Week 4: Dermatology Flashcards
(86 cards)
1
Q
Macule
A
flat, non palpable color change, variable shape
2
Q
Papule
A
elevated, palpable
3
Q
Plaque
A
elevated plateau-like lesion greater than 10 mm; superficial
4
Q
Nodule
A
firm papule, palpable, extends into dermis or subcutaneous tissue
5
Q
Tumor
A
large nodule greater than 10 mm
6
Q
Vesicle
A
fluid-filled blister less than 10 mm (clear fluid)
7
Q
Bullae
A
vesicles larger than 10 mm
8
Q
Pustule
A
elevated lesion containing pus
9
Q
Urticaria (wheals or hives)
A
transient elevated lesion due to localized edema; feels kind of damp/fluidy
10
Q
Scale
A
accumulation of epithelium; dry, whitish
11
Q
Crust
A
dried pus, blood or serous exudate on the surface; usually due to broken pustules or vesicles
12
Q
Erosion
A
loss of epidermis
13
Q
Excoration
A
linear erosion usually caused by scratching
14
Q
Ulcer
A
deeper erosions involving the dermis; (bleeding and scaring)
15
Q
Petechiae
A
small non-blanchable punctuate foci of hemorrhage (vascular rash)
16
Q
Purpura
A
larger area or hemorrhage, maybe palpable (bruises or ecchymosis: a coalesced petechia patch)
17
Q
Atrophy
A
paper thin wrinkled and dry-appearing skin
18
Q
Scar
A
fibrous tissue replacement after injury
19
Q
Telangiectasia
A
dilated superficial blood vessels
20
Q
What are the 6 categories used to describe and chart a lesion?
A
Secondary morphology/configuration (shape of single lesion or cluster of lesions) Texture Location and distribution Color Other Clinical Signs Diagnostic Tests
21
Q
Annular
A
rings with central clearing
22
Q
Nummular
A
circular
23
Q
Target
A
rings with central duskiness
24
Q
Serpiginous
A
fungal and parasitic infections
25
Reticulated
lacy pattern
26
Verrucous
irregular surface
27
Lichenification
epidermal thickening with accentuation of skin lines due to chronic irritation
28
Induration
dermal thickening; skin feels hard and rough
29
Umbilicated
with a central indentation
30
Red (Erythema), indicates......
increased blood flow to the skin
31
Orange indicates......
hypercarotenemia
32
Yellow indicates.......
jaundice, heavy metal poisoning, myxedema, uremia
33
Green indicates.......
in fingernails suggests pseudomonas
34
Violet indicates.....
darkening cutaneous hemorrhage, vasculitis
35
Gray/blue skin indicates........
cyanosis; metal deposits
36
Black indicates.......
melanocytic lesions, infection or arterial insufficiency
37
White indicates........
tinea, Pityriasis alba, vitiligo
38
Dermatographism
urticaria after stroking the skin
39
Diascopy
pressure to indicate blanching (hemorrhagic lesions don't blanch, inflammatory lesions do)
40
Darier's sign
stroking lesions causes intense and sudden erythema and wheal formation
41
Nikolsky's sign
bullae formation and erosion following gentle traction pressure
42
Auspitz' sign
pinpoint bleeding after removal of plaques
43
Koebner's phenomenon
development of lesions with areas of trauma
44
What two diagnostic tests are used regarding fungi?
Wood's lamp and KOH test
45
A pruritus diagnosis must include what in it's history?
Drug and occupational/hobby exposures
46
What is the most common cause of pruritus?
Dry skin
47
What is pruritus?
Itching of the skin
48
What testing can be done for a pt. with pruritus?
Biopsy, CBC, liver, kidney, thyroid function, evaluation for underlying malignancy, immunoglobulins
49
What is Urticaria?
Migratory, erythematous pruritic plaques mostly involving release of histamine.
50
What determines acute vs. chronic urticaria?
>6 weeks duration
51
Etiology of Urticaria?
Viral/bacterial infection, IgE allergy, medications (NSAIDs), rare autoimmune dz, malignancy
52
What are important aspects of the history to gather with Urticaria?
Duration, triggers, frequency, concomitant symptoms (GI), always ask about respiratory system, use of drugs, travel and family history
53
What testing should be done with Urticaria?
CBC, Immunoglobulins to foods, ANA or thyroid studies, biopsy if uncertain
54
What PE should be done in a Urticaria case?
Complete examination of the skin; look for signs of infection and systemic disease
55
What does acne vulgaris present (s/sx) with?
Comedones, papules, pustules, inflamed nodules, superficial pus filled cysts and sometimes deep purulent sacs.
56
What are dietary causes for acne vulgaris?
