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2 Dermatology Flashcards

(63 cards)

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1
Q

Functions of epidermis?

A
  • barrier from environment

- waterproofing

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2
Q

What is in the dermis?

A
  • blood vessels
  • hair follicles
  • sebaceous glands
  • sweat glands
  • nails
  • apocrine glands
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3
Q

What is in the subcutaneous (hypodermis)?

A

-subcutaneous fat and connective tissue

conserves heat

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4
Q

What are the layers of epidermis?

A

“can lucy get some balm”

  • Stratum corneum: superficial with shedding dead skin
  • Stratum lucidum: layer found on palmar and plantar surface
  • Stratum granulosum: keritinization
  • Stratum spinosum: spiny-chaped cells (strength/flexible)
  • Stratum basale: cells germinate: keratinocytes
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5
Q

What are the 4 types of cells within the epidermis?

A
  • keratinocytes
  • melanocytes
  • merkel cells
  • langerhans cells
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6
Q

what are 3 layers of dermis?

A

-papillary dermis
superficial dermis
comprised of a loose network of collagen buncles
-reticular dermis
deep dermis
comprised of densely packed and thick collagen bundles
-ground substance

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7
Q

What is the function of eccrine glands and where?

A
  • produce sweat
  • cover most of the body
  • abundant on palms, soles and forehead
  • release salt and water to keep body cool
  • does not cause odor (does when mixed with bacteria on skin surface)
  • Duct opens in pore at skin’s SURFACE
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8
Q

What is the function of apocrine glands and where?

A

-produce thick clear odorless fluid (unless bacteria on surface breat them down and make odor)
-concentrated in axillary and genital regions
-Secretes into the SAC of hair follicle
-triggered by nervous system:
stress, exercise, hormones, emotion

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9
Q

What are two types of hairs and what is the bulb?

A

-vellus hairs: short and fine (forehead)
-Terminal hairs: long and thick (scalp/axillae)
-Bulb: enlargement at the base of follicle
matrix cells at inferior aspect of bulb
melanocytes within matrix contribute to pigment

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10
Q

What are morphologic characteristics of skin leasons?

A
  • distribution
  • shape/arrangement
  • border/margin
  • pigmentation/color
  • palpation
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11
Q

Distribution- what does localized mean?

A

lesions appear in one small area

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12
Q

Distribution- what does regional mean?

A

lesions appear in a specific region of the body

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13
Q

Distribution- what does generalized/disseminated mean?

A

lesions appear widely distributed or in multiple areas simultaneously

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14
Q

What is common with distribution of flexors?

A

atopic eczema

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15
Q

What is common with distribution of extensors and scalp?

A

psoriasis

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16
Q

What is common with seborrhoeic distribution?

A

seborrhoeic dermatitis on scalp and upper chest

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17
Q

What is common with sun-exposed sites?

A

light sensitive disorders

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18
Q

What does morbilliform shape mean?

A
  • measles-like

- erythematous maculopapular lesions that become confluent on the face and body

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19
Q

What are the ABCDEs of melanoma?

A
  • A: asymmetry
  • B: borders (irregular)
  • C: color (variegated)
  • D: diameter
  • E: evolution or elevation
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20
Q

What is a macule?

A

-flat, non-palpable
*< 1 cm in diameter
-circumscribed color change
-ex. freckles (ephelides)
1

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21
Q

What is a patch?

A

-flat, non-palpable
-can have irregular shape
* > 1 cm in diameter
-often hypo or hyperpigmented
-ex. cafe au lait
1

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22
Q

What is a papule?

A

-Palpable, firm
*< 1 cm in diameter
-circumscribed
-can be flesh colored, red, brown
-may be confluent
-ex. seborrheic keratosis
1

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23
Q

What is a plaque?

A

-elevated
-firm
-palpable
* > 1 cm in diameter
-ex. psoriasis
1

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24
Q

What is a nodule?

A

-elevated
-circumscribed
*often > 1.5 cm in diameter
-deeper and firmer than papule
-can be compressible, soft, rubbery, or firm to palpation
-ex. epidermoid inclusion cyst
1

