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822: Integumentary > Basic Dermatology > Flashcards

Basic Dermatology Flashcards

1
Q

What are the 3 duties of the PT?

A
  • Document presentation of skin disorder
  • Make an assessment
  • Refer to another provider, if warranted
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2
Q

What are the 5 primary functions of the skin?

A
  • Protection
  • Sensation
  • Metabolism
  • Thermoregulation
  • Communication
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3
Q

Why are 2 reasons why skin changes with age?

A
  • time

- cumulative effects of sun exposure

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4
Q

What are 11 skin changes that occur with increased age?

A
  • Decreased dermal ground substance, elastin, collagen
  • Decreased epidermal turnover and vitamin D production
  • Flattened rete pegs/dermal papillae
  • Decreased dermal and subcutaneous thickness
  • Decreased vascularity and immune response
  • Decreased sweat glands and skin elasticity
  • Decreased barrier function
  • Decreased sensory perception and immune function
  • Decreased moisture content
  • Thickened nails
  • Decreased thermoregulation
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5
Q

What are the 2 most common skin problems with patients in nursing homes?

A
  • Xerosis: dry skin

- Pruritus: severe itching of the skin

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6
Q

What are rashes?

A

Temporary eruptions of the skin such as those associated with heat, childhood diseases, diapers, and drug-induced reactions

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7
Q

What is a lesion?

A

A pathological or traumatic loss of normal tissue continuity, structure, or function

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8
Q

Lesions that are first to appear are called _____ lesions, and their identification is the most important aspect of the dermatological physical examination

A

primary

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9
Q

List a few examples of primary lesions

A
  • Macules
  • Patches
  • Papules
  • Plaques
  • Nodules
  • Tumors
  • Wheals
  • Vesicles
  • Bullae
  • Pustules
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10
Q

Primary lesions may continue to develop or they may become modified by trauma, regression, or other extraneous factors producing _____ lesions

A

secondary

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11
Q

Primary lesions are nonpalpable, flat, changes in skin color, they can be classified as either a _____ if they are small and less than 1 cm. Or a _____ if they are larger than 1 cm.

A

Macule

Patch

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12
Q

If a primary lesion is palpable, elevated, and a solid mass if is classified as one of the following:

Less than or equal to 0.5 cm: _____
Larger than 0.5 cm and can be a coalescence of smaller ones: _____
Anywhere from 0.5-2.0 cm and deeper and firmer than a papule:_______
A nodule greater than 2.0 cm: _______
Localized skin edema, irregular, transient, superficial, and variable in size:_______

A

papule

plaque

nodule

tumor

wheal

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13
Q

If a primary lesion is characterized by a superficial elevation formed by fluid within a cavity of between tissue layers it is classified as one of the following:

Less than or equal to 0.5 cm and is serous-filled:______
Greater than 0.5 cm: _______
Any size and filled with purulent material: _______

A

vesicle

bulla

pustule

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14
Q

Describe the general presentation of secondary lesions

A

They are depressed and manifest below the plane of the skin

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15
Q

List a few examples of secondary lesions

A
  • Scales
  • Crusts
  • Excoriations/Abrasions
  • Fissures
  • Erosions
  • Ulcers
  • Scars
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16
Q

Describe the characteristics of scales

A
  • dry or greasy laminated masses of keratin
  • pathologic exfoliation involving the epidermis
  • vary in size and color
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17
Q

Describe the characteristics of crusts

A
  • dried blood, serum, or pus mixed with epithelial and bacterial debris
  • vary in size, shape, thickness, color, and composition
  • commonly referred to as scabs
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18
Q

Describe the characteristics of excoriations/abrasions

A

Linear or punctate abrasion produced by mechanical trauma often associated with pruritus and scratching

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19
Q

Describe the characteristics of fissures

A
  • Linear crack or cleft through the epidermis and often into the dermis
  • vary in shape, size, and moisture content
  • commonly occur in thickened and inelastic skin due to dryness and inflammation
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20
Q

Describe the characteristics of erosions

A
  • loss of portions or all of the epidermis only
  • heal without scar tissue
  • sometimes areas of erosion are referred to as denuded
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21
Q

Describe the characteristics of ulcers

A
  • vary in size, shape, and etiology
  • excavation involving complete loss of the epidermis and a portion of the dermis
  • usually heal with scar formation
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22
Q

Describe the characteristics of scars

A
  • collagen and connective tissue that replace lost dermis
  • size and shape are dependent upon etiology and level of tissue destruction
  • hypertrophic and keloid scars are pathological
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23
Q

What mnemonic can be used to assist the clinician in performing a thorough integumentary examination?

