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Y2 - Derm > 1_Dermoscopy_Pt 1 > Flashcards

1_Dermoscopy_Pt 1 Flashcards

1
Q

what are the layers of the skin?

A

epidermis, dermis, subcutaneous tissue

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2
Q

what are the layers of the EPIDERMIS?

A
  • Basal (stratum germinativum) – deepest layer
  • Prickle (stratum spinosum)
  • Granular (stratum granulosum)
  • Stratum lucidum** (**ONLY IN PALMS AND SOLES**) **(*KNOW FOR EXAM, “always a good test question”)
  • Horny (stratum corneum) – most superficial layer
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3
Q

where in the body is STRATUM LUCIDUM found?

A

This layer of the epidermis is ONLY FOUND in the PALMS AND SOLES

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4
Q

what are the functions of the skin?

A
  1. cold/ heat/ radiation
  2. pressure/ blows/ abrasion
  3. action of chemical substances
  4. invasion by microorganisms
  5. heat & water loss
  6. defense against invading microorganisms
  7. absorption of certain substances
  8. perspiration
  9. circ and therm regulation (via derm vasc system)
  10. pressure/vibration/touch/pain/temp sensory organs
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5
Q

what is another name for the basement membrane?

why is it an area of research interest?

A
  • Dermal-epidermal interface (basement membrane)
  • area of research interest bc pathology here can cause visible skin disease
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6
Q

what is the anatomy of the DERMIS layer?

which sublayer has more collagen?

A
  • Separated into _papillary and reticular l_ayer
    • **the RETICULAR layer has a lot of collagen
  • Place where hair and glands begin
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7
Q

what are the FUNCTIONS of the DERMIS layer?

A
  • Temperature regulation through control of cutaneous blood flow and sweating
  • Mechanical protection of underlying structures
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8
Q

which skin layer: consists of spongy connective tissue with energy-storing adipocytes

A

Subcutaneous or Subcutis layer:

  • Consists of spongy connective tissue with energy-storing adipocytes (fat cells)
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9
Q

(T/F) The fat content of the subcutis is the same in all body regions and individuals.

A
  • The fat content of the subcutis is NOT the same in all body regions and DIFFERS in men and women
    • Zero fat in and around nail tissue
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10
Q

what is the fat content in and around the nail tissue?

A
  • Zero fat in and around nail tissue
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11
Q

when in development does nail begin to develop?

A

between 10th-17th week in utero

is when the nail begins to develop

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12
Q

which cells make up the nail plate?

A
  • Onychocytes: one of the tightly packed keratinized cells arranged in layers to make up the nail plate.
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13
Q

what is the nail plate comprised of, in general terms?

A

the nail plate is formed by mostly nail matrix – w/ some contribution from nail bed, shape contributed from matrix and phalanx

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14
Q

what is directly deep to the nail plate?

A

distal phalanx directly underneath nail plate;

there is NO SUBCUTANEOUS tissue

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15
Q

compare hair and nails w/ regards to:

  • growth
  • keratin content
  • function
  • assoc glands
  • where
A
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16
Q

what are the key differences between APOCRINE and ECCRINE glands of the skin?

A
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17
Q

what is a sebaceous gland?

A
  • Apocrine gland associated with hair follicle;
  • aka Pilosebaceous unit
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18
Q

which glands are where ACNE occurs?

what causes these glands?

A
  • Sebaceous glands are where acne occurs
  • Sebaceous glands are caused by metabolic, environmental, etc factors
    • can become colonized and then infected
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19
Q

which glands produce sebum?

what is the normal rate, and what decreases the rate?

A
  • sebaceous glands produce sebum
  • normal amount is 1mg/10cm2 every 3 hours
    • Skin is dry if produces less than that amount
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20
Q

how long does it take for keratinocyte to pass from basal to corneal layer?

A

8-10 weeks for epidermal cell turnbover

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21
Q

describe the process of epidermal cell turnover

A
  • Keratinocytes divide in basal cell layer, differentiate, and progress upwards to the stratum corneum (no nuclei in corneum)
  • No cell division detected past the basal layer
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22
Q

where is no cell division detected past WHICH SKIN LAYER?

A

No cell division detected past the BASAL layer

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23
Q

what are the big 3 of the skin exam?

A

ASK

LOOK

PALPATE

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24
Q

What are examples of questions to ASK the patient when preventing for a skin exam?

A

FIRST, NLDOCAT

  • Evolution (How did it begin? How did it change?)
  • Involution (How did it go away?)
  • What other body parts affected
  • History of rashes/skin cancer
    • Topical med history (OTC/Rx/Folk/Home, failure or success?)
  • Have you seen a dermatologist?
  • Have you had a biopsy?
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25
Q

what factors should you consider when VISUAL AND TOUCH assessment?

(LOOK AND PALPATE)

A
  • Distribution/location (where on the body?)
  • Grouping/configuration
  • Shape (primary or secondary lesions)
  • Size (cm)
  • Color (red, blue/cyanotic, pale)
  • Temperature (use backs of hands/fingers to determine if cool or warm)
  • Mobility (does it lift up?) and turgor (the speed to which it returns to normal)
  • Nails
  • The skin around the lesions (especially with wounds)
  • Moist or dry (wetness or flakes?)
  • CHECK THE HANDS!!!
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26
Q

which configuration is “Blisters on a red base” or “Dew drops on a rose petal”?