Dairy, sugar and bromine
57
What are the grading criteria for acne vulgarism?
Mild = 5 cysts or 125 lesions
58
Name the chronic inflammatory disorder characterized by facial flushing, telangiectasias, erythema, papules, pustules and possible rhinopyma?
Rosacea
59
Pts with Rosacea have higher infection rates of __________ and __________
Pts with Rosacea have higher infection rates of H. Pylori and SIBO
60
What are some triggers for rosacea episodes?
hot or spicy foods
drinking alcohol
temperature extremes
emotional reactions
61
What are the stages of Rosacea?
Pre-rosacea
Vascular phase
Inflammatory phase: papules, pustules, nodules and cycts present
Late stage/rhinophyma
62
Rosacea must display one primary and one secondary feature. Name possibilities for each of those.
Primary: Flushing, non-transient erythema, papules and pustules, telangiectasia
Secondary: Burning or stinging, plaque, dry appearance, edema, ocular manifestation, peripheral location, phymatous changes
63
Name this uncommon, chronic pruritic bullous disease.
Bullous pemphigoid
64
What do all bullous diseases have in common?
Autoimmune causes
65
What causes outside of autoimmunity does bullous pemphigoid have?
Drug induced from furosemide, captopril and NSAIDS
66
Does bullous pemphigoid have a positive or negative Nikolsky's sign?
Negative
67
What does the prodromal phase of bullous pemphigoid look like?
Pruritic eczematous papular or uticaria-like skin lesions that become tense bullae
68
What is the distribution pattern for bullous pemphigoid?
Trunk, lower legs, extremity flexures, axillary and inguinal folds
69
What is bullous pemphigoid associated with and what is the age range affected?
Associated with dementia, parkinson's disease and unipolar/bipolar
Age>60
70
What diagnostic criteria are used for bullous pemphigoid?
Biopsy: shows sub epidermal bulla with infiltrate of eosinophils;
Direct immunofluorescence (GOLD STANDARD) of skin shows IgG and/or C# in a linear band in basement membrane.
71
What disease presents in ages 20-50; male:female __(?)___; as chronic, recurring, intensely itchy with symmetrical groups of inflamed vesicles, papules and hives?
What disease presents in ages 20-50; male:female 2:1; as chronic, recurring, intensely itchy with symmetrical groups of inflamed vesicles, papules and hives?
Dermatitis herpetiformis
72
Dermatitis herpetiformis is caused by autoimmune diseases, especially _________ and also associated with ________ disorders
Dermatitis herpetiformis is caused by autoimmune diseases, especially celiac disease (even asx) and associated with thyroid disorders.
73
What is the distribution of dermatitis herpetiformis?
symmetrical extensor aspects, sacrum, base of head or generalized (rare)
74
How is dermatitis herpetiformis diagnosed?
Skin biopsy of lesions and adjacent skin = sub epidermal clefting and papillary dermal tips w/neutrophils and eosinophils;
Direct immunoflorescence is a GOLD STANDARD: IgA deposition
75
Pemphigus vulgaris is ________________ with the highest incidence occurring in ___________.
Pemphigus vulgaris is a rare potentially fatal (15%) blistering disease with the highest incidence occurring in Ashkenazi Jews.
76
Pemphigus vulgaris' distribution
Oral lesions precede skin lesions in 50-70%; then found on groin, scalp, abd, back, upper legs, axilla and umbilicus
77
How is pemphigus vulgaris diagnosed?
Biopsy = intradermal bulla or separation of epidermal cells
Immunfluorescence from edge of fresh lesion
Nikolsky's sign (+)
78
Epidermal thickening that is usually asymptomatic with intact skin lines
Callus
79
Epidermal thickening that maybe painful with pressure that has a yellowish core when pared and interrupts skin lines
Corn
80
Scaling and flaking of skin is called......
Ichthyosis
81
What are characteristics of inherited Ichthyosis?
Autosomal Dominant and X-linked; resembles cracked pavement; accentuated palmar creases
82
What is the distribution of ichthyosis?
shins and outer arms
83
What is required for diagnosis?
H and PE
| No biopsy
84
What happens during Keratosis pillaris?
Horny plugs fill the openings of hair follicles: follicular papules on lateral aspects of upper arms, thighs and buttocks. On the face of children (sandpaper skin)
85
What are causes of keratosis pillaris?
Nutritional deficiency, or genetic
86
Name and describe the causes of this immune-mediated skin inflammation with a genetic component?
Atopid Dermatitis
Causes: Genetics (atopy), food and environmental allergies, aggravated by dry skin, wool, sweating, allergens, tight clothing, emotional stress, nutritional
