2: History and Physical - Mahoney

Question 1

four general characteristics of skin lesions

Answer 1

TADS
type
arrangement
distribution
shape

Question 2

define primary lesion vs secondary lesion

Answer 2

Primary lesion: physical changes in the skin caused directly by the disease process-types of primary lesions are rarely associated with a single disease entity

Secondary lesions: may arise from primary lesions or from external causes

Question 3

define macule

Answer 3

flat, colored lesion

Question 4

freckle

Answer 4

macule

other examples: freckle, flat mole, rashes of rickettsial infections, measles, allergic drug eruptions, vitiligo (white), talon noir (black), café-au-lait (brown), hemosiderin, purpura

Question 5

define patch

Answer 5

large, > 0.5 cm flat lesion with a color different from the surrounding skin (i.e., large macule)

Question 6

port-wine stain

Answer 6

patch

Examples: port-wine stain, tattoo (not the art kind), infections, drug eruptions

Question 7

define papule

Answer 7

solid lesion,

Question 8

wart

Answer 8

papule

other examples: wart, nevi, drug eruption, insect bite

Question 9

define nodule

Answer 9

solid, firm lesion 0.5 to 1.0 cm in diameter raised above the surface of the skin (i.e., large papule)

Question 10

lipoma

Answer 10

nodule

other examples: lipoma, fibroma, keratinous cyst, erythema nodosum, neoplasm

Question 11

define tumor

Answer 11

solid, firm lesion > 1 cm above the surface of the skin

Question 12

define plaque

Answer 12

flat-topped raised lesion > 1 cm with distinct edges (psoriasis) or gradually blend with surrounding skin (eczema)-coalescence of papules

Question 13

define vesicle

Answer 13

fluid-filled lesion,

Question 14

tinea pedis

Answer 14

vesicle

other Example: acute tinea, allergic contact dermatitis

Question 15

turbid

Answer 15

• presence of neutrophil, not signify inection

Question 16

define bulla

Answer 16

fluid-filled raised, translucent lesion > 0.5 cm

ex: friction blister, bullous pemphigoid, bullosis diabeticorum

Question 17

name example...
bullous pemphigoid
impetigo
friction blister
contact derm and acuter T. pedis

Answer 17

subepidermal-bullous pemphigoid subcorneal-impetigo

subgranular cell layer-friction blister

spongiotic-contact derm and acute T. pedis (intercellular edema in epidermis)

Question 18

Colleges Like Good Stron Beer

Answer 18

layers of skin vessels

Question 19

define pustule

Answer 19

a vesicle filled with leukocytes or pus

Question 20

pimple

Answer 20

pustule

Question 21

define abscess

Answer 21

pus-filled lesion > 0.5 cm (large vesicle)-usually indicates infection

ex: paronychia

Question 22

define cyst and how it is formed

Answer 22

raised, encapsulated lesion

• • Originates from invagination of epidermis into dermis
• • Process continues until lesion detaches from epidermis and becomes completely lined by epidermis

Question 23

define wheal

Answer 23

raised, erythematous papule or plaque, usually representing short-lived dermal edema

Question 24

examples of wheal

Answer 24

allergic reaction to drugs, insect bites, sensitivity to cold, heat, pressure, sunlight

Question 25

define angioneurotic edema

Answer 25

larger localized area of edema

Question 26

define telangiectasia

Answer 26

TELANGIECTASIA: dilated, superficial blood vessel

Question 27

example of telagiectasia

Answer 27

scleroderma, long-term topical steroid therapy, necrobiosis lipoidica diabeticorum

Question 28

long term effects of topical steroids

Answer 28

- skin atrophy | - telangiectasia

Question 29

example verruca

Answer 29

papilloma [upward proliferation of dermal papillae}

Question 30

general term referring to extravasated blood

Answer 30

purpura | - can also be considered a macule

Question 31

area of massive bleeding into the skin and underlying tissues

Answer 31

hematoma

Question 32

small circumscribed punctate foci of extravasation

Answer 32

Petechia - ecchymosis is a larger confluent area of extravasation

Question 33

A lesion that is 7mm in diameter and is flat and non-palpable is called a

Answer 33

patch

Question 34

The bulla of tinea pedis is most often associated with

Answer 34

spongiotic blistering

Question 35

define lichenification

Answer 35

distinctive, thickening of skin characterized by accentuated skin-fold markings and feels thick and firm on palpation secondary skin lesion Example: lichen simplex chronicus

Question 36

dried exudate of body fluids that may be either yellow (serous) or red (hemorrhagic)

Answer 36

crust ex: acute tinea pedis

Question 37

loss of epidermis without an associated loss of dermis

Answer 37

erosion Example: pemphigus, herpes viruses

Question 38

loss of epidermis and at least a portion of the underlying dermis

Answer 38

ulcer ex: diabetic neurotrophic ulcer

Question 39

loss of epidermis and at least a portion of the underlying dermis

Answer 39

excoriation ex: venous stasis ulcer

Question 40

acquired loss of substance which may appear as a depression with intact epidermis or as a site of shiny, delicate, wrinkled lesions

Answer 40

atrophy ex: topical steroid use, atrophie blanche

Question 41

white area within larger area of venous stasis

Answer 41

atrophie blanche

Question 42

what is a scar?

Answer 42

change secondary to trauma or inflammation-may be erythematous, hypopigmented, or hypertrophic ex: keloid

Question 43

All of these are examples of a secondary skin lesion, EXCEPT - scar - nodule - ulcer - excoriation - atrophy

Answer 43

nodule

Question 44

linear arrangement

Answer 44

poison ivy or Koebner phenomenon (pts with psoriasis - draw on pt, form rxn)

Question 45

annular vs. iris/target

Answer 45

Annular: round or circular with central clearing (T. pedis) Iris (target): bull’s eye lesion, annular with central internal activity zone (erythema multiforme)

Question 46

steven-johnson syndrome

Answer 46

early stages see target lesions

Question 47

serpiginous

Answer 47

meandering | ex: cutanea larva migrans

Question 48

cleavage plane

Answer 48

arranged along lines of tension

Question 49

children don't get tinea, children more likely get ...

Answer 49

eczema | ask for hx of allergy