A

DERMATOLOGICAL

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24
Q

Describe the “D” in the mnemonic

A

DESCRIBE integrity

- Is the skin intact or present with injury

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25
Q

Describe the “E” in the mnemonic

A

EDEMA

  • location
  • pitting vs. non-pitting
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26
Q

Describe the “R” in the mnemonic

A

REVIEW sensory status

- intact or altered

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27
Q

Describe the “M” in the mnemonic

A

MOISTURE

- dry or moist to touch

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28
Q

Describe the first “A” in the mnemonic

A

ATROPHIC changes

- shiny, hairless, extremities

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29
Q

Describe the “T” in the mnemonic

A

TURGOR/TEXTURE

- normal vs. slow

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30
Q

Describe the first “O” in the mnemonic

A

OBSERVE nail composition and hair quality

- hirsutism vs. alopecia

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31
Q

Describe the “L” in the mnemonic

A

LOOK and feel for color and temp changes

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32
Q

Describe the second “O” in the mnemonic

A

OBSERVE skin folds

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33
Q

Describe the “G” in the mnemonic

A

GERONTODERMATOLOGICAL changes

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34
Q

Describe the “I” in the mnemonic

A

INQUIRE about allergies and PMH

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35
Q

Describe the “C” in the mnemonic

A

CALLUS

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36
Q

Describe the second “A” in the mnemonic

A

ASSESS vascular status

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37
Q

Describe the second “L” in the mnemonic

A

LESIONS

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38
Q

What can be defined as an inflammatory skin response to any injurious agent?

A

eczema

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39
Q

Even though eczema and dermatitis are used interchangeably, eczema is more commonly used to denote _______ disease and dermatitis is more commonly used to denote _______ disease

A

endogenous

exogenous

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40
Q

What are the 5 types of dermatitis?

A

1) allergic
2) contact
3) hand
4) seborrheic
5) stasis

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41
Q

Describe allergic dermatitis

A

Erythema commonly found on the eyelids

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42
Q

What are 2 treatment considerations when treating allergic dermatitis?

A
  • determine irritant and avoid exposure

- consider makeup as a possible irritant

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43
Q

Describe contact dermatitis

A

Localized erythema common on the hands

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44
Q

What is a treatment consideration when treating contact dermatitis?

A

Determine irritant and avoid exposure

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45
Q

Describe hand dermatitis

A

persistent erythema with scaling on the digits and palms

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46
Q

What is a treatment consideration when treating hand dermatitis?

A

topical steroids

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47
Q

Describe seborrheic dermatitis

A

Erythemous, scaly eruptions on the face, scalp, and body

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48
Q

What is a treatment consideration when treating seborrheic dermatitis?

A

Topical hydrocortisones and tar-containing shampoos

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49
Q

Describe stasis dermatitis

A

Erythema, pigment changes, thickening of the skin, and dependent edema

50
Q

What is a treatment consideration when treating stasis dermatitis?

A

Leg elevation, support stockings, exercise, topical and/or systemic management

51
Q

Describe the general acute presentation of a person with eczema

A

The acute presentation is often denoted by poorly defined red patches, papules, and plaques with or without scales.
The skin also appears edematous with excoriations from frequent scratching.

52
Q

Describe the general chronic presentation of a person with eczema

A

Chronic cases present with a thickening of the skin known as lichenification.

53
Q

Where does chronic eczema tend to occur on the body?

A
  • neck
  • flexor surfaces
  • eyelids
  • forehead and face
  • dorsal of hands and feet
54
Q

What can be defined as pruritic edematous pink or red wheals, more common referred to as hives?

A

Urticaria

55
Q

What is the most common mediator of Urticaria?

A

histamine

56
Q

What is acute urticaria most commonly associated with?