A

Herpetiform configuration,

often assoc w/ VIRAL distribution

27
Q

geographic distribution usually indicates what condition?

28
Q

what is the following configuration?

A
  • wood grain
  • usually malignant, and VERY RARE
29
Q

what is the pigmentation of a new scar?

A
  • New scar is usually darker than skin color (hyperpigmented) and gets lighter as it progresses
30
Q

how would you describe a blue lesion?

red lesion?

A
  • cyanic is blue
  • erythematous is red
31
Q

how do you describe: reddish brown, scaly papules on the palms and soles?

A

COPPER PENNY LESIONS;

32
Q

plane lesion:

define

A

lesions that are FLUSH WITH SKIN;

eg. macule and patch

33
Q

what is a “flat, non palpable lesion smaller than 1 cm”

34
Q

what is a “flat, non-palpable lesion LARGER THAN 1 CM”?

A

Patch

(aka macule > 1 cm)

35
Q

what is: a “circumscribed, solid elevations with NO visible fluid from a pinhead size to 1cm”

A

PAPULE,

an elevated lesion < 1 cm

36
Q

what is a “circumscribed, solid elevation with NO visible fluid that is LARGER THAN 1 CM in diameter”?

A

nodule,

elevation; aka papule > 1 cm

37
Q

what is the following derm condition?

A

“TOASTED SKIN SYNDROME”;

  • Multiple macules, with both hypopigmentation and hyperpigmentation
  • From infrared radiation
38
Q

what is: “an elevated mass 2cm or more in diameter”

39
Q

what is: “an elevated confluence of papules or a broad papule, 1cm or more in diameter”

A

plaque;

(more geographic than dome shaped)

40
Q

what is: “edematous elevations of various sizes that DO NOT last more than 24 hours”

A

wheals or hives;

these are not permanent; “when doing an injection, raise a wheal”

41
Q

which skin elevation involves “dermal hardening and thickening”?

A

INDURATION

42
Q

define: heat urticaria

A

hives after exercising

43
Q

what is: a “circumscribed fluid-filled elevations 1mm to 1cm in size, can be serous, purulent, sero-sanguinous filled”

A

VESICLE, or small blister

44
Q

what is a: “circumscribed fluid filled elevations LARGER THAN 1 CM in size, can be serous, purulent, sero-sanguinous filled”

A

Bulla, or big blister

45
Q

what is: a “circumscribed fluid filled elevations 1mm to 1cm in size, with purulent material in them”

*does not have to be a sign of infection, does not have to be bacteria-filled

A

PUSTULE;

aka a vesicle w/ purulent material

46
Q

what is: “dry or greasy skin flakes”?

47
Q

what is: “a horny projection from skin** (**calluses and warts)”

48
Q

what is: “a heap of dried plasma, WBC, RBC”

A

CRUST,

(crust = scab, if dried fluid)

49
Q

what is “tissue necrosis”?

what is “dried fluid”>

A
  • ESCHAR is tissue necrosis (right)
  • CRUST is dried fluid (left)
50
Q

what is: “a depression below skin level; loss of part or all EPIDERMIS (burn)”

A

EROSION

(there is NO SCAR with loss of epidermis)

51
Q

what is: “a depression below the skin level with LOSS OF EPIDERMIS AND PART DERMIS”

A

ULCER:

  • If you lose part of dermis, you will scar
52
Q

what are the 3 types of skin openings?

(meaning there’s a break WITHOUT LOSS OF EPIDERMIS)

A
  • fissure
  • burrow
  • cyst
53
Q

what is: “an opening in which a linear cleft through the epidermis which may go into the dermis (think chapped lips)”

54
Q

what is: “an opening with narrow, elevated tortuous tunnel produced by a parasite”

A

BURROW;

such as from CLM (cutaneous larva migrans)

55
Q

what is: “an opening, circumscribed lesion with a wall AND a lumen, may contain fluid or solid matter”

A

CYST

  • Elevations that have lumen (opening) and also a wall
  • Usually start as ingrown hair or some foreign body
  • Have to remove wall by excising it to fully remove it
56
Q

what is: “a punctate or linear abrasion produced by mechanical means usually to epidermis”

A

EXCORIATION

57
Q

what is: “an appearance of surface softening due to constant wetting”

A

MACERATION

58
Q

what is: “flat topped thickening of skin induced by scratching, skin lines are accentuated”

A

LICHENIFICATION

59
Q

what is: “a depression in the skin resulting from thinning of the epidermis or dermis”

60
Q

what is: “dilated superficial blood vessels, blanch with pressure”

A

TELANGIECTASIA

61
Q

what is: “greater than 5mm, less than 1cm.

Do not blanch with pressure**, **extravasation of blood cells into dermis”

62
Q

what is: “less than 5mm.** **Do not bland with pressure**, **extravasation of blood cells into dermis”

63
Q

what are the 3 zones of a target lesion?

A
  • bull’s eye dark center,
  • pale zone,
  • rim of erythema (most common is erythema multiforme)
64
Q

what are the differences between a hypertrophic scar and a keloid scar?

Y2 - Derm (7 decks)

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