vocab

Question 1

Distribution of lesions along distal aspects of the head (ears, nose) and extremities is described as

Answer 1

Acral

Question 2

Distribution of lesions along area of skin supplied by a particular nerve root, does not cross midline of body

Answer 2

Dermatomal

Question 3

Lesions distributed within skin folds and creases

Answer 3

Intertriginous

Question 4

Photodistributed lesions might be found -

Answer 4

Sun-exposed areas

forehead
nose
ears
cheeks

upper lip
neck

forearms
dorsum of hands

Question 5

lesions arranged in a ring shape

Answer 5

Annular

Question 6

lesions arranged in an arc shape

Answer 6

Arcuate

Question 7

Lesions arranged in a netlike shape

Answer 7

Reticular

Question 8

Clustered lesions

Answer 8

Grouped

Question 9

Lesions arranged in coalescing circles / rings

Answer 9

Polycyclic

Question 10

Snake-like arrangement of lesions

Answer 10

Serpiginous

Question 11

Target / bulls’ eye lesion

Answer 11

Targetoid

Question 12

Stirred appearance of lesion/s

Answer 12

Whorled

Question 13

Most common form of systemic vasculitis in children

Answer 13

Henoch-Schonlein Purpura

palpable purpura, arthritis, abdominal pain, and kidney disease.
Seasonal pattern with a peak in incidence during the winter

supportive Tx +/- prednisone

Question 14

Painful subcutaneous hypermigemented nodules which can ulcerate along medium sized vessels
Fever, decreased sensation and reflexes
May also present with livedo reticularis
May affect any organ, most often skin, peripheral nerves, kidneys, joints, GI tract

Answer 14

Polyarteritis Nodosa

Question 15

Most common skin disorder in developed countries affecting up to 20% of children and 1-3% of adults

Develops before the age of 5 years and generally clears by adolescence

Answer 15

Atopic dermatitis

Question 16

Type IV delayed hypersensitivity response to numerous antigens

Inflammatory process involving the septa between subcutaneous fat lobules, with an absence of vasculitis and presence of radial granulomas.

Typically on shins
Begin as flat, firm, hot, red, painful lumps that are about an inch across
Within a few days they may become purplish
Over several weeks, the lumps fade to brownish, flat patch

Answer 16

Erythema Nodosum

Question 17

3 questions to ask when evaluating a pigmented lesion

Answer 17

Has it remained the same for the last year or so?

Is it symmetric, distinct borders, primarily one color?

Is it similar to other moles?

if yes to all 3, likely benign

Question 18

Melanomas are usually > _____ mm but can be smaller

Answer 18

> 6mm

Question 19

Indications for biopsy

Answer 19

ABCDE’s

Changes
New Lesions
> 50 yrs old
“ugly duckling”

Question 20

Most common form of skin cancer, >1 million cases per year in the US

Answer 20

Basal Cell Carcinoma

Question 21

Erythematous papules or plaques with rolled boarders. Telangectasias in sun-exposed areas. Fragile, will bleed or scab easily with minimal trauma.

Answer 21

Basal Cell Carcinoma

Question 22

Other conditions to R/O when considering basal cell carcinoma

Answer 22

Sebaceous hyperplasia

Fibrous papule

Question 23

Tx of choice for basal cell carcinoma

Answer 23

Surgical removal

Curette and Desiccation
Cryosurgery
Excision with standard 3-4mm margins

Moh’s micrographic surgery

Question 24

Tx for non-surgical, superficial BCC

Answer 24

Imiquimod
5% fluorouracil cream
Photodynamic therapy
Radiation

Question 25

BCC prognosis

Answer 25

locally invasive, rarely metastatic. Increased risk for other non-melanoma and melanoma skin cancers

Question 26

Most common type of melanoma (?)

Answer 26

Superficial spreading. Horizontal growth, as opposed to vertical. - on back in men - back and legs in women

Question 27

Type of melanoma with rapid growth, more aggressive. Growth is vertical, so thicker tumors.

Answer 27

Nodular

Question 28

"sunspot"

Answer 28

Lentigo maligna Occurs on chronically sun-damaged skin, more common in elderly patients. Slow progression. Growth tumor is primarily horizontal.

Question 29

Melanoma more common in people with darker skin color (African or Asian). Diagnosis is often delayed, so lesions tend to be larger. Look at the soles of your patients feet.

Answer 29

Acral lentiginous`

Question 30

characterized by a marked increase in dermal thickness on the upper neck or posterior back. It is found mostly in overweight, middle aged, poorly controlled type II diabetics

Answer 30

Diabetic Scleroderma

Question 31

Pediculosis

Answer 31

Head lice

Question 32

oval salmon colored lesions in a Christmas tree pattern

Answer 32

Pityriasis Rosea

Question 33

Most common infections of the hand

Answer 33

Paronychia Acute: staphylococcus, streptococci, pseudomonas Nail biting, finger sucking, aggressive manicuring, trauma, hang nail Chronic: Yeast – candida, atypical mycobacteria, gram negative rods Repeatedly exposed to water or irritants

Question 34

precancerous skin lesion caused by chronic sun exposure. These lesions are typically pink or red in color and rough or scaly to the touch. They occur on sun-exposed areas of the skin such as the face, scalp, ears, backs of hands or forearms.

Answer 34

actinic keratosis Actinic keratoses may start as small, red, flat spots but grow larger and become scaly or thick, if untreated. Sometimes they're easier to feel than to see. There may be multiple lesions next to each other.

Question 35

arise from keratotic patches and become more nodular and erythematous with growth, sometimes including keratin plugs, horns, or ulceration

Answer 35

squamous cell carcinoma Squamous cell carcinomas arising from actinic keratoses are scaly, as are actinic keratoses, but tend to grow thicker, and the pink macular to papular area develops into an erythematous raised base. Sometimes the lesion develops an overlying keratin horn (Figure 7). The lesions may take the form of a patch, plaque, or nodule, sometimes with scaling or an ulcerated center. The borders often are irregular and bleed easily. Unlike basal cell carcinomas, the heaped-up edges of the lesions are fleshy rather than clear in appearance.

Question 36

Hyperkeratotic, exophytic, dome-shaped papules or plaques Most common on fingers, dorsal hands, knees or elbows Punctate black dots representing thrombosed capillaries May be koebnerize: spread with skin trauma

Answer 36

verruca vulgaris

Question 37

Skin-colored or pink Smooth surface, slightly elevated, flat topped papules Dorsal hands, arms, and face (exposed areas)

Answer 37

verruca planae

Question 38

Thick endophytic (depressed into skin of sole) papules Mosaic warts: plantar warts coalescing into large plaques Can accumulate a thick callus over and around the wart May be painful when walking

Answer 38

paloplatar verruca