Skin

Question 1

Macule vs patch?

Answer 1

Both flat lesions

Macule < 2 cm

Patch > 2 cm

Question 2

Papule vs nodule vs Tumor?

Answer 2

Slightly elevated… (vs flat)

Papule (small skin induration) < 1 cm

Nodule 1-5 cm

Tumor > 5cm (e.g., SCC)

Question 3

Vesicle vs bullae vs pustule

Answer 3

Fluid filled

Vesicle < 1 cm

Bullae > 1cm (think burns)

Pustule = vesicle filled w/ pus

Question 4

Ulcer vs crust vs excoriation?

Answer 4

Ulcer = epidermal defect (e.g., syphilitic chancre)

Crust = skin defect covered w/ dried blood/plasma (healing wounds)

Excoriation = superficial skin defect from scratching

Question 5

Fissure vs wheal vs scales?

Answer 5

Fissure - sharp edged defect into deeper layers (e.g., athelte’s foot)

Wheal = elevated itchy, transient lesion w/ erythema (insect bite)

Scales = skin flakes easily removed by scraping (e.g, seborrheic dermatitis)

Question 6

Most common congenital skin anomaly

normal skin elements arranged abnormally

Answer 6

Nevus

Question 7

1. Melanotic nevus?
2. Nevus flammeus
3. Cherry/strawberry hemangiomas

Answer 7

1. common birthmark
2. “Port wine stain” = clustered capillaries
3. vascular malformations of ENTIRE capillary; intense red color

Question 8

Generalized hypopigmentation, lacking enzymes for melanin synthesis

White hair, red eyes

(should avoid sun, incrased risk for skin cancer)`

Answer 8

Albinism

Question 9

Skin covered in large thick scales

Higher risk for infxn (treat w/ exfoliants/moisturizers)

autosomal dominant trait

Answer 9

Ichthyosis (fish skin)

Question 10

jagged tear throgh skin into deeper tissue

rapid stretching of skin/impact

Answer 10

laceration

Question 11

Epidermis only

MIld erythema/some edema

Heals quickly (1 week)

Answer 11

1st degree

Question 12

Dermis is mostly spared

Bulla/blisters

Slower healing/new skin is thinner

Answer 12

2nd degree (partial thickness)

Question 13

Epidermis/dermis completely burnt

Muscle deeper tissues often involved

Heals slowly w/ SIGNIFICANT SCARRING

May require grafting/special care

Answer 13

3rd degree

full thickness

Question 14

Prolonged exposure to NONfreezing cold/wet environment

Answer 14

trench foot

Question 15

Subfreezing temps

Upon rewarming, blotchy red, swollen, painful

Answer 15

frostbite

Question 16

Damage involves deep tissue/internal organs

deep thrombi, compartment syndorme, arrhythmias, rhabo

Burns at entry and exit

Answer 16

electrical injuries

Question 17

Sunlight (most common)

Ionizing (med procedures/occupational)

Answer 17

radiation injury

Question 18

1. HSV
2. Shingles
3. HPV

Answer 18

1. cold sores
2. Herp Zoster re-eruption of chickenpox
3. verruca vulgaris (common wart)

Question 19

post viral rashes?

Answer 19

exanthems

Question 20

Occur on apparently normal skin

Typically caused by pus-forming “pyogenic” bacteria (staph a, strep pyogenes)

Answer 20

Primary bacterial skin infxn

Question 21

Complicate and impede healing of existing skin wounds (eczema)

may be nosocomial infxn w/ abx resistant bacteria

Answer 21

Secondary skin infxn

Question 22

Honey crusted lesions most often on face of children

Highly contagious but responds well to abx

Answer 22

Impetigo

staph, strep

Question 23

Infxn limited to hair follicles (typically staph)

furuncle vs carbuncle?

Answer 23

Folliculitis

Furuncle = boil, single hair, POINTED appearance

Carbuncle = enlarged furuncle; multiple hair shafts

Question 24

Thrush in children?

Secondary agent from intertrigo (dermatitis occuring at skin folds, esp obese people)

Answer 24

Candida albicans

Question 25

Live in dead skin Little inflammation but itching and scratching (could lead to secondary infxn) Classic ringworm

Answer 25

Tinea (dermatophyte)

Question 26

Redness, flaking, scaling, itching of skin (chronic) Tx - steroids/sulfur-based shampoos

Answer 26

Seborrheic dermatitis

Question 27

Elevated patches/plaques covered by silvery scales Mostly on EXTENSOR surfaces (ELBOWS, KNEES) and scalp/nails

Answer 27

Psoriasis t-lymphocyte mediated autoimmune d/o involving keratinocytes

Question 28

Warning signs of skin cancer?

Answer 28

Pesistent non healing ulcer Friable (bleeds easily) Irregular shape/unclear margins Surrounded by atrophic/keratotic skin

Question 29

``` A B C D E ```

Answer 29

``` asymmetry borders (irregular/notching = bad) color (variations = bad) diameter (>6 cm = bad) evolving (lesion changing = bad) ```

Question 30

Common benign epidermal tumor Brownish, flat, wart w/ stuck-on appearance Tx = cryotherapy

Answer 30

Seborrheic keratosis (epithelial tumor) Seb Ks

Question 31

Pre cancerous lesions (may precede SCC) arise from sun exposure Atrophic, redden macules, w/ rough keratotic/scaly surface

Answer 31

actinic keratosis AKs Tx = cryotherapy or Antineoplastic solution for desquamation

Question 32

Malignant Elevated nodule often w/ central depression "rolled up" w/ pearl-like color Rarely metastasizes

Answer 32

BCC tx = excision/cautery/curettage

Question 33

Invasive malignant tumor Varible forms.. small flat plaque or persistent ulcer or slightly elevated papule OFTEN W/ RECURRENT BLEEDING/CRUSTING

Answer 33

SCC tx = full depth excision BCC, SCC can appear similar so when in doubt cut it out

Question 34

Macule/patch of melanocytes Hyperreactive to UV light

Answer 34

freckle (benign)

Question 35

Sharoly demarcated macule, unresponsive to UV light

Answer 35

Lentigo (benign)

Question 36

overabundance of melanocytes

Answer 36

melanotic nevus (benign)

Question 37

flat macule originating from freckle/nevus Localized for 10-15 years then invasive

Answer 37

Lentigo maligna (type of malignant melanoma)

Question 38

Most common melanoma Maculae w/ irregular shape/border typically on legs of women, backs of men

Answer 38

Superficial spreading melanoma (type of malignant melanoma)

Question 39

Rapidly grwoing/infiltrating variant that has poor prognisis once invasiion into subQ

Answer 39

Nodular melanoma