Basic Dermatology Flashcards
1
Q
Small, up to 1 cm. Non-palpable, flat, change in skin color.
A
Macule
2
Q
Larger than 1 cm. Non-palpable, flat, change in skin color.
A
Patch
3
Q
Up to 0.5 cm. Palpable, elevated solid mass.
A
Papule
4
Q
Palpable, elevated surface.
A
Plaque
5
Q
Palpable, solid mass. .05-2.0 cm, deeper, and firmer than palpule.
A
Nodule
6
Q
Palpable, solid mass. Larger than 2.0 cm.
A
Tumor
7
Q
Localized skin edema, irregular, transient, superficial, varies in size.
A
Wheal
8
Q
Superficial elevation, formed by fluid residing in a space between tissue layers. Up to 0.5 cm, filled with serous fluid.
A
Vesicle
9
Q
Vesicle > 0.5 cm, filled with serous fluid.
A
Bulla
10
Q
Superficial elevation, formed by purulent material residing in a space between tissue layers filled, varies in size.
A
Pustule
11
Q
Primary lesions
A
They are the FIRST to appear. Identification is the most important. May progress to secondary lesions via trauma, regression, or other factors.
12
Q
Secondary lesions
A
Lesions are usually depressed and manifest below the plane of the skin.
13
Q
What are examples of secondary lesions?
A
Scales, crusts, excoriations/abrasions, fissures, erosions, ulcers, and scars
14
Q
Eczema is an endogenous or exogenous disease? Dermatitis is an endogenous or exogenous disease?
A
Eczema = endogenous
Dermatitis = exogenous
15
Q
What is the clinical term for dry skin?
A
Xerosus
16
Q
Eczema and dermatitis involve what layers of the skin?
A
Epidermis and dermis
17
Q
Poorly defined red patches, papules, and plaques, with or without scales. Skin may be edematous with excoriation from scratching. Lichenification seen in chronic cases.
A
Eczema and dermatitis
18
Q
What is lichenification?
A
Thickening of the skin
19
Q
What is the clinical term for hives?
A
Urticaria
20
Q
If acute urticaria, what is it caused by? Chronic?
A
Acute: food, medications, exposure to allergens, or chemicals.
Chronic: lasts longer than 6 weeks
21
Q
Characterized by round, circumscribed, erythematous, dry scaling plaques, size varies, covered by silvery white scales. Often found on the scalp, nails, extensor surfaces of the extremities, elbows, knees, umbilical region, and sacral region.
A
Psoriasis
22
Q
What is the pathogenesis of psoriasis?
A
Alteration of the cell kinetics of keratinocytes. Cell cycle is reduced from 311 hours to 36 hours. Results in 28 times the normal production of epidermal cells.
23
Q
True or False: Psoriasis can be non-pustular or pustula.
A
True
24
Q
What joints are typically affected by psoriatic arthritis?
A
Interphalangeal joints, spine, and large joints.
25
What are the 4 types of Pyoderma Gangrenosum? Which is the most common?
Ulcerative, pustular, bullous, and vegetative. Ulcerative is most common form.
26
What is Pyoderma Gangrenosum caused by?
50% of cases are idiopathic. 50% are associated with systemic diseases such as Chron's, ulcerative colitis, chronic active hepatitis, lupus, etc.
27
How do lesions of Pyoderma Gangrenosum look initially? What happens to them with time?
Lesions begin as painful nodule or pustules surrounded by an erythematous halo. Rapidly ulcerate with purple or dusky red irregular wound margins, raised, undermined, boggy perforations that drain purulent exudate. Wound base is often hemorrhagic and partially covered with eschar.
28
Which dermatologic condition could be mistaken for a venous ulcer or pressure ulcer? What could be used from the patients subjective history to help us determine what it is?
Pyoderma Gangrenosum
If the patient reports having a systemic disease.
29
Commonly known as moles which appear in childhood and peak in young adulthood.
Nevi
30
What appearance of a Nevi would indicate that you should refer the patient back to their physician?
If it develops rapidly, changes in size or color, weep, bleed, or present with pruritis.
31
Mongolian Spots
Congenital blue-gray macular lesions.
32
Where are Mongolian Spots typically found?
Lumbosacral area
33
Do Mongolian Spots stay throughout life or do they disappear?
Disappear in early childhood
34
What population do Capillary Hemangiomas appear in?
Children at or soon after birth. Disappear at about the 5th year of life.
35
How are Capillary Hemangiomas described?
Soft, bright red to deep purple, vascular nodules or plaques.
36
Irregularly shaped, red, macular, vascular malformations of dermal blood vessels that are present at birth. They do not spontaneously resolve. Are found on the neck, forehead, near the nose, or eyelids. May worsen over lifetime.
Port-Wine Stains
37
Cherry Angiomas
Very common, asymptomatic, bright red, domed vascular lesions, typically found on the trunk; tiny, small, and benign. Typically seen in older patients.
