Approach To Dermatologic Diagnosis

Question 1

solid, elevated lesion less than 0.5 cm in size

Answer 1

Papule

Question 2

Example of Papule

Answer 2

Lichen Planus

Question 3

solid plateau-like elevation that occupies a relatively large surface area in comparison with its height above the normal skin level and has a diameter larger than 0.5 cm

Answer 3

Plaque

Question 4

Example of plaque

Answer 4

Psoriasis

Question 5

solid, round or ellipsoidal, palpable lesion that has a
diameter larger than 0.5 cm

Answer 5

Nodule

Question 6

the granulomatous nodular lesion of tertiary syphilis

Answer 6

Gumma

Question 7

an encapsulated cavity or sac lined with a true epithelium that contains fluid or semisolid material

Answer 7

Cyst

Question 8

Its spherical or oval shape results from the tendency of the contents to spread
equally in all directions

Answer 8

Cyst

Question 9

a swelling of the skin that is characteristically evanescent, disappearing within hours.

Answer 9

Wheal
Aka. Hives/ urticaria

Question 10

These lesions, also known as hives or urticaria, are the result of edema produced by the escape of plasma through vessel walls in the upper portion of the dermis.

Answer 10

Wheal

Question 11

How to manage chronic urticaria?

Answer 11

• manage w/o steroids, only anti histamine
• chronic is 6 weeks

Question 12

a deeper, edematous reaction that occurs in areas with very loose dermis and subcutaneous tissue such as the lip, eyelid, or scrotum.

Answer 12

Angioedema

Question 13

arises from proliferation of fibrous tissue that replaces previously normal collagen after a wound or ulceration breaches the reticular dermis

Answer 13

Scar

Question 14

Keloid vs. Atrophic scars

Answer 14

Keloids exceed the area of initial wounding.

Atrophic scars are thin depressed plaques.

Question 15

a hair follicle infundibulum that is dilated and plugged by keratin and lipids

Answer 15

Comedo

Question 16

a hyperkeratotic conical mass of cornified cells arising over an abnormally differentiating epidermis

Answer 16

Horn

Question 17

Example of Jorn

Answer 17

Verruca vulgaris

Question 18

deposits of calcium in the dermis or subcutaneous tissue may be appreciated as hard, whitish nodules or plaques, with or without visible alteration of the skin’s surface

Answer 18

Calcinosis

Question 19

is a moist, circumscribed, depressed lesion that results from loss of a portion or all of the viable epidermal or mucosal epithelium.

Answer 19

Erosion

Question 20

Erosion vs. Ulcer

Answer 20

Erosion - superficial, not reach dermis

Ulcer - reach dermis

Question 21

is a defect in which the epidermis and at least the upper (papillary)
dermis have been destroyed

Answer 21

Ulcer

Question 22

refers to a diminution in the size of a cell, tissue, organ, or part of the body.

Answer 22

Atrophy

Question 23

refers to the combination of atrophy, telangiectasia, and varied pigmentary changes (hyper- and hypo-) over an area of skin.

Answer 23

Poikiloderma

Question 24

Example of poikiloderma

Answer 24

Chronic radiodermatitis

Question 25

a tract connecting deep suppurative cavities to each other or to the surface of the skin

Answer 25

Sinus

Question 26

Example of sinus

Answer 26

Hidradenitis suppurativa

Question 27

are linear depressions of the skin that usually measure several centimeters in length and result from changes to the reticular collagen that occur with rapid stretching of the skin

Answer 27

Striae

Question 28

a wavy, threadlike tunnel through the outer portion of the epidermis excavated by a parasite

Answer 28

Burrow

Question 29

Refers to a circumscribed or diffuse hardening or induration of the skin that results from dermal fibrosis

Answer 29

Sclerosis

Question 30

is flat, even with the surface level of surrounding skin, and perceptible only as an area of color different from the surrounding skin or mucous membrane. A clinical example is lentigo.

