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Skin Lymph Blood Exam 2 > Clinical Perspectives In Skin Changes - Dr. Tyler > Flashcards

Clinical Perspectives In Skin Changes - Dr. Tyler Flashcards

1
Q

Nodule is what and examples

A

papule or lesion that extends into the dermis and SUBQ,

  • cysyts
  • lipomas
  • fibromas
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2
Q

when do you see vesicles

A

acute allergic contact dermatitis
dermatitis herpetiform
chicken pox (at different stages)

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3
Q

when do you nee pustules

A

bacterial infections
folliulitis
pustular psoriasis

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4
Q

when do I see Bullae

A 
blister bigger then 10mm
irritant contact dermatitis
allergic contact dermatitis 
burns / bites
drug reactions 
pemphigous vulgaris**, bullous pemphigoid**
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5
Q

I see Petichiae when

A

foci of hemorrhage

from platelet problems, vasiculitis, infections, Rocky Mountain spotted fever, Rickettsia

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6
Q

Purpura is seen when

A

PALPABLE : ** Leukocytoclastic vasiculitis , palpable, vasculitis
NON-PALPABLE : hemorrhage, microvascular occlusions + ischemic hemorrhage
(can be seen in coagulopathy)

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7
Q

urticaria

A

wheals, hives
elevated
pruretic, red, sharp boarders*
usually from hypersensitivity, bites, drugs, autoimmunity, usually lasts up to 24hrs

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8
Q

Scale

A

Excessive accumulation of stratum corneum (flaking of skin)

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9
Q

Crust

A

dried body fluid (serous = yellow, hemorrhagic = red)

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10
Q

Excoriation

A

linear defects in epidermis (usually from scratching)

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11
Q

Erosion

A

Loss of epidermis , with dermis in tackt

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12
Q

Ulcer

A

full thickness destruction of epidermic and dermis

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13
Q

Fissure

A

linear break in epidermis usually along skin lines

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14
Q

Lichenification

A

visible thickening in skin causing accentuated skin fold markings

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15
Q

Atrophy

A

loss of substance (depressed or shiny delicate skin on epidermis)

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16
Q

Nummular

Annular

A

coin like circular

ring like with clear center(fungal)

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17
Q

Target lesions is seen in what

A

Erythema multiforme

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18
Q

Seroinginous lesions

A

linear, branched, curving (parasitic)

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19
Q

Reticulated lesions

A

lacy, network looking

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20
Q

Herpetiform

A

groups of papules or vesicles (Herpes)

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21
Q

Herpesvirus 1 and 2

A

stomatits (lip), GU lesions, Bell’s palsy, encephalitis

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22
Q

Herpes Varicella rash

A

pruritic, centrifugal, papular changing to vesicular to pustular to crusting all at once
= chicken pox or shingles

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23
Q

Herpes Zoster rash

A

tingling pain, eruption of vesicles in dermatome distribution, pustules, crusting,
- usually on face and shoulders

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24
Q

what is something that a person with Herpes zoster can get

A

Post- herpetic neuralgia

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25
Q

Meningitis SX

A

fever, H,V, delirium,
= Petechial rash (skin and oral)
= + Brudzinski, + Kernig sign
= purulent spinal fluid (GRAM - diplococci)

26
Q

rash in meningitis

A

perichiae

disseminated intravascular coagulation (DIC) can happen especially if patient is in septic shock = Purpura fulminans

27
Q

Seborrheic Keratosis

A

benign papules + plaques, brown, black, velvety, warty surface (3mm - 20mm)
= look stuck on
= no tx needed (can be mistaken as melanoma)

28
Q

Actinic Keratosis

A 
macules and papules (0.2cm - 0.6cm)
=flesh colored pink, some hyperpigmentation
= sandpaper
= tender
= sunexposed areas
= premalignant, can become SCC
29
Q

rosacea

A

red papules all over face (red papule rash)

overgrowth of nose epithelium

30
Q

Seborrheic dermatitis

A

scalp, face, chest, umbilicus, back, eyelids, GU,
= yellow dandruff oily
= pruritus
= high it parkinsons disease

31
Q

BCC looks like what

A

pearly papule, red, 6mm or bigger
= sun exposed areas
= nonhealing ulcer
= 2nd most common skin cancer

32
Q

risk of BCC

A

history of bleeding

intense intermittent sun exposure esp light skinned

33
Q

SCC looks like what

A 
nonhealing ulcer or warty nodule 
= from long-term sun exposure
= ear, temple, lip, oral, GU (can metastasize) 
= common in light skinned transplant pts
= most common skin cancer
34
Q

