Skin Abnormalities Flashcards
(51 cards)
1
Q
What are the 3 layers of skin?
A
- Epidermis
- Dermis: blood vessels, hair follicles, sebaceous glands, sweat glands
- Subcutaneous
2
Q
What are the appendages of the skin?
A
- Hair
- Nails
- Sebaceous glands
- Sweat glands
3
Q
What do sebaceous glands do and where are they located?
A
- Produce fatty substance onto skin surface through hair follicles
- Present on all skin surfaces except palms and soles
4
Q
What are the different types of sweat glands and what do they do?
A
- Eccrine: Widely distributed, open directly onto skin surface, help control body temp (via sweat production)
- Apocrine: Found chiefly in axillary and genital regions, usually open into hair follicles. Can be stimulated by emotional stress. Bacterial decomposition of apocrine sweat causes body odor
5
Q
What are the key history questions for skin (HPI/ROS)
A
- Color changes?
- Rashes?
- Lumps?
- Itching?
- Dryness?
- Hair and nail changes?
- Weight changes, fever, chills or difficulty sleeping?
6
Q
Describe the differences between Central and Peripheral cyanosis
A
- Central cyanosis: consistent with cardiac or pulmonary disease
- Peripheral cyanosis: may be seen with cold temperature or anxiety
7
Q
What can be associated with jaundice?
A
Icterus-conjunctivae
8
Q
What are the Skin- Color of lesions?
A
- Flesh-colored: same color as surrounding skin
- Erythematous: variable shades of red (pink, bright red, dull red)
- Violaceous: light violet
- Tan-brown
- Black or blue-black
- White
9
Q
Describe the Morphology of Primary and Secondary Lesions
A
- Primary skin lesions: initial presentation, arise from previously normal skin –> Key to diagnosis
- Secondary skin lesions: results from changes to primary lesions –> Usually due to overtreatment, scratching or infection of the primary lesion
10
Q
What are the Primary skin lesions?
A
- Flat: Macule or patch
- Palpable: Papule, plaque, nodule, tumor or wheal
- Palpable with contents: Vesicle, bulla, pustule or cyst
11
Q
Describe a Macule
A
- <1 cm diameter
- Flat, non-palpable
- Variable color
- Examples: freckles, petechiae
12
Q
Describe a Patch
A
- ≥1 cm diameter
- Flat, non-palpable
- Irregular shape
- Examples- Café au lait spots, vitiligo
13
Q
Describe a Papule
A
- <1 cm diameter
- Palpable, firm
- Circumscribes
- Flesh-colored, red, brown
- May be confluent and form plaques
- Examples- Molluscum contagiosum, warts, nevi (moles)
14
Q
Describe Plaque
A
- ≥ 1 cm diameter
- Elevated, firm, rough
- Circumscribed
- Example- psoriasis
15
Q
Describe a Nodule
A
- ≥ 1 cm but <2 cm diameter
- Deeper and firmer than a papule (must palpate to determine)
- Usually round
- Examples- lipoma, some skin cancers
16
Q
Describe a Tumor
A
- ≥ 2 cm
- A larger nodule
- Examples- hemangioma, tumors, lipoma
17
Q
Describe a Wheal
A
- Irregular, transient, superficial edema
- Examples- mosquito bites, urticaria (hives)/allergic reaction
18
Q
Describe a Vesicle
A
- <1 cm diameter
- Well-circumscribed
- Filled with serous fluid
- Examples- Herpes simplex “Dew drops on a rose petal”
19
Q
Describe a Bulla (plural = bullae)
A
- ≥ 1 cm diameter
- Well-circumscribed
- Filled with serous fluid
- Examples- blisters, 2nd degree burns
20
Q
Describe a pustule
A
- Well-circumscribed
- Elevated, superficial, epidermal
- Filled with pus
- Example- acne
21
Q
Describe a cyst
A
-Nodule filled with liquid or semisolid material
22
Q
What are the Secondary skin lesions?
A
- Loss of skin surface- erosion, ulcer or fissure
- Material on skin surface- scale or crust
- Other- Excoriation, lichenification or atrophy
23
Q
Describe Erosion
A
- Loss of superficial epidermis
- Surfaces is moist but doesn’t bleed
- Heals without scarring
- Examples- ruptured vesicle, atopic dermatitis
24
Q
Describe an ulcer
A
- Deeper loss of epidermis and dermis
- Heals with scarring
- Examples- stasis ulcer
25
Describe a fissure
- Linear crack or break from the epidermis to the dermis
| - Examples- atopic dermatitis, tinea pedis, angular cheilitis
26
Describe a scale
- A thick flake of exfoliated epidermis
| - Examples- seborrhea, psoriasis
27
Describe crust
- Dried residue of serum, pus or blood
| - Example- impetigo
28
Describe excoriation
- Abrasion or scratch mark
- May be linear or rounded
- Usually due to scratching
- Examples- scabies, atopic dermatitis, dry skin
29
Describe Lichenification
- Thickening and roughening of the skin
- Increased visibility of skin markings
- Examples- atopic dermatitis, chronic dermatitis
30
Describe atrophy
- Thinning of the skin with loss of normal markings
- Skin looks shinier and more translucent
- Example- striae (stretch marks)
31
Describe a keloid
- Hypertrophic scarring
| - Extends beyond the borders of initial injury
32
What are the Skin Lesions? Describe if they blanch or not.
