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Multisystems > CM- Intro to Skin and Derm Diagnosis > Flashcards

CM- Intro to Skin and Derm Diagnosis Flashcards

1
Q

What are the steps of the dermatology examinations?

A
  1. overall clinical appearance
  2. distribution of the lesion
  3. arrangement and shape of the lesion
  4. Type of lesion [primary or secondary]
  5. general medical history
  6. Derm history
  7. Review of systems, PMH, FHx, SHx
    8 Physical exam
  8. Lab procedures
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2
Q

What is acral?

A

Head, neck, extremities

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3
Q

What is the difference between extensor and flexor in terms of skin surface?

A 
Extensor = anterior part of legs, posterior arms
Flexor= anterior arms, posterior legs
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4
Q

What is meant by dermatomal?

A

Follows the distribution of a spinal nerve route

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5
Q

What is the difference between non-glabrous and glabrous skin?

A 
Non-glabrous = hair-bearing
Glabrous = non- hair-bearing
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6
Q

What are the seborrheic areas?

A

Areas with high concentrations of sebaceous glands like:

  1. brows
  2. nasolabial folds
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7
Q

What is meant if a skin lesion is intertriginous?

A

It is in areas where the skin folds on itself

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8
Q

What is meant if a skin lesion is koebnerization?

A

it is sites of trauma

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9
Q

What is a periungual skin lesion?

A

around the fingernails

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10
Q

What are the 7 arrangements of skin lesions?

A
  1. isolated
  2. scattered
  3. grouped [herpetiform, zosteriform]
  4. circular [annular, arciform, polycyclic]
  5. linear
  6. angular
  7. reticulated/mat-like
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11
Q

What are the 2 types of “grouped” arrangements for skin lesions? Describe the difference.

A
  1. Herpetiform - random grouping

2. Zosteriform - grouping in dermatomes

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12
Q

What are the 3 types of circular arrangements of skin lesions?

A

Annular - full circle
Arciform - incomplete ring
polycyclic- multiple rings

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13
Q

What are polycyclic arrangements of skin lesions suggestive of?

A

subacute cutaneous lupus erythematosus

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14
Q

What term describes a non-palpable change in skin color with distinct borders less than 1cm in size?
Is it a primary or secondary lesion?

A

Macule- primary

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15
Q

What term describes a non-palpable change in skin color with distinct borders that is over 1cm in size?
Is it primary or secondary?

A

Patch - primary

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16
Q

What term describes a palpable solid lesion less than 1cm in diameter?
Over 1cm in diameter?

Are these lesions primary or secondary?

A

Less than 1cm = papule
Over 1cm = nodule

Both are primary lesions

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17
Q

What term is given to a flat-topped elevation of skin that covers a relatively large area?
Is it primary or secondary?

A

Plaque- primary

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18
Q

What is a fluid-containing, superficial, thin-walled cavity less than 1cm in diameter? More than 1cm in diameter?

Is this lesion type primary or secondary?

A

1cm is a bulla

These are primary lesions

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19
Q

What term describes a lesion with concentric rings [like a target]?
Is is primary or secondary?
What does this lesion typically indicate the presence of?

A

Target [Iris] is a primary lesion.

It indicates the presence of Erythema multiforme [possible immune complex deposition]

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20
Q

What term describes a lesion made of incomplete rings? Is this a primary or secondary lesion?
What 3 things are on the DDx for a lesion like this?

A 
Arciform - primary lesion
DDx:
1. granuloma annulare
2. leprosy
3. T-cell Lymphoma
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21
Q

What term describes a skin lesion with a central depressed area?
Is it primary or secondary?

A

Umbilicated - primary

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22
Q

What term describes a pus containing, superficial, thin-walled cavity?
Is it primary or secondary lesion?

A

Pustule- primary lesion

23
Q

You are performing a dermatological exam on a patient and note scratched or abraded skin. What term describes this?
Is this a primary or secondary lesion?

A

excoriation- secondary lesion

24
Q

On dermatological exam, what term describes dried exudate [serous, purulent, hemorrhagic]?
Is it a primary or secondary lesion?

A

Crust- secondary lesion

25
Q

What term describes a thick-walled nodule containing fluid? Pus?
Are these lesions primary or secondary lesion?

