Clinical Skills

Question 1

what 3 areas do you look at when examining the skin

Answer 1

Distribution - which areas are affected

Configuration - how lesions are arranged

Morphology - what the lesion(s) looks like

Question 2

what is nail pitting?

Answer 2

small depressions of the nail plate

Question 3

what is Onycholysis?

Answer 3

separation of the nail plate from bed

Question 4

describe Hypertrichosis

Answer 4

general excess growth

Question 5

describe Hirsutes

Answer 5

excess growth male pattern

Question 6

describe Alopecia

Answer 6

loss of hair – localized or generalised

Question 7

when looking at a rash what are the key factors to consider

Answer 7

Colour
Size
Raised or flat 
Border features
Surface features: scale, crust

Question 8

describe Purpura

Answer 8

red areas of skin that are slightly raised.
they do not blanch on pressure
they are caused by extravasation of blood

Question 9

describe Petechia

Answer 9

1- 2 mm area of flat purpura

Question 10

describe Erythema

Answer 10

areas of red skin caused by vascular dilatation.

blanches on pressure

Question 11

what are the 2 states of pigmentation

Answer 11

Hyperpigmented

Hypopigmentation

Question 12

Describe a macule

Answer 12

localised flat colour change < 1cm

Question 13

Describe a Patch

Answer 13

localised flat colour change > 1cm

Question 14

Describe a Papule

Answer 14

localised elevated area < 0.5cm

Question 15

Describe a Nodule

Answer 15

localised elevated area > 0.5cm

Question 16

what is the difference between a papular rash and a macular rash

Answer 16

A papular rash is elevated

A macular rash is flat

Question 17

Describe a maculopapular rash

Answer 17

it is a rash that has both flat and elevated components

Question 18

Describe a Plaque

Answer 18

raised edge and flatter surface > 1cm

Question 19

Describe a Pustule

Answer 19

it is a raised pus filled lesion

Question 20

Describe a Vesicle

Answer 20

a raised fluid filled lesion that is <0.5cm

Question 21

Describe a Bulla

Answer 21

a raised fluid-filled lesion that is >0.5cm

Question 22

Describe a Wheal

Answer 22

compressible dermal swelling

Question 23

Describe a Cyst

Answer 23

nodule containing semi-solid material

*it is dermal

Question 24

Describe the 5 border features

Answer 24

Well defined / Poorly defined

Irregular or regular

‘target’ lesion

Question 25

Describe Scale

Answer 25

accumulated fragments of keratin layer

Question 26

Describe Crust

Answer 26

dried exudate e.g. serum

Question 27

Describe Lichenification

Answer 27

thickening with increased skin markings

Question 28

Describe a Scar

Answer 28

normal tissue replaced by fibrous tissue

Question 29

Describe a Fissures

Answer 29

linear split in epidermis

Question 30

Describe an Erosion

Answer 30

superficial break in epidermis

Question 31

Describe an Ulcer

Answer 31

deeper break into dermis

Question 32

Describe Atrophy

Answer 32

loss of epidermis +/- dermis

Question 33

Describe Flexors / extensors

Answer 33

Flexors: joints

extensors: surfaces

Question 34

what are the areas that are rich with sebaceous areas

Answer 34

face
chest
back

Question 35

Describe a Discrete lesion

Answer 35

lesions well demarcated, individual lesions can clearly be seen

Question 36

Describe a Coalescing lesion

Answer 36

individual lesions present but starting to merge together to form larger abnormal areas

Question 37

Describe a Confluent lesion

Answer 37

no normal skin visible

Question 38

Describe a Grouped lesion

Answer 38

Linear: in a line
Annular: ring-shaped

Question 39

what are the morphologies of Pigmented lesions

Answer 39

use ABCD approach
A – asymmetry (shape and colour)
B – border  -? Irregular
C – colour (uniform or variable)
D – diameter 
(E – elevation)