Do NOT blanch
- Petechiae
- Purpura
- Ecchymosis
- Cherry angioma
Blanch
- Spider angioma
- Spider veins
- Telangiectasia
- Hemangioma
33
Describe Petechia (pleural = petechiae)
- 0.1-0.3 cm (1-3 mm) diameter
- Represent blood outside of a vessel
- Round or irregular
- Deep red or purple-red
- Seen with infections and bleeding disorders
- Do NOT blanch
34
Describe Purpura
0. 3-1 cm
- Same as petechiae but larger
- Do NOT blanch
35
Describe Ecchymosis
- Generally >1 cm diameter
- “Bruise”
- Represent blood outside of vessels due to trauma, bleeding disorders
- Round, oval or irregular borders
- Purple lesions of variable size. Fade to green, yellow, brown
- Does NOT blanch
36
Describe Cherry angioma
1-3 mm diameter
- Flat or raised
- Red
- Non-pulsatile
- Seen on trunk
- Associated with aging
- Do NOT blanch
37
Describe Spider angioma
- Very small up to 2 cm diameter
- Central body with surrounding erythema, and radiating legs (spider)
- Seen on face, neck, arm and upper trunk
- Associated with- liver disease, pregnancy
- Do blanch
- A type of telangiectasia
38
Describe Spider veins
- Very small to several inches
- Variable shape, may resemble spider, be linear or irregular
- Most often seen on legs (varicose veins)
- Blanch with diffuse pressure only
39
Describe Telangiectasia
- Irregular lines secondary to dilations of capillaries
- Red
- Seen with basal cell skin cancers, sun-damage, rosacea
- Do blanch
40
Describe Hemangioma
- Irregular lesion secondary to dilation of dermal capillaries
- Red
- Starts as a macule, can progress to plaque or nodule
- Example- “strawberry hemangioma”
41
Describe Maculopapular lesions
-Macules with papules
-Examples:
♣ Viral exanthems: generalized, erythematous, maculopapular rash
♣ Drug eruptions
42
Describe Papulosquamous lesions
-Papules with plaques and scales
-Examples
♣ Lichen planus
♣ Pityriasis rosea
43
Describe Vesiculobullous lesions
- Vesicles and bullae
- Examples: Herpes simplex, Herpes zoster, Pemphigus vulgaris, Serious autoimmune disease affecting skin and mucous membranes
-Associated with a positive Nikolsky’s sign- slight rubbing of the skin results in exfoliation of the outermost layer
44
Describe Skin lesions- distribution
- Localized: lesions or abnormality appears in one small area
- Regional: lesions appear in a specific region of the body
- Examples- flexor surfaces, extensor surfaces
-Generalized/disseminated- Lesions or abnormality appears widely distributed or in multiple areas simultaneously
45
Describe the different characteristic distribution of skin lesions
Acne vulgaris: Face, chest, upper back
Atopic Dermatitis: Flexor surface (behind the knees/elbow crease)
Photosensitive eruptions: places exposed to the sun
Pitybiasis rosea: Tank top region and butt
Psoriasis: Knees and elbows
Seborrehic dermatitis: head
46
Describe Round/discoid lesions
- Coin shaped with no central clearing
- Example- nummular eczema (a form of atopic dermatitis)
- Umbilicated lesions
- Example- seen with molluscum contagiosum
47
Describe Oval/Ovoid lesions
-Example- Pityriasis rosea
48
Describe Annular lesions
- Round; active margins with central clearing
| - Seen with tinea (fungal) infections
49
Describe shape/arrangement of lesions
- Dermatomal: Following a nerve segment (Herpes Zoster)
- Linear
- Serpiginous: Cutaneous larva migrans from hookworm larvae)
- Morbilliform: Measles-like (Erythematous maculopapular lesions that become confluent on the face and body)
- Target/targetoid: Pink macules with purple central papules (Erythema multiforme)
50
Describe Skin borders/margins
- Distinct: Well-demarcated or defined; able to draw a line around the area with confidence
- Indistinct: Poorly defined; borders merge with normal skin
- Active: Margin of lesion shows greater activity than center (Tinea infections)
- Irregular: Margins are notched, not smooth (malignant melanoma)
- Raised borders: Center of lesion is depressed compared to edge (Basal cell carcinoma)
51
What are the ABCDEs of Melanoma?
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A- Asymmetrical shape
B- Borders (irregular)
C- Color (variation)
D- Diameter (> 6mm, pencil eraser)
E- Evolving
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