38
What common benign neoplasms and hyperplasias are common in children?
Nevi, Mongolian Spots, Capillary Hemangiomas, and Port-Wine Stains
39
What common benign neoplasms and hyperplasias are common in older adults?
Cherry Angiomas, Seborrheic Keratosis, Skin Tags.
40
What is the most common benign epithelial tumor?
Seborrheic Keratosis
41
What benign tumor could be described as having a pedunculated look?
Seborrheic Keratosis
42
What can Skin Tags also be called?
Cutaneous papillomas or fibromas
43
What population typically has skin tags?
Older and obese patients
44
What are benign tumors of fatty tissue?
Lipomas
45
What benign tumors are soft, develop slowly, rounded, and can be moved beneath the overlying skin?
Lipomas
46
To help differentiate between a lipoma and metastatic tumors + malignant cysts, how will a patient present if they have the latter?
Associated pain, develop rapidly, and may present with ulcerations.
47
What benign tumor may be domed or depressed below the plane of surrounding skin?
Dermatofibromas
48
What is the "dimple sign" and what dermatologic condition is it associated with?
Lateral compression with the thumb and the index finger produces a dimpling effect with the lesion. It is associated with dermatofibromas.
49
What is the most common form of skin cancer?
Basal Cell Carcinoma
50
How should BCCs be treated?
Aggressively because they can extend wide and deep, and destroy skin, cartilage, and bone.
51
Majority of BCCs are found where on the skin?
Head, neck, and face (sun exposed areas).
52
What is the most common type of BCC?
Nodular ulcerative BCC
53
How does a BCC initially look?
Small, pink, or flesh-colored, smooth, translucent nodule that enlarges with time. The center of the lesion becomes depressed.
54
What can a nodular ulcerative BCC turn into?
Can become keratotic (horny), increases difficulty in distinguishing from normal aged skin.
55
How will a superficial BCC present?
Usually on the back or chest; difficult to assess, appear as other benign skin presentations; flat, nonpalpable, erythematous plaques; slowly enlarge; nodular margins; and telangiectatic base.
56
What is a malignant tumor of the outer epidermis?
Squamous Cell Carcinoma (SCC)
57
True or False: BCCs metastasize more readily than SCCs.
False. SCCs are more rapid than BCCs.
58
What are the two types of SCCs?
Intraepidermal: remains confined to epidermis, may eventually penetrate the dermis and metastasize to the regional lymph nodes (invasive).
Invasive: involves penetration into dermis and lymph nodes.
59
What skin cancer is keratotic, scaly, elevated lesions, has irregular borders, and shallow central ulcers?
SCCs
60
What skin cancer can often appear "meaty" due to hypergranulation?
SCCs
61
What is a rapidly progressing form of skin cancer that involves the melanocytes?
Malignant Melanoma
62
What is prognosis dependent upon for Malignant Melanoma?
Thickness of the tumor and the level of invasion into surrounding tissue.
63
True or False: Malignant Melanomas can appear anywhere on the body.
True
64
How does a Malignant Melanoma typically appear (colors)? What are the colors indicative of?
Surrounding area is typically red, inflamed, and tender due to inflammation. Dark melanomas are usually mottled with red, white, and blue hues, representing three current processes:
Red (inflammation)
White (scar tissue formation)
Blue (melanoma growth)
65
What are the four different types of melanoma?
Superficial spreading
Lentigo maligna
Nodular
Acral-lentiginous
66
Which type of Malignant Melanoma occurs almost exclusively on the face of older individuals who have had excessive exposure to the sun?
Lentigo maligna
67
Small pigmented tumors should be considered suspicious when some or all of the following are present:
Rapid growth over a few weeks or months; changes in pigmentation; inflamed, erythematous margin; weeping; crust formation; bleeding; pruritis.
68
What skin cancer is the malignancy of endothelial cells that line small blood vessels?
Kaposi's Sarcoma
69
Classic or European Kaposi's Sarcoma has what kind of characteristics?
Elderly males of eastern European heritage; LEs; lymph nodes and abdominal viscera affected; progresses slowly.
70
African-endemic Kaposi's Sarcoma has what kind of characteristics?
Non-HIV associated; four clinical patterns: nodular, florid or vegetating, infiltrative, and lymphadenopathic.
71
What are the 3 common pigmentary disorders?
Albinism, Vitiligo, and Melasma.
72
What is the pathophysiology of Albinism?
Normal number of melanocytes, but lack the enzyme, tyrosinase, necessary for synthesis of melanin.
73
What is the pathophysiology of Vitiligo?
Macular depigmentation (loss of melanocytes).
74
Vitiligo is more prevalent in people with...
Thyroid disease, pernicious anemia, and diabetes.
75
What pigment disorder involves acquired light or brown hyperpigmentation?
Melasma
76
What is Melasma associated with?
Exposure to sunlight, pregnancy, and oral contraceptives.