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25
What is a tumor?
-a large nodule -deeper in the dermis * > 2 cm in diameter -ex. lipoma (benign subcutaneous soft tissue tumor) 1
26
What is a wheal?
-irregular -transient: comes and goes -superficial edema -ex. hives (urticaria), mosquito bite 1
27
What is a vessicle?
-elevated -well circumscribed * < 1 cm in diameter -fluid-containing, usually clear -ex. chickenpox "dew drops on a rose petal" 1
28
What is a bulla?
-elevated -well circumscribed * > 1 cm diameter -filled with serous fluid -plural of bulla is bullae -ex. bullous pemphigoid 1
29
What is a pustule?
-elevated -superficial -well circumscribed -filled with pus -ex. folliculitis 1
30
What is a furuncle?
-infection of a SINGLE hair follicle -S. aureus -also called a boil 1
31
What is a carbuncle?
-infection of MULTIPLE hair follicles -S. aureus -an result from abscess 1
32
What is crust?
-dried residue of serum, pus, or blood on the surface -adherent -may include bacteria -ex. impetigo 2
33
What is scale?
-hyperkeratosis -accumulation of stratum corneum due to increased proliferation and/or delayed desquamation -ex. psoriasis (micaceous- silvery- scale) 2
34
What are fissures?
-linear cleft in skin -often painful -results from marked drying, skin thickening, and loss of elasticity -ex. cracks on hand in knuckles 2
35
What is erosion?
-partial, or sometimes complete. loss of the epidermis -moist, oozing, and/or crusted lesion -ex. pemphigus foliaceus 2
36
What is an ulcer?
-a deeper defect (compared to an erosion), with loss of at least the entire epidermis PLUS superficial dermis -may have loss of the entire dermis or even subcutis -ex. venous (stasis) ulcer 2
37
What is excoriation?
-exogenous injury to all or part of the epidermis -may be linear or rounded -usually due to scratching -ex. neurotic excoriations 2
38
What is atrophy?
-epidermal atrophy: thinning of the epidermis, leading to wrinkling and a shiny appearance -Dermal atrophy: loss of dermal collagen and/or elastin, leading to a depression -ex. striae (stretch marks) due to topical steroid use 2
39
What is lichenification?
-thickenig of the epidermis -increased visibility of skin markings -ex. lichen simplex chronicus 2
40
What is petechiae?
-deep red/purple-red lesions *< 0.5 cm -round -irregular *non-blanchable -variable distribution -represents blood outside of vessel -seen with infections and bleeding disorders V
41
What is purpura?
-deep red/purple-red lesions * >0.5 cm -round -irregular * non-blanchable -variable distribution -represents blood outside of vessel -seen with infections and bleeding disorders V
42
What is ecchymosis?
-aka bruising -purple lesions of variable size -fade to green, yellow, brown -round/oval -irregular borders -represents blood outside of vessels due to trauma or bleeding disorder V
43
What is a spider angioma?
-fiery red lesion -small in size (up to 2 cm) -central body with surrounding erythema and radiating legs *blanch with pressure -seen on face, neck, arms and upper trunk -usually develop in otherwise healthy women and children -seen with liver disease -pregnancy (often a normal finding) V
44
What is a cherry angioma?
-bright red papules -1-6 mm in size -can be flat or raised -non-pulsatile -usually seen on the trunk or upper extremities *non blanchable -associated with genetic and aging V
45
What are telangiectasias?
-permanently dilated superficial cutaneous blood vessels -red to blue-violet in color *blanchable -fine -irregular -seen with basal cell carcinomas, sun-damaged skin, rosacea V
46
What is hemangioma?
*benign vascular neoplasm that represents the most common tumor of infancy -red, irregular lesion seconary to dilation of dermal capillaries -starts as a macular patch, can progress to a plaque or nodule -spontaneously involutes by age 5-10 V
47
What does umbilicated mean?
rolled borders
48
What are 4 categories of skin disease?
- papulosquamous - nodular - vesiculobullous - maculopapular
49
What are papulosquamous lesions?
- papules, plaques and scales | - ex. psoriasis
50
What is lichen planus? hint the 5 P's
- pruriticy - polygonal - purple - planar - papules
51
What are nodular lesions?
-benign and malignant epidermal and dermal nodules -ex. of benign lesions nevi cherry angiomas epidermoid cysts -ex. of malignant lesions -squamous cell carcinoma isolated keratotic, eroded papule or nodule located in sun exposed areas -basal cell carcinoma pearly nodules in sun exposed areas associated with central ulcerations and telangiectasias -ask how long has it been there
52
What are vesiculobullous lesions?
- vesicles and bullae | - ex. impetigo, herpes, pemphigus
53
What are maculopapular lesions?
-macules and papules -ex. viral exanthems generalized, erythematous, macuopapular rash -drug eruptions
54
What is clubbing of the nail?
-rounded, bulbous nail base -feels spongy Diagnose by: -flex the fingers of both hands -bring index fingers together until distal phalanxes are touching -diamond space between nails indicates no clubbing Schamroth's window Schamroth's sign associated with lung cancer?
55
What are Beau's lines?
-transverse depressions secondary to trauma or acute illness -lines grow out with nail fingers take 6m toes take 1y
56
What is paronychia?
- inflammation of the proximal and lateral nail folds - accute < 6 weeks - chronic > 6 weeks
57
What is onychocryptosis?
- ingrown toenail - usually involving the large toe - very common - nail grows into the dermis - may have pain - can become infected
58
What are Terry's nails?
- mostly white with a distal band of reddish brown - characteristic "ground glass" appearance - without any lunula
59
What is leukonychia?
-trauma to nails causing areas of white discoloration
60
What is koilonychia?
- "spoon nail" - spoon shaped, concave nail - iron deficiency
61
What is onycholysis?
-painless separation of the nail plate from the nail bed
62
What is onychomycosis?
- fungal infection of the nail bed, plate or matrix | - common with increased age
63
What is nail pitting?
- small punctate depressions - caused by nail matrix inflammation - associated with hair loss

Physical Diagnosis (3 decks)

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