A
  • foods
  • medications
  • exposure to allergens
  • chemicals
57
Q

If daily episodes of urticaria persist for longer than _ weeks, then the condition is considered chronic

A

6

58
Q

True or False

It is important for PTs to recognize the clinical features of urticaria because a patient may develop a reaction with the use of cold pack or ice massage

A

True

59
Q

What does cholinergic urticaria present like?

A

Small wheals surrounded by bright red flares and intense pruritus

60
Q

What does cold urticaria present like?

A

Red or pale, swollen and pruritic

61
Q

What does dermographism urticaria present like?

A

Pruritic linear wheals with a bright red flare

62
Q

What does pressure urticaria present like?

A

Large, painful, or pruritic swelling at a site of pressure

63
Q

What does solar urticaria present like?

A

Pale or red swelling the is pruritic

64
Q

Psoriasis is a chronic, recurrent inflammatory disease of the skin that affects up to _% of the population in western countries

A

2

65
Q

What is the cause of psoriasis?

A

Unknown, however it tends to be inherited

66
Q

What is the general presentation of psoriasis?

A

Round, erythematous, dry, scaling plaques covered by silvery white scales

67
Q

Where is psoriasis commonly found?

A
  • scalp
  • nails
  • extensor surfaces of extremities
  • elbows
  • knees
  • umbilical
  • sacral regions
68
Q

The pathogenesis of psoriasis involves the alteration of what cell kinetics?

A

keratinocytes

69
Q

What are the 2 classifications of psoriasis?

A

pustular and nonpustular

70
Q

Patients with psoriasis may also present with what type of chronic, destructive arthritis?

A

psoriatic arthritis

71
Q

What is the focus of treating psoriasis?

A

Although there is no cure, the disease can be converted from an active state to a latent state.

Interventions include:

  • Systemic and topical steroids and immunosuppressives
  • UV therapy
  • coal tar produc
72
Q

What mnemonic can clinicians use to help detect melanoma?

A

ABCDE

A: Asymmetrical - most early melanomas are asymmetrical
B: Border - most melanomas are uneven
C: Color - shades of brown, tan, black can be first sign of melanoma
D: Diameter ≥6 mm or larger than common moles
E: Elevation or evolving - changing in size, shape, color, bleeding, crusting

73
Q

What are 8 of the most common benign neoplasms and hyperplasias that may present in the clinical environment?

A
  • melanocytic nevi
  • Mongolian spots
  • capillary hemangiomas and post-wine stains
  • cherry angiomas
  • seborrheic keratosis
  • skin tags
  • lipomas
  • dermatofibromas
74
Q

What are nevi most commonly referred to as?

A

moles

75
Q

By the 3rd and 4th decade, Caucasian adults present with approximately how many nevi?

A

30-50

76
Q

Describe the general presentation of nevi

A

Light to dark brown, flat or round tumors, with or without hair, 1-2 mm in size

77
Q

Describe the general presentation of Mongolian spots

A

Congenital blue-gray macular lesions

78
Q

Where are Mongolian spots generally found?

A

lumbosacral area

79
Q

What ethnicity are Mongolian spots common?

A

Amerindian and Asian infants

80
Q

Describe the general presentation of capillary hemangiomas

A

soft, bright red or deep purple, vascular nodules or plaques

81
Q

Capillary hemangiomas disappear spontaneously by the ____ year of life

A

fifth

82
Q

Describe the general presentation of port-wine stains

A

Irregularly shaped, red, macular vascular malformations present at birth

83
Q

Where are port-wine stains most commonly found?

A
  • neck
  • forehead
  • glabella
  • eyelids
84
Q

Describe the general presentation of cherry angiomas

A

Asymptomatic, bright red, domed lesions

85
Q

Where are cherry angiomas

most commonly found?

A

trunk

86
Q

What is the most common benign epithelia tumor?

A

Seborrheic Keratosis

87
Q

Describe the general presentation of seborrheic keratosis

A

Initially flat, well-demarcated, small, brown pigmented areas.
Over time become raised, darker, with a soft, crumbly surface.

88
Q

In what age population is seborrheic keratosis most common?

A

elderly

89
Q

Describe skin tags

A

Soft, round, skin colored or tan or brown benign tumors ranging from 1 mm to 10 mm

90
Q

In what age population is skin tags most common?

