and redness are prominent.**
Incorrect diagnosis and use of steroid may eventually exacerbate the infection.
Tinea manuum:
97
Tinea manuum
98
\_\_\_\_\_\_
Affects the beard area.
Redness, scaling and pustules are common.
Tinea barbae:
99
Tinea barbae
100
\_\_\_\_\_\_\_
◦It can cause hair loss with broken hairs at the surface.
◦Clinical appearance is variable.
Tinea capitis:
101
Tinea Capitis
102
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
◦Onycholysis or separation of the nail from the nail bed commonly occurs.
◦Nail dystrophy with thickening and discolouration of the nail develops.
Tinea unguium (onychomycosis):
103
\_\_\_\_\_\_\_\_\_\_\_ is useful for tinea capitis especially.
Ultraviolet light (Wood's light)
104
Acute, self-limiting skin condition.
A primary plaque (**'herald patch'**) is followed by a distinctive, generalised itchy rash 1-2 weeks later.
The rash lasts for approximately 2-6 weeks.
Lesions are typically oval, dull pink and appear in a 'Christmas tree' distribution, usually on the trunk and the upper arms and legs
PITYRIASIS ROSEA
105
PITYRIASIS ROSEA
106
a rheumatic disease of unknown cause, is characterized by autoantibodies directed against self antigens, leading to inflammatory damage of many target organs including the joints, kidneys, blood-forming cells, and the central nervous system
The diagnosis of lupus is confirmed by the combination of clinical and laboratory manifestations revealing multisystem disease. The presence of 4 of 11 criteria
SLE
107
Malar rash SLE
108
Photosensitive rash SLE
109
discoid rash SLE
110
What is the classic triad of HSP
"classic triad“= Purpura, arthritis and abdominal pain
111
112
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_is a systemic vasculitis (inflammation of blood vessels) and is characterized by deposition of immune complexes containing the antibody IgA.
HSP
113
HSP
114
abnormally low platelet count(thrombocytopenia) of no known cause (idiopathic).
related to the production of antibodies against platelets
immune thrombocytopenic purpura or immune thrombocytopenia are terms also used.
Oftenit is asymptomatic (devoid of obvious symptoms) and can be discovered incidentally, but a very low platelet count can lead to an increased risk of bleeding and purpura (large skin bruises).
ITP
115
an immune-complex-mediated hypersensitivity complex.
It ranges from mild skin and mucous membrane lesions to a severe, sometimes fatal systemic disorder.
Ocular symptom:ulcerative conjunctivitis, keratitis, iritis, uveitis, and sometimes blindness.
Steven Johnson Syndrom
116
Drug most commonly associated in SJS
allopurinol.
117
SJS
118
Often starts with a non-specific upper respiratory tract infection, which may be associated with fever, sore throat, chills, headache, arthralgia, vomiting and diarrhea, and malaise.
Mucocutaneous lesions develop suddenly and clusters of outbreaks last from 2-4 weeks. The lesions are usually not pruritic.
Mouth involvement may be severe
Respiratory involvement may cause a cough productive of a thick purulent sputum.
Patients with genitourinary involvement may complain of dysuria or an inability to pass urine.
SJS
119
is an acute-onset, potentially life-threatening, idiosyncratic mucocutaneous reaction, usually occurring after commencement of a new medication.
Widespread full-thickness epidermal necrosis develops, producing erythema, large blisters and/or exfoliation of large sheets of skin, leaving a raw base.
The skin has an appearance similar to a scald.
It usually affects the trunk, face and one or more mucous membranes
Toxic Epidermal Necrolysis
Note: There is thought to be an immune complex-mediated hypersensitivity reaction to the presence of toxic drug metabolites which accumulate in the skin.
Infection, malignancy and vaccination have also been suggested as other possible etiologies.
There may be no obvious trigger (idiopathic toxic epidermal necrolysis (TEN)).
120
An ill-defined red **'burning/painful' macular or papular rash** then develops, spreading from the face or the upper trunkBullae form and then coalesce
The epidermis can then slough in sheets.
The **Nikolsky sign**: if areas of seemingly normal skin between lesions are rubbed, the epidermis easily separates from its underlying surface.
Toxic Epidermal Necrolysis
121
\_\_\_\_\_\_\_\_\_\_\_\_appear on the skin as wheals which are red, very itchy, smoothly elevated areas of skin often with a blanched center.
They appear in varying shapes and sizes, from a few millimeters to several inches in diameter anywhere on the body.
**One hallmark of hives is their tendency to change size rapidly and to move around, disappearing in one place and reappearing in other places, often in a matter of hours.** Individual hives usually last no longer than 24 hour
Hives (medically known as urticaria)
122
Urticaria
123
ANGIOEDEMA
124
\_\_\_\_\_\_\_\_\_\_\_\_ is the rapid swelling (edema) ofthe dermis, subcutaneous tissue,mucosa and submucosal tissues.
Cases where angioedema progresses rapidly should be treated as a medical emergency as airway obstruction and suffocation can occur.
Epinephrine may be lifesaving when the cause of angioedema is allergic
Angioedemaor Quincke's edema
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