Skin conditions

Question 1

Poor digital skin infarctions
Heliotrope rash
Rash on knuckles

Answer 1

Dermatomyositis

Question 2

Is dermatomyositis indicative of an underlying cancer?

Answer 2

YES

Question 3

What components are necessary for the skin exam?

Answer 3

Inspection and Palpation

Question 4

Should patients be inspected from head to toe?

Answer 4

YES

Question 5

Is adequate lighting necessary?

Answer 5

YES

Question 6

Exam equipment?

Answer 6

Centimeter ruler, flashlight, Wood’s lamp, handheld magnifying lens

Question 7

Inspection?

Answer 7

Lesion type, distribution, secondary characteristics, shape of individual lesions, arrangement of multiple lesions, color, consistency

Question 8

Palpation?

Answer 8

Feel. Moisture, temperature, texture, turgor, mobility

Question 9

Normal moisture

Answer 9

Minimal perspiration or oiliness present

Question 10

Temperature

Answer 10

Check using dorsum of hands or fingers

Question 11

Texture

Answer 11

Smooth, soft or even, verrucuous

Question 12

Turgor

Answer 12

Depends on if patient is considerably dehydrated or if edema is present

Question 13

Mobility

Answer 13

Skin should move easily when pinched and return to pace immediately when released

Question 14

Macule

Answer 14

Freckle-like, flat, non-palpable

Question 15

Papule

Answer 15

Elevated nevus, Palpable, circumscribed

Question 16

Nodule

Answer 16

Wart, well-circumscribed

Question 17

Vesicle

Answer 17

Blister, serous-filled

Question 18

Pustule

Answer 18

Acne, vesicle with pus in it

Question 19

Wheal

Answer 19

Mosquito bite, irregular borders

Question 20

Primary lesions

Answer 20

How it came about

Question 21

Secondary lesion

Answer 21

After scratching

Question 22

Plaque

Answer 22

Psoriasis, large (>5 mm), formed by confluence of papules

Question 23

Cysts

Answer 23

Ex: Sebaceous cyst. Enclosed cavity with lining containing liquid or semisolid material

Question 24

Teleangiectasia

Answer 24

Dilated superficial vessel. Indicative of liver disease. Blanches when pressed on and fills back when pressure is released

Question 25

Bullae

Answer 25

Ex: Pemphigus. Large

Question 26

Secondary lesions

Answer 26

``` Excoriation Lichenification Edema Scale Crust ```

Question 27

Excoriation

Answer 27

Superficial skin erosion casued by scratching

Question 28

Lichenification

Answer 28

Increased skin markings and thickening secondary to chronic inflammation by scratching or other inflammation

Question 29

Edema

Answer 29

Swelling due to accumulation of water

Question 30

Scale

Answer 30

Superficial dead cells

Question 31

Fissure

Answer 31

Deep split in skin extending into dermis

Question 32

Erosion

Answer 32

Superficial focal loss of part of the epidermis

Question 33

Ulceration

Answer 33

Focal loss of epidermis extending into the dermis

Question 34

Atrophy

Answer 34

the elderly, decreased skin thickness due to skin thinning

Question 35

Scar

Answer 35

Abnormal fibrous tissue replacing normal tissue after skin injury

Question 36

Hypo-, hyper or de-pigmentation

Answer 36

Hypo- Patient's skin is the base but has white spots Hyper- Patient's skin is the base but has darker spots. Ex: sun exposure De- vitiligo. Common on extremities and around eyes

Question 37

ABCDE of staging a nevus

Answer 37

A-ASSYMETRY. One 1/2 doesn't match the other B-BORDERS. Irreg, ragged, notched, blurred C- COLOR. Heterogeneous D-DIAMETER. Greater than 6 mm E-EVOLUTION.

Question 38

Why automatic referral by PCP to derm or surgery for possible melanoma?

Answer 38

Biopsying the specimen may help metastasis if melanoma

Question 39

Basal cell carcinoma

Answer 39

Usually doesn't metastasize | Hallmark: Pearly border with shallow "ulcer" at center

Question 40

Squamous cell carcinoma

Answer 40

Typical in sun-exposed areas of skin, metastasize, bleed, irreg borders Rx: excision

Question 41

malignant melanoma

Answer 41

Lethal, common in NON sun-exposed areas, metastasizes early and widely, evolves over time

Question 42

Kaposi sarcoma

Answer 42

Cancer of the epithelium due to HHV8 | Assoc'd with HIV patients

Question 43

Eczematous dermatitis

Answer 43

Irritant contact, allergic contact, atopic dermatitis

Question 44

Rosacea

Answer 44

Chronic inflammatory skin disorder | Rx: sun protection, removal of casue

Question 45

Follicultis

Answer 45

Inflammation of hair follicle, infected with bacteria, usually Staph Rx: warm compresses

Question 46

Cellulitis

Answer 46

Infection Can be severe Rx: Elevation, treat underlying condition and empiric antibx Rx

Question 47

Psoriasis

Answer 47

Heriditary Thick-red silvery plaques on extensor surfaces. Ex: Elbows and knees Rx: PhotoRx

Question 48

Acanthosis nigricans

Answer 48

Nonspecific rxn | Assoc'd with DM, insulin resistance and obesity. Also PCOS

Question 49

Herpes Simplex type I

Answer 49

Lip

Question 50

Type II

Answer 50

Shaft

Question 51

Herpes Zoster

Answer 51

Grouped vesicles on erythematous base following a dermatome Usually unilateral Risk: Elderly, immunosuppressed

Question 52

Alopecia areata

Answer 52

Sudden, rapid loss of hair usually from scalp or face

Question 53

Cherry hemangiomas/angiomata

Answer 53

Mature capillary proliferation. | Does not blanch when pressed

Question 54

Seborrheic keratoses

Answer 54

Waxy, benign, slowly-growing tumor

Question 55

Chronic venous stasis

Answer 55

das

Question 56

Plantar's wart

Answer 56

Black dots seen around tissue | Rx: salcyclic acid or liquid nitrogen

Question 57

Paronychia (Witlow)

Answer 57

Inflammation under the nail due to biting naills

Question 58

Fro exam

Answer 58

- Melanoma send to derm - Know bad things in ABCDE - Pattern recognition and picture recognition