Clinical Skin Morphology Flashcards
Types of skin biopsies
Shave/snip, punch, exisional
Steps of the dermatological exam
What is the primary lesion (color/size), what are the secondary changes, configuration/shape, body distribution
Dermatologic description
Distribution, configuration, color/size primary lesion with +/- secondary change
Primary lesions
Macule, papule, vesicle, pustule, patch, plaque, nodule, tumor/mass, bulla
Macule
Flat and small, can’t feel it, “spot”
Patch
Flat, larger than macules, can’t feel it
Papule
Small, raised lesions, caused by a proliferation of cells in epidermis or superficial dermis
Plaque
Bigger, can feel them, cast a shadow with side lighting, caused by proliferation of cells in epidermis or superficial dermis
Nodule
Usually smaller, deep, palpable, caused by proliferation of cells into the mid-deep dermis or fat, “small knot”
Vesicle
Small, fluid-filled palpable lesion
Bulla
Large, fluid-filled palpable lesion
Pustule
Palpable bump filled with white fluid (pus)
Secondary changes
Scale, crust, excoriation, erosion, ulcer, fissure, lichenification, atrophy, scar
Scale
Accumulated skin (stratum corneum)
Crust
Dried exudate (blood, serum, pus)
Excoriation
Traumatized due to scratching
Erosion
Depression with loss of epidermis (superficial), may occur after vesicle forms and top peels off, may weep fluid and become crusted, does not scar
Ulcer
Depression with loss of epidermis and dermis (deeper), “sore”, usually heal with scarring
Fissure
Linear cleavage
Lichenification
Thickening, accentuated skin lines
Atrophy
Depression, thinning and wrinkling
Scar
Permanent fibrotic change
Vascular/vasculitic indicators
Will not blanch with pressure (diascopy)
Petechiae/petechial
Acute to subacute leakage of capillaries within skin, generally pinpoint to small
Purport/pupuric
Acute to subacute leakage of capillaries or small-larger vessels within skin, usually larger, may be palpable
Ecchymotic
Subacute to chronic hemorrhage within skin, usually larger
Distribution definition
Location(s) on the body
Configuration definition
How the lesions are arranged or related to each other
Configuration examples
Solitary, discrete, annular (ring-like), confluent, clustered/grouped, linear, reticulated
Solitary
A single lesion
Discrete
The borders are well defined
Annular
Pathology is on the outside, the inside is normal or relatively normal
Confluent
Multiple lesions coming together
Clustered
Multiple discrete lesions in a similar area
Linear
Forming straight lines
Reticulated
Having the appearance of a net
Distribution terms
Generalized, symmetric, unilateral, dermatomal, lines of blaschko
Generalized
Involves the entire body
Symmetric
Affects both sides the same way
Unilateral
Only one side is affected
Dermatomal
The lesions are specific to a dermatome
Lines of Blaschko
Lesions give a fountain like appearance
Distribution patterns
Acral, truncal, extensor, flexor, follicular, koebnerized, photodistributed, pressure/dependency
Acral
Involves the finger tips, nose, toes, ears
Truncal
Involves the parts of the body associated with the trunk
Extensor
Affects the part of the flat parts of the body (not where the folds are)
Flexor
Affects the parts of the body where the folds are
Follicular
Affects the skin where there are follicles (hairy parts)
Koebnerized
The lesion spreads to an area of injury or trauma on the skin
Photodistributed
The lesion affects parts of the body exposed to sunlight
Pressure/dependency
Stasis or vasculitis related
