2: History and Physical - Mahoney Flashcards
four general characteristics of skin lesions
TADS type arrangement distribution shape
define primary lesion vs secondary lesion
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
define macule
flat, colored lesion
freckle
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
define patch
large, > 0.5 cm flat lesion with a color different from the surrounding skin (i.e., large macule)
port-wine stain
patch
Examples: port-wine stain, tattoo (not the art kind), infections, drug eruptions
define papule
solid lesion,
wart
papule
other examples: wart, nevi, drug eruption, insect bite
define nodule
solid, firm lesion 0.5 to 1.0 cm in diameter raised above the surface of the skin (i.e., large papule)
lipoma
nodule
other examples: lipoma, fibroma, keratinous cyst, erythema nodosum, neoplasm
define tumor
solid, firm lesion > 1 cm above the surface of the skin
define plaque
flat-topped raised lesion > 1 cm with distinct edges (psoriasis) or gradually blend with surrounding skin (eczema)-coalescence of papules
define vesicle
fluid-filled lesion,
tinea pedis
vesicle
other Example: acute tinea, allergic contact dermatitis
turbid
- presence of neutrophil, not signify inection
define bulla
fluid-filled raised, translucent lesion > 0.5 cm
ex: friction blister, bullous pemphigoid, bullosis diabeticorum
name example... bullous pemphigoid impetigo friction blister contact derm and acuter T. pedis
subepidermal-bullous pemphigoid subcorneal-impetigo
subgranular cell layer-friction blister
spongiotic-contact derm and acute T. pedis (intercellular edema in epidermis)
Colleges Like Good Stron Beer
layers of skin vessels
define pustule
a vesicle filled with leukocytes or pus
pimple
pustule
define abscess
pus-filled lesion > 0.5 cm (large vesicle)-usually indicates infection
ex: paronychia
define cyst and how it is formed
raised, encapsulated lesion
- Originates from invagination of epidermis into dermis
- Process continues until lesion detaches from epidermis and becomes completely lined by epidermis
define wheal
raised, erythematous papule or plaque, usually representing short-lived dermal edema
examples of wheal
allergic reaction to drugs, insect bites, sensitivity to cold, heat, pressure, sunlight
define angioneurotic edema
larger localized area of edema
define telangiectasia
TELANGIECTASIA: dilated, superficial blood vessel
example of telagiectasia
scleroderma, long-term topical steroid therapy, necrobiosis lipoidica diabeticorum
long term effects of topical steroids
- skin atrophy
- telangiectasia
example verruca
papilloma [upward proliferation of dermal papillae}
general term referring to extravasated blood
purpura
- can also be considered a macule
area of massive bleeding into the skin and underlying tissues
hematoma
small circumscribed punctate foci of extravasation
Petechia
- ecchymosis is a larger confluent area of extravasation
A lesion that is 7mm in diameter and is flat and non-palpable is called a
patch
The bulla of tinea pedis is most often associated with
spongiotic blistering
define lichenification
distinctive, thickening of skin characterized by accentuated skin-fold markings and feels thick and firm on palpation
secondary skin lesion
Example: lichen simplex chronicus
dried exudate of body fluids that may be either yellow (serous) or red (hemorrhagic)
crust
ex: acute tinea pedis
loss of epidermis without an associated loss of dermis
erosion
Example: pemphigus, herpes viruses
loss of epidermis and at least a portion of the underlying dermis
ulcer
ex: diabetic neurotrophic ulcer
loss of epidermis and at least a portion of the underlying dermis
excoriation
ex: venous stasis ulcer
acquired loss of substance which may appear as a depression with intact epidermis or as a site of shiny, delicate, wrinkled lesions
atrophy
ex: topical steroid use, atrophie blanche
white area within larger area of venous stasis
atrophie blanche
what is a scar?
change secondary to trauma or inflammation-may be erythematous, hypopigmented, or hypertrophic
ex: keloid
All of these are examples of a secondary skin lesion, EXCEPT
- scar
- nodule
- ulcer
- excoriation
- atrophy
nodule
linear arrangement
poison ivy or Koebner phenomenon (pts with psoriasis - draw on pt, form rxn)
annular vs. iris/target
Annular: round or circular with central clearing (T. pedis)
Iris (target): bull’s eye lesion, annular with central internal activity zone (erythema multiforme)
steven-johnson syndrome
early stages see target lesions
serpiginous
meandering
ex: cutanea larva migrans
cleavage plane
arranged along lines of tension
children don’t get tinea, children more likely get …
eczema
ask for hx of allergy