Psoriasis looks like

A

thick, well demarcated salmon color plaque
= silvery scale on top
= EXTENSOR muscels, scalp, palms, feet
= pitting nails

35
Q

inverse psoriasis

A

on flexor muscels

36
Q

psoriasis is associated with what

A
  1. metabolic syndrome
  2. Cardiovascular disease
  3. 30% have psoriatic arthritis
37
Q

how does psoriasis happen

A

chronic inflammation of papulosquamous and immune mediated skin disorder

38
Q

what makes psoriasis come or worse

A 
stress
koebner phenomena (trauma)
cold, hot
infection (strep, HIV)
mediactions (NSAIDS, sterioids, antimalaria)
39
Q

erythema migrans

A

bulls eye lesions

Borrelia burgdorferi = lymes disease

40
Q

erythema multiforme

A

target lesions
can have a bullae
halo around it, center is red patch/plaque
rings of light then dark red around

41
Q

what causes erythema multiforme

A

Herpes Simplex

Mycoplasma pneumoniae

42
Q

SLE looks like

A

pruritis
sensitive to sunlight
arthralgia, myalgia, fatigue, malaise, fever, night sweats, headache, hair loss, visual changes (diffuse nonscarring nondescript lesions)
= butterfly rash

43
Q

Dermatomyositis

A

chronic immune mediated disorder of skin and proximal skeletal muscles
= pruritus and rash looks like other dermatitis
= usually associated with celiac disease
= scarly red patches in scalp, knuckles (Gottrons papules)
= difficulty climbing stairs or raising arms
= photosensitive

44
Q

pt with dermatomyositis are in risk for

A

malignancy

45
Q

acanthosis nigracans

A

velvet like hyperpigmented plaques lateral neck of DM

46
Q

Pretibial myxedema

A

pink, waxy, indurated plaque on lower leg (looks like a wet shiny raw leg)
= Graves disease (hyperthyroidism)

47
Q

Erythema nodosum

A

non-granulomatous lesions
= associated with sarcadosis*
= usually anterior tibia (lower legs)
= tender, red, subcutaneous nodule

48
Q

Erythema infectiosum

A

Parovirus B15, fifth disease
= fiery slapped cheek appearence, circumoral pallor
= lacy rash (trunk limbs)
= malaise, H, D, pruritus , fever before rash**

49
Q

scarlet fever

A

strawberry tongue **
= from toxin B-hemolytic strep (usually from exudative pharyngitis)
=sunburn like rash, fine red papules = sandpaper skin **

50
Q

Streptococcal pharyngitis

A

strep, sudden onset feverm sore throat, pain swallowing, tneder cervical LN, malaise, N
purulaent exudate, red pharynx, tonsilsm soft palate
= Centor clinical criteris = fever, tneder cervical LN, NO cough, pharyngotonsillar exudate**

51
Q

Measles

A

fever malaise, conjunctivities, coryza, COUGH, rash, KOPLIK SPOTS (befroe teh other body rash comes)
blanching skin red rash (dots on trunk and can move to extremities)

52
Q

Nikolsky sign

A

some lateral pressure on skin cases epidermis to slough or blister to rupture
(pulling away with 2 fingers on either side of blister only not on blister the skin next to it)

53
Q

where is Nikolsky sign seen

A

Pemphigoid Vulgaris (NOT pemphigus bullous)

54
Q

Bullous pemphigoid

A

starts on legs then spreads after years
elderly
usually from UV exposure, drugs like PCN
- Type 2 hypersensitive

55
Q

Pemphigoid vulgaris

A

autoimmune, large superfiical loose bullae peel off leaving denuded skin
oral mucosa and skin

56
Q

Vasculitis

A

inflammation and damage to BVs
= small vessels in epidermis
= medium vessels in dermis

57
Q

large BV vasculitis

A

giant cell arteritis
polymyalgia rheumatica
aortitis
Takayasu arteritis

58
Q

Medium vaculitis

A

=polyarteritis nodosa = NO ANCA autoantibodies**

=Granulomatosis

59
Q

small vasculitis

A 
= Hypersensitivity vasculitis
=IgA
=Cryoglobulinemia
=Goodpasture syndrome
=Anti-Glomerular BM
60
Q

most important determinant is dx prognosis of melanoma

A

tissue depth

Skin Lymph Blood Exam 2 (9 decks)

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