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DERMA > APPROACH TO PATIENT > Flashcards

APPROACH TO PATIENT Flashcards

1
Q

How the condition has spread or developed over time

A

EVOLUTION

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2
Q

constant, waxing and waning,
worst at night, worst in winter

A

PERIODICITY

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3
Q

if the lesion of the patient with pimple, its in the mid
to lower face, probably

A

PCOS

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4
Q

medical conditions associated with skin
disease

A

diabetes
renal and hepatic disease
infection with HIV or hepatitis viruses
polycystic ovarian
syndrom
lupus
thyroid disease
skin disease (asthma, allergies)

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5
Q

solid, elevated lesion less than 0.5 cm in size in which a significant portion projects above the plane of the surrounding skin

A

PAPULE

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6
Q

Papules surmounted with scale

A

papulosquamous lesions

ex. Lichen planus

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7
Q

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

A

PLAQUE

ex. psoriasis

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8
Q

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

A

NODULE
ex. nodular basal cell
carcinoma.

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9
Q

Different surfaces of nodules:

A

smooth, keratotic,
ulcerated, or fungating

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10
Q

also sometimes included under the heading of
nodule, is a general term for any mass, benign or malignant.

A

Tumor

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11
Q

the granulomatous nodular lesion
of tertiary syphilis.

A

gumma

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12
Q

a nodule that is ulcerated and bleeding, you have to think of

A

basal cell carcinoma

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13
Q

If nodule is fungating, most likely it’s

A

a verruca vulgaris (or warts)

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14
Q

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

A

CYST

Can be hard, doughy, fluctuant
hidradenoma.

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15
Q

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

A

WHEAL

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16
Q

other name of wheal

A

also known as hives or urticaria,.

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17
Q

the result of edema produced by the escape of plasma through vessel walls in the upper portion of the dermis

A

hives or urticaria

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18
Q

evanescent or disappearing for less than
24 hours.

A

Wheal

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19
Q

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

A

Angioedema

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20
Q

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

A

SCAR

if it only involves the epidermis, then it will not
result to scarring and will just result to hypo- or
hyper-pigmentation.

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21
Q

typically take the form of firm papules,
plaques, or nodules. This will not exceed the wounding area.

A

Hypertrophic scars

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22
Q

exceed the area of initial wounding

A

Keloids

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23
Q

thin depressed plaques

A

Atrophic scars

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24
Q

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

A

comedo

Are the non-inflammatory lesions in acne vulgaris.

Inflammatory lesions of acne vulgaris are the
cysts, cystic acne, papules, pustules, etc.

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25
Q

When the pilosebaceous unit is open to the
surface of the skin with a visible keratinaceous
plug.

A

OPEN COMEDO / BLACKHEAD

The black color of the comedo is due to the oxidized sebaceous content of the infundibulum (“blackhead”).

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26
Q

the follicular opening is unapparent accumulates whitish keratin

A

CLOSED COMEDO (WHITEHEAD

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27
Q

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

A

HORN

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28
Q

A clinical example is verruca vulgaris.

A

HORN

or in layman’s term: filiform wart

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29
Q

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.

A

CALCINOSIS

ex. scleroderma.
A clinical example is cutaneous calcinosis in
dermatomyositis.

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30
Q

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

Does not involve the dermis

do not scar unless infected

ex. TEN

A

EROSION

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31
Q

layer of the dermis that is thicker, where collagen is found.
Other structures are blood vessels, nerves, and elastin.

A

Reticular dermis

32
Q

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

Breach of the dermis and destruction of adnexal structures impede reepithelialization, and the defect heals with scarring.

A

ULCERS

  • A clinical example is pyoderma gangrenosum.
33
Q

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

A

ATROPHY

34
Q

An atrophic ____ is glossy, almost transparent, paper thin and wrinkled, and may not retain normal skin lines.

Atrophy of the ____ manifests as a depression of the skin

A
  • epidermis
  • papillary or reticular dermal connective tissue
35
Q

pepper-and-salt/ salt-and-pepper
appearance of the skin.

A

POIKILODERMA

36
Q

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

A

POIKILODERMA

  • A clinical example is chronic radiodermatitis.
37
Q

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

A

SINUS

hidradenitis suppurativa.

38
Q

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.

A

STRIAE

39
Q

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

A

BURROW

40
Q

Refers to a circumscribed or diffuse hardening or induration of the skin that results from dermal fibrosis. It is detected more easily by palpation, on which the skin may feel board like, immobile, and difficult to pick up.

A

SCLEROSIS

A clinical example is
morphea.

41
Q

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

MACULE

A clinical example
is lentigo.

42
Q

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.

A

PATCH

Clinical examples include vitiligo.

43
Q

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

ERYTHEMA

A clinical
example is fixed drug eruption.

44
Q

Is a generalized deep redness of the skin involving more than 90% of the body surface within days to weeks.