77
What are the two common systemic disorders that will cause integumentary issues?
Lupus erythematosus and scleroderma
78
What is Systemic Lupus Erythematosus (SLE)?
Serious progressive disease; mainly involves the internal organs. Seen primarily in young women. Butterfly rash on the face. Varying levels of malaise and fatigue. Cutaneous involvement in 80% of cases.
79
What is Discoid Lupus Erythematosus (DLE)?
Chronic dermatological disease. Organ involvement may last for months or years. Primarily involves the neck and face. Skin lesions are psoriasiform or annular.
80
Difference between skin lesions that are either psoriasiform or annular?
Psoriasiform: well demarcated and slight scaling, lead to bright red plaques.
Annular: bright red with minimal scaling, slight depression centrally.
81
What is Scleroderma?
Slow, progressive, incurable, multi-system disorder. Involves skin, internal organs. Skin and internal organs undergo inflammatory, vascular, and sclerotic changes. Skin appears hard, smooth, hypopigmented in areas that are immobile or bound down.
82
What is the percentage of people with Scleroderma who have Limited Systemic Scleroderma?
60%
83
What is the percentage of people with Scleroderma who have Diffuse Systemic Scleroderma?
40%
84
Which Scleroderma includes the CREST syndrome? What does it mean?
Limited Systemic Scleroderma
Calcinosis cutis (calcium deposits in the skin)
Raynaud's
Esophageal dysfunction
Sclerodactylia
Telangiectasia
85
Common skin disorders associated with Diabetes
Diabetic dermopathy
Bullous diabeticorum
Necrobiosis lipoidica diabeticorum
86
Characteristics of Diffuse Systemic Scleroderma.
Rapid onset
Diffuse involvement of hands, feet, trunk, and face
Present with synovitis, tenosynovitis, and early onset of internal involvement.
87
Adverse cutaneous drug involvement occurs in what patient population?
Hospitalized patients
88
What are the symptoms associated with adverse cutaneous drug involvement?
Transient, mild, pruritis, which resolves after the offending drug is discontinued.
89
What life-threatening diseases can adverse cutaneous drug involvement lead to?
TENS; Stevens-Johnson Syndrome; Erythema multiforme minor; and anaphylactic reactions.
90
What two medicines are typically used in wound care?
Sulfa-based (sulfonamides) and penicillin
91
What is an adverse effect of Penicillin?
Allergic reactions
92
What are the adverse effects of Sulfonamides?
Allergic reaction, GI distress, and photosensitivity.
93
What is the first line of defense against the environment and sources of infection?
Skin
94
What are the types of bacterial infections?
Impetigo
Ecthyma
Abscesses
Furuncles
Carbuncles
Cellulitis
95
Difference between Impetigo and Ecthyma?
Impetigo is a superficial infection of the epidermis while Ecthyma is an infection that extends into the dermis.
96
Impetigo is more common in what patient population?
Infants and children
97
Impetigo manifests as bullous or non-bullous; which one is more common and how will it present?
Bullous
Blistering with several days later, the blisters rupture, leaving crusted erosions that can last several days to weeks.
Typically occurs on exposed areas of the body, face, neck, extremities, and hands.
98
How does Ecythma present?
Yellow-green crust, into the dermis. Lesions begin as pustule or vesicle on erythematous base, developing into ulcers with crusting and a violaceous halo. Lesions may last weeks or months.
99
Abscess, Furuncle, and Carbuncle are usually caused by what bacteria?
Staph A.
100
How will an Abscess present?
May originate in the dermis, subcutaneous adipose, muscle, or deeper structures. Usually begins as a tender red nodule and with time, purulent material develops centrally.
101
How will a Furuncle present?
Firm tender nodules in dermis or subcutaneous tissue near hair follicles. Present with central necrotic plug filled with purulent material. Usually located on hair-bearing areas.
102
What is a Carbuncle and how will it present?
It is the deep extension of two or more coalescing furuncles. Red, tender, and indurated. Drain purulent material. Patient may experience malaise, fever, chills, and pain. Tend to recur.
103
Zoster or Shingles travel how?
Along a sensory nerve to skin and mucosal surfaces it innervates.
104
Dermatophytes are what type of organism and what do they have an affinity for?
Fungal organism
Affinity for epidermal keratin, stratum corneum, nails, and hair.
105
What kind of infection is Tinea Pedis? How does it present?
Fungal infection
Also known as athlete's foot
Involves interdigital spaces and the plantar surface of the feet. Erythema, pruritis, scaling, maceration, and/or bulla formation. Can also present in inguinal area, trunk, face, scalp, and hands.
106
What kind of infection is Candidiasis? How does it present?
Fungal infection
Keratinized surfaces: red, pustular, well-defined, scaling eruptions
Mucous membranes: white, cheesy, adherent masses on red surfaces.
Common in individuals with decreased immunity, diabetes, infection, obesity, chronic steroid use, hyperhidrosis, and those who in or close to water.
