Chapter 1 Fundamentals of Clinical Dermatology: Morphology and Special Clinical Considerations Flashcards
Accurately identifying _________ is an essential step in generating a differential diagnosis
morphology
In taking a history from a patient presenting with a new skin complaint, the physician’s primary goal is to ________________, with a secondary goal of ________________________
establish a diagnosis
evaluating the patient as a candidate for therapy
________________ on the buccal mucosa in lichen planus, for instance
__________ are a sign of sun damage and suggest the need for improved sun pro- tection
Wickham’s striae
lentigines
Certain lesions, especially pigmented lesions, are best examined with a ________ to identify characteristic concerning features
dermatoscope
flat-topped or planar papules and plaques tend to be processes affecting the _______ and___________, while dome-shaped or nodular lesions often exhibit deeper infiltration into the ______ or _______
epidermis and superficial dermis
dermis or subcutis
The combination of primary morphology and secondary change (or absence of secondary change) determine a diagnostic category, also known as the “___________.”
reaction pattern
_______, also sometimes included under the heading of nodule, may be used to describe a more irregularly shaped mass, benign or malignant
Tumor
Fissures frequently occur on the palms and soles where the thick ________ is least expandable
stratum corneum
______ - Densely adherent scale with a sandpaper texture.
______ - Scale is shiny with a sheet-like desquamating edge, like peeling paint
Gritty
Shellac-like
___________ induce melanin production in the overlying epidermis, often leading to brown color overlying the focus of mast cells in the _______
Mast cells
dermis
Melanin in the dermis, either within melanocytes or extracellular, may appear brown, gray, or blue. This gray-blue color results from the “____________,”
Differentiation between epidermal and dermal melanin also can be aided by a _______, which accentuates epidermal but not dermal melanin
Tyndall effect
Wood lamp
black color - Intraepidermal hemorrhage (pathology) –> ____________ (example)
yellow color - Histiocytic inflammation (pathology) –> ___________ (example)
talon noir
Necrobiosis lipoidica
True red is often associated with ____________ (as seen in cellulitis or _____________);
Granulomatous brown (______________, marked by the classis “apple jelly” color
neutrophilic inflammation
Sweet syndrome
sarcoidosis
Resembling a straight line; often implies an external contactant or _______ phenomenon has occurred in response to scratching; may apply to a single lesion (such as a scabies burrow, _____________, or _____________)
Koebner
poison ivy dermatitis, or bleomycin pigmentation
________ - Having multiple angulated edges, resembling a star; example –>
Eschar overlying stellate purpura –> ________
Stellate
calciphylaxis
________ –> Like marble cake, with 2 distinct colors interspersed in a wavy pattern; usually seen in mosaic disorders in which cells of differing genotypes are interspersed (incontinentia pigmenti, ______________, linear and whorled nevoid hypermelanosis).
Whorled
hypomelanosis of Ito
Lying along the distribution of a lymph vessel; implies an infectious agent that is spreading centrally from an acral site. –> _________
When individual papules or nodules lie along the distribution of a lymphatic network, this pattern is termed ___________
Lymphangitic
Sporotrichoid
______________ –>
Horny plugs at the undersurface of scale removed from a lesion; seen in __________
carpet tack sign
chronic cutaneous lupus
_______________ –>
Transient induration of a lesion or piloerection after rubbing; seen in __________
Pseudo-Darier sign
congenital smooth muscle hamartoma
________________ –> a rumpled rim of epidermis hanging from the erosion’s edge
“mauserung” desquamation