Answer 30

Macule

Question 31

it is a flat area of skin or mucous membranes with a different color from its surrounding. It is larger than 0.5 cm, and it may have a fine, very thin scale. Clinical examples include vitiligo.

Answer 31

Patch

Question 32

represents the blanchable pink to red color of skin or mucous membrane that is due to dilatation of arteries and veins in the papillary and reticular dermis. A clinical example is fixed drug eruption.

Answer 32

Erythema

Question 33

a generalized deep redness of the skin involving more than 90% of the body surface within days to weeks. A clinical example is Sézary syndrome.

Answer 33

Erythroderma

Question 34

refers to an excessive or thickened stratum corneum, often but not always scaly

Answer 34

Hyperkeratosis

Question 35

are hardened deposits that result when serum, blood, or purulent exudate dries on the surface of the skin.

Answer 35

Crusts (encrusted exudates)

Question 36

are surface excavations of epidermis that result from scratching.

Answer 36

Excoriations

Question 37

Repeated rubbing of the skin may induce a reactive thickening of the epidermis. These changes produce a thickened skin with accentuated markings, which may resemble tree bark.

Answer 37

Lichenification A clinical example is lichen simplex chronicus.

Question 38

an excessive accumulation of scale (hyperkeratosis) that results in a yellowish thickening of the skin, usually on the palms or soles, that may be inherited (abnormal keratin formation) or acquired (mechanical stimulation).

Answer 38

Keratoderma

Question 39

Implies tissue necrosis, infarction, deep burns, gangrene, or other ulcerating process. It is a circumscribed, adherent, hard, black crust on the surface of the skin that is moist initially, protein rich, and avascular.

Answer 39

Eschar

Question 40

A __ is a fluid-filled cavity or elevation smaller than or equal to 0.5 cm, whereas a __ measures larger than 0.5 cm

Answer 40

A vesicle is a fluid-filled cavity or elevation smaller than or equal to 0.5 cm, whereas a bulla (blister) measures larger than 0.5 cm. Bullae are tense or flaccid weepy blisters.

Question 41

a circumscribed, raised cavity containing pus. Example: superficial pyoderma

Answer 41

Pustule

Question 42

a deep necrotizing folliculitis with suppuration. It presents as an inflamed follicle-centered nodule usually greater than 1 cm with a central necrotic plug and an overlying pustule.

Answer 42

Furuncle Several furuncles may coalesce to form a carbuncle.

Question 43

a localized accumulation of purulent material so deep in the dermis or subcutaneous tissue that the pus is usually not visible on the surface of the skin.

Answer 43

Abscess

Question 44

Extravasation of red blood from cutaneous vessels into skin or mucous membranes results in reddish-purple lesions.

Answer 44

Purpura

Question 45

__ are small, pinpoint purpuric macules. __ are larger, bruise-like purpuric patches.

Answer 45

Petechiae are small, pinpoint purpuric macules. Ecchymoses are larger, bruise-like purpuric patches.

Question 46

an area of cutaneous necrosis resulting from a bland or inflammatory occlusion of blood vessels in the skin. A clinical example is cholesterol emboli.

Answer 46

Infarct

Question 47

Ring-shaped; implies that the edge of the lesion differs from the center, either by being raised, scaly, or differing in color (e.g., granuloma annulare, tinea corporis, erythema annulare centrifugum).

Answer 47

Annular

Question 48

Coin-shaped; usually a round to oval lesion with uniform morphology from the edges to the center (e.g., nummular eczema, plaque-type psoriasis, discoid lupus).

Answer 48

Round/nummular/discoid

Question 49

Formed from coalescing circles, rings, or incomplete rings (e.g., urticaria, subacute cutaneous lupus erythematosus).

Answer 49

Polycyclic

Question 50

Net-like or lacy in appearance, with somewhat regularly spaced rings or partial rings and sparing of intervening skin (e.g., livedo reticularis, cutis marmorata).

Answer 50

Reticular