Clinical Morphology Flashcards

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1
Q

What are the four core characteristics of clinical diagnosis of a rash?

A
  1. Morphology of individual lesion
  2. Location
  3. Color
  4. Configuration (i.e. how the lesions are grouped)
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2
Q

What is a papule vs a macule vs a patch vs a plaque? Give an example of each

A

Macule - flat lesion, color change only, <1 cm (i.e. freckle)

Patch - flat lesion, color change only, >1 cm (i.e. vitiligo)

Papule - raised but superficial lesion with distinct borders, <1 cm (i.e. comedone)

Plaque - raised but superficial lesion with distinct borders, >1 cm (i.e. psoriasis) (remember it’s a plaque cuz Hellen Keller reads her Braille plaque)

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3
Q

What is a nodule vs a wheal? Give an example of each.

A

Nodule - hefty, solid, deep, dome-shaped lesion (i.e. dermatofibroma)

Wheal - transient raised lesion without surface change (smooth papula or plaque), due to dermal edema, <24 hours (i.e. urticaria)

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4
Q

What are vesicles vs bullae vs pustules?

A

Vesicle - Fluid-containing blister <1cm, i.e. shingles

Bulla - Fluid-containing blister >1cm. I.e. bullous pemphigus

Pustule - Vesicle filled with pus (purulent fluid) i.e. acne

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5
Q

What are secondary skin changes?

A

Skin changes on or around the primary lesion which are not necessarily due to the original lesion (i.e. non-smooth surface characteristics, or things happening around the lesion)

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6
Q

What is desquamation vs excoriation?

A

Desquamation - Peeling off of sheets of stratum corneum

Excoriation - erosion due to scratching (self-induced erosions)

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7
Q

What is erosion vs ulcer vs fissure?

A

Erosion - superficial lost of skin (epidermis)

Ulcer - Loss of deeper skin (i.e. dermis, subcutaneous fat)

Fissure - linear erosion / ulcer

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8
Q

What is scale vs crust?

A

Scale - Shedding / flaking of the stratum corneum, usually due to thickening / increased cell turnover (i.e. psoriasis has scaling of plaques)

Crust - dried exudate of some kind (i.e. impetigo)

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9
Q

What is an eschar?

A

A dark scab, typically in the center of an area of large skin loss

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10
Q

Define atrophy and induration?

A

Atrophy - Thinned, depressed skin (usually secondary to corticosteroids)

Induration - Dermal thickening (not a groove man, dermal THICKENING). Duracion is the french word for hardness

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11
Q

Define lichenification.

A

Thickening of skin with accentuation of skin lines

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12
Q

What is a telangiectasia and when do they commonly occur?

A

Dilated superficial blood vessels, often in chronic sun damage

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13
Q

What is the cause of petechia / purpura and do they often blanch?

A

Petechiae - fine, speckled, red color -> due to thrombocytopenia / microhemorrhages, non-blanching (not due to little capillaries)

Purpura - Larger than petechiae, also due to extravasated blood (i.e. a bruise), may even be a palpable plaque in vasculitis (i.e. palpable purpura). They are larger hemorrhages -> also do not blanch

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14
Q

What is hypo vs hyper vs depigmentation?

A

Hypopigmentation - lighter than normal color, i.e. tinea versicolor

Hyperpigmentation - darker than normal color (as compared to skin) i.e. freckle

Depigmentation - absence of skin pigment whatsoever (ie. vitiligo)

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15
Q

What is an serpiginous vs arcuate configuration?

A

Serpiginous - curving irregularly, like a snake

Arcuate - Forming part of a circle (an arc)

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16
Q

What is nummular vs annular?

A

Nummular - coin-shaped with center fully filled (i.e. discoid lupus)

Annular - Forming a ring, generally with central clearing and an active, scaling border (i.e. granuloma annulare)

17
Q

What is linear vs grouped vs confluent vs reticulated?

A

Linear - arranged in a line

Grouped - clustered together

Confluent - smaller lesions joining to form larger ones

Reticulated - net-like

18
Q

What does acral distribution mean?

A

Limbs, fingers, ears, nose -> parts of body which are peripheral

19
Q

What is Blaschkonian?

A

Along linear bands of skin migration (Lines of Blashko)

20
Q

What are papulosquamous disorders and some examples of them?

A

Well-defined plaques with scaling “dry rashes”

-> psoriasis, lichen planus, tinea, secondary syphillis, pityriasis rosea, mycosis fungoides

21
Q

What are eczematous disorders? How is it different than papulosquamous?

A

Scaly plaques w/ diffuse borders that itch (ill-defined, vs papulosquamous)

Scale is often finer than papulosquamous, and may see crusts or vesicles in acute phase

22
Q

What are some examples of eczematous skin conditions?

A

Atopic dermatitis, lichen simplex chronicus, contact dermatitis, xerotic eczema, stasis dermatitis

23
Q

What are granulomatous skin conditions and some examples?

A

Papules and plaques with no scaling, deep dermal inflammation

i.e. Granuloma annulare, sarcoid, necrobiosis lipoidicum (NLD), mycobacteria, deep fungal

24
Q

What are examples of vesiculobullous skin disorders?

A

Bullous pemphigoid, pemphigus vulgaris, porphyria cutanea tarda, HSV / VZV, bullous impetigo