A

ERYTHRODERMA

A clinical example is Sezary syndrome

45
Q

Is flat plate or flake arising from the outermost layer of the stratum corneum.

Groups of coherent cornified cells packed
with filamentous proteins desquamate in scales.

A

SCALE, DESQUAMATION (SCALING)

A clinical
example is psoriasis vulgaris

46
Q

What is involve in the scale what layer of the skin is involved?

A

Stratum corneum (outermost layer)

47
Q

increased transition of keratinocytes from the stratum basale to stratum corneum

A

Psoriasis vulgaris

48
Q

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

A

HYPERKERATOSIS

49
Q

Are hardened deposits that result when serum, blood, or purulent exudate dries on the surface of the skin. The color of crust is a
* yellow-brown when formed from dried serous secretion;
* turbid yellowish green when formed from purulent secretion; and
* reddish-black when formed from hemorrhagic secretion

A

CRUSTS (ENCRUSTED EXUDATES)

50
Q

Are surface excavations of epidermis that result from scratching

A

EXCORIATIONS

No involvement of dermis → it will not produce scarring.

51
Q

Is a linear of continuity of the skin’s surface or mucosa that results from excessive tension or decreased elasticity of the involved tissue.

A

FISSURE

52
Q

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

A

LICHENIFICATION

A clinical example is lichen simplex chronicus

53
Q

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).

A

KERATODERMA

clinical example is plantar keratoderma in
psoriasis

-tenia pedis is a consideration

54
Q

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.

A

ESCHAR

A clinical example is thermal burn.

55
Q

a fluid-filled cavity or elevation smaller than
or equal to 0.5 cm

A

vesicle

  • Vesicles and bullae arise from cleavage at various levels of
    the epidermis (intraepidermal) or of the dermal–epidermal
    interface (subepidermal).

ex. blistering aspect of impetigo.

56
Q

measures larger than 0.5 cm;
tense or flaccid weepy blisters

A

A bulla (blister)

A clinical example of bulla is a
bullous pemphigoid.

  • FLACCID, the evolvement or the split of
    the skin is superficial, so its intraepidermal involvement.
  • TENSE blisters, it’s more of the lower layers, it’s subepidermal.
57
Q

Is a circumscribed, raised cavity containing pus.
The purulent exudate, composed of leukocytes with or without cellular debris, may contain bacteria or may be sterile.

A

PUSTULES

clinical example is superficial pyoderma

58
Q

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

A

furuncle

59
Q

Several furuncles may coalesce to form a
____

A

carbuncle

60
Q

is 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.

is a pink erythematous, warm, tender, fluctuant nodule

A

abscess

61
Q

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

A

PURPURA

62
Q

The application of pressure with two glass slides

A

diascopy

  • The application of pressure with two glass slides
    (diascopy) on a reddish-purple lesion is a simple and
    reliable method for differentiating redness due to vascular
    dilatation (erythema) from redness due to extravasated erythrocytes (purpura).
  • If the redness is non blanching
    under the pressure of the slide, the lesion is purpuric
63
Q

are small, pinpoint purpuric macules.

A

Petechiae

64
Q

larger, bruise-like purpuric patches.

These lesions correspond to a noninflammatory
extravasation of blood.

A

Ecchymoses

65
Q

Are persistent dilatations of small capillaries in the superficial dermis that are visible as fine, bright, non pulsatile red lines or netlike patterns on the skin

A

TELANGIECTASIA

66
Q

Is an area of cutaneous necrosis resulting from a bland or inflammatory occlusion of blood vessels in the skin.

A

INFARCT

A clinical example is cholesterol emboli

67
Q

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

A

ANNULAR

68
Q

Coin-shaped; usually round to oval lesion with
uniform morphology from the edges to the center

A

ROUND/NUMMULAR/DISCOID

69
Q

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

A

POLYCYCLIC

70
Q

Arc-shaped; often a result of incomplete formation of an annular lesion (e.g. urticaria, subcutaneous lupus erythematosus)

A

ARCUATE

71
Q

Resembling a straight line; often implies an
external contactant or Koebner phenomenon has occurred in response to scratching

A

LINEAR

72
Q

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)

A

RETICULAR

73
Q

Serpentine or snake-like (e.g. cutaneous larva
migrans, in which the larva migrates this way and
that through the skin in a wandering pattern

A

SERPIGINOUS

74
Q

o Target-like, with at least three distinct$ zones (e.g.
erythema multiforme)

A

TARGETOID

75
Q

Like marble cake, with two distinct colors
interspersed in a wavy pattern; usually seen in
mosaic disorders in which cells of differing
genotypes are interspersed

A

WHORLED

(e.g. incontinentia pigmenti, hypomelanosis of Ito, linear and whorled nevoid hypermelanosis)

76
Q

Lesions clustered together (e.g. classic example is
her[es simplex virus 1)

A
  • Grouped/herpetiform
77
Q

o Irregularly distributed

A

Scattered

DERMA (1 decks)

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