A

elderly and/or obese patients

91
Q

Describe lipomas

A

Fatty tumors that develop slowly, are easily movable beneath skin. Generally painless

92
Q

Describe Dermatofibromas

A

Button-like dermal nodules that are commonly found on the extremities.

93
Q

What is a classic finding of dermatofibromas?

A

the “dimple sign” where lateral compression with the thumb and index finger produces a dimpling effect with the lesion

94
Q

Small, pigmented tumors should be considered suspicious when some or all of what 8 criteria are present?

A
  • rapid growth over weeks to months
  • diameter ≥ 6 mm
  • changes in pigmentation
  • inflamed margin
  • irregular, ragged borders
  • crust formation
  • bleeding
  • pruritus
95
Q

What are 4 skin cancer types?

A
  • Basal cell carcinoma
  • squamous cell carcinoma
  • malignant melanoma
  • Kaposi’s sarcoma
96
Q

What is the most common form of skin cancer?

A

basal cell carcinoma

97
Q

Describe the general presentation of basal cell carcinoma

A

Small, pink or flesh-colored nodules that enlarge over time

98
Q

__% of basal cell tumors present on the head, neck, and face

A

80

99
Q

Why must basal cell tumors be treated aggressively?

A

they can extend widely and deeply, destroying skin, cartilage, and bone

100
Q

True or False

Basal cell tumors have a limited ability to metastasize

A

True

101
Q

Squamous Cell Carcinoma is a malignant tumor of what part of the skin?

A

outer epidermis

102
Q

Describe the general presentation of squamous cell carcinoma

A

Scaly, elevated lesions with irregular borders and shallow central ulcers

103
Q

What are the 2 types of squamous cell carcinoma?

A

Intraepidermal (local) and Invasive (metastatic)

104
Q

Patients with squamous cell carcinoma have a __% recurrence rate

A

40

105
Q

What percentage or squamous cell tumors will metastasize?

A

2-6%

106
Q

Malignant melanoma is a rapidly progressing, metastatic form of cancer involving what cell types?

A

melanocytes

107
Q

Describe the general presentation of malignant melanoma

A

Characterized by irregular borders, uneven surfaces, black or brown. The surrounding area tends to be red, inflamed, and tender. They tumors may also bleed or ulcerate.

108
Q

Kaposi’s sarcoma is the malignancy of what cells?

A

Those lining the blood vessels

109
Q

What 2 diseases is Kaposi’s sarcoma linked with?

A

Herpes virus 8 and HIV

110
Q

What do Kapsosi’s sarcomas originally present as? Describe how they evolve.

A

An ecchymotic-like macule, that evolves into papules, plaques, nodules, and tumors of varying colors

111
Q

Normal skin color is composed of four biochromes, what are they?

A
  • Melanin (brown)
  • Carotenoids (yellow)
  • Oxyhemoglobin (red)
  • Reduced hemoglobin (blue)
112
Q

Skin color is determined by all 4 biochromes, however which is the main determinant?

A

melanin

113
Q

What can be defined as a congenital disorder affecting skin, hair, and eyes in which the patient lacks the enzyme to synthesize melanin. This results in pale or pink skin, yellow or white hair, and light-colored eyes.

A

Albinism

114
Q

Vitilligo is the loss of what cell type?

A

melanocytes

115
Q

Describe the general presentation of patients with vitilligo

A

They have distinct white borders typically on their face, neck, axillae, extremities

116
Q

Vitilligo is inherited and found in people with what types of disorders?

A
  • thyroid disease
  • pernicious anemia
  • diabetes
117
Q

What can be defined as an acquired light or brown hyperpigmentation that presents most frequently on the face?

A

Melasma

118
Q

What are the 4 most common causes of Melasma?

A
  • Exposure to sunlight
  • Pregnancy
  • Oral contraceptives
  • Idiopathic
119
Q

What are Ephilides more commonly referred to as?

A

freckles

120
Q

What are Lentigines more commonly referred to as?

A

liver spots

121
Q

END SYSTEMIC DISORDERS

A

SLIDE 64

PAGE 420

822: Integumentary (16 decks)

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