Chapter 1 - Fundamentals

Question 1

TABLE 1-4
Types of Scale

Desquamation giving the appearance of dried,
cracked skin. Combination of hyperkeratosis
and fissuring, which appears like the cracked
bed of a dry river.

Answer 1

Craquelé/xerotic

Question 2

TABLE 1-4
Types of Scale

Conical projection of compact stratum corneum.

Answer 2

Cutaneous horn

Question 3

TABLE 1-4
Types of Scale

Scales split off from the epidermis in finer scales
or in sheets.

Answer 3

Exfoliative/desquamative

Question 4

TABLE 1-4
Types of Scale

Scales appear as keratotic plugs, spines, or filaments.

Answer 4

Follicular

Question 5

TABLE 1-4
Types of Scale

Densely adherent scale with a sandpaper texture.

Answer 5

Gritty

Question 6

TABLE 1-4
Types of Scale

Scales are regular, polygonal plates arranged in parallel rows or diamond patterns (fish-like, tessellated)

Answer 6

Ichthyosiform

Question 7

TABLE 1-4
Types of Scale

Scales appear as thick, compact, adherent layers of stratum corneum.

Answer 7

Keratotic/hyperkeratotic

Question 8

TABLE 1-4
Types of Scale

Scales are thin large plates or shields attached in the middle and looser around the edges.

Answer 8

Lamellar

Question 9

TABLE 1-4
Types of Scale

Scale is small and branny.

Answer 9

Pityriasiform

Question 10

TABLE 1-4
Types of Scale

Scale is silvery and brittle and forms thin plates in several loose sheets, like mica (micaceous scale). Large scales may accumulate in heaps, giving the appearance of an oyster shell (ostraceous scale)

Answer 10

Psoriasiform (micaceous and ostraceous)

Question 11

TABLE 1-4
Types of Scale

Scales are thick, waxy or greasy, yellow-to-brown, flakes.

Answer 11

Seborrheic

Question 12

TABLE 1-4
Types of Scale

Scale is shiny with a sheet-like desquamating edge, like peeling paint.

Answer 12

Shellac-like

Question 13

TABLE 1-4
Types of Scale

Scale appears as a lacy white pattern overlying violaceous flat-topped papules.

Answer 13

Wickham striae

Question 14

TABLE 1-6
A Selection of Cutaneous Diagnostic Signs

A yellowish hue is produced from pressure on the lesion with a glass slide

Answer 14

Apple-jelly sign

Question 15

TABLE 1-6
A Selection of Cutaneous Diagnostic Signs

Noted in granulomatous processes

Answer 15

Apple-jelly sign

Question 16

TABLE 1-6
A Selection of Cutaneous Diagnostic Signs

Lateral extension of a blister with downward pressure

Answer 16

Asboe–Hansen sign

Question 17

TABLE 1-6
A Selection of Cutaneous Diagnostic Signs

Noted in blistering disorders in which the pathology is above the basement membrane zone

Answer 17

Asboe–Hansen sign

Question 18

TABLE 1-6
A Selection of Cutaneous Diagnostic Signs

Pinpoint bleeding at the tops of ruptured capillaries with forcible removal of outer scales from a psoriatic plaque

Answer 18

Auspitz sign

Question 19

TABLE 1-6
A Selection of Cutaneous Diagnostic Signs

Not entirely sensitive or specific for psoriasis

Answer 19

Auspitz sign

Question 20

TABLE 1-6
A Selection of Cutaneous Diagnostic Signs

A flesh-colored, soft papule feels as though it can be pushed through a “buttonhole” into the skin

Answer 20

Buttonhole sign

Question 21

TABLE 1-6
A Selection of Cutaneous Diagnostic Signs

Noted in a neurofibroma

Answer 21

Buttonhole sign

Question 22

TABLE 1-6
A Selection of Cutaneous Diagnostic Signs

Horny plugs at the undersurface of scale removed from a lesion

Answer 22

Carpet tack sign

Question 23

TABLE 1-6
A Selection of Cutaneous Diagnostic Signs

Noted in lesions of chronic cutaneous lupus

Answer 23

Carpet tack sign

Question 24

TABLE 1-6
A Selection of Cutaneous Diagnostic Signs

Urticarial wheal produced in a lesion after it is firmly rubbed with a finger or the rounded end of a pen; the wheal, which is strictly confined to the borders of the lesion, may not appear for several minutes

Answer 24

Darier sign

Question 25

TABLE 1-6
A Selection of Cutaneous Diagnostic Signs

Noted in urticaria pigmentosa and rarely with cutaneous lymphoma or histiocytosis

Answer 25

Darier sign

Question 26

TABLE 1-6
A Selection of Cutaneous Diagnostic Signs

Firmly stroking unaffected skin produces a wheal along the shape of the stroke within seconds to minutes

Answer 26

Dermatographism

Question 27

TABLE 1-6
A Selection of Cutaneous Diagnostic Signs

Symptomatic dermatographism represents a physical urticaria

Answer 27

Dermatographism

Question 28

TABLE 1-6
A Selection of Cutaneous Diagnostic Signs

Transient induration of a lesion or piloerection after rubbing

Answer 28

Pseudo-Darier sign

Question 29

TABLE 1-6
A Selection of Cutaneous Diagnostic Signs

Noted in congenital smooth muscle hamartoma

Answer 29

Pseudo-Darier sign

Question 30

TABLE 1-6
A Selection of Cutaneous Diagnostic Signs

Dimpling of the skin with lateral compression of the lesion with the thumb and index finger produces dimpling as a result of tethering of the epidermis to the dermal lesion

Answer 30

Fitzpatrick (dimple) sign

Question 31

TABLE 1-6
A Selection of Cutaneous Diagnostic Signs

Characteristic of dermatofibroma

Answer 31

Fitzpatrick (dimple) sign

Question 32

TABLE 1-6
A Selection of Cutaneous Diagnostic Signs

Lateral pressure on unblistered skin with resulting shearing of the epidermis

Answer 32

Nikolsky sign

Question 33

TABLE 1-6
A Selection of Cutaneous Diagnostic Signs

Noted in blistering disorders in which the pathology is above the basement membrane zone; relevant entities include pemphigus vulgaris and toxic epidermal necrolysis

Answer 33

Nikolsky sign