A 
Cyst = fluid-filled
Abscess = pus-filled

Both are secondary lesions

26
Q

What term is used for sclerotic tissue that forms in response to injury?
Is it a primary or secondary lesion?

A

scar- secondary lesion

27
Q

What term describes exaggerated skin markings?

Primary or secondary?

A

Lichenification - secondary

28
Q

What term is used to describe the thinning of the epidermis, dermis, subcutaneous fat or a combination of all three?
Is this a primary or secondary lesion?

A

Atrophy- secondary lesion

29
Q

You are examining the color of a skin lesion and note that it is violaceous. What does this tell you about the underlying cause of the lesion?

A

connective tissue disease

30
Q

What features of a skin lesion can be discerned via palpation?

A
  1. consistency - doughy, firm, hard, rubbery, soft
  2. tenderness
  3. fixed or mobile
  4. dry vs. wet
  5. surface features - smooth, velvety, pebbled
31
Q

What layer of skin does the pathology involve if you see:

  1. scales- psoriasiform, eczematous, ichthyotic
  2. increased brown, grey, black pigmentation
  3. decreased brown, grey, black pigmentation
A

epidermis

32
Q

What layer of the skin does the pathology involve if you see:

  1. edema
  2. red or violaceous pigment [with or without blanching]
  3. telagiectasias
  4. blue, green or yellow pigmentation
A

dermis

33
Q

You are looking at a skin lesion that is red or violaceous. It blanches. Where is the pathology?

A

Red/violaceous indicates that the injury is in the dermis.

Blanching indicates that it is erythema [intravascular]

34
Q

You are looking at a skin lesion that is red or violaceous. It does not blanch when pressed. Where is the pathology?

A

The red/violaceous indicates dermis involvement. The fact that is does not blanch means that it is purpura indicating the extravasation of blood components

35
Q

You dermatology exam you note a lesion with poorly demarcated borders and fixation to underlying tissue. What layer of skin is the pathology involved?

A

Subcutis

36
Q

What 3 features describe an epidermis lesion?

A
  1. scales - psoriasiform, eczematous, ichtyotic
  2. increased brown, black, grey
  3. decreased brown, black, grey
37
Q

What 4 features describe a dermis lesion?

A
  1. red or violaceous pigment
    - blanch = erythema
    - no blanching = purpura
  2. edema
  3. telangiectasia
  4. blue, green or yellow pigmentation
38
Q

What 2 features describe a lesion in the subcutis?

A
  1. fixed to adjacent tissues

2. poorly demarcated border

39
Q

Describe papulo-squamous lesions.

A

Papules [palpable lesions less than 1cm] coalescing into plaques with scale.

40
Q

Describe erythrodermic lesions.

A

Erythema [intravascular pathology that blanches] and scales over most of the body surface area.

41
Q

Describe ichthyosiform lesions.

A

Fish-like scales on skin.

  • vulgaris
  • acquired
  • x linked
  • drug rxn
42
Q

Describe vesico-bullous lesions.

A

Vesicles [less than 1cm fluid filled, thin-walled] and bullae [fluid-filled sacs larger than 1cm] on the skin.

43
Q

You are examining a patient and note blisters with papules, plaques, ulcers and erosions. How would you classify it?

A

vesiculo-bullous

44
Q

Describe a pustular lesion.

What 5 things are on DDx?

A

Small pus-filled, superficial, thin-walled cavities on the skin.

DDx:
acne vulgaris, acne rosacea, drug rxn, pustular psoriasis and Reiters

45
Q

Describe a sclerotic lesion.

What 5 things are on the DDx?

A

It is discreted scarred papules or plaques that may be atrophic.

  1. keloid
  2. scleroderma
  3. morphea [localized scleroderma]
  4. necrobiosis lipoidica diabeticorum [pretibial]
  5. lichen sclerosis
46
Q

Describe a hypomelanosis, circumscribed skin lesion.

What 7 things are on DDx?

A

It is discrete macules [<1cm] with loss of pigment

  1. post inflammatory
  2. tinea versicolor
  3. vitiligo
  4. ash leaf macule of tuberous sclerosis
  5. discoid lupus
  6. leprosy
  7. arsenic
47
Q

Describe hypermelanosis, circuscribed skin lesions.

What 10 things are on DDx?

A

Discrete areas with increased pigment [macules or patches].

  1. nevi
  2. freckles
  3. lentigines [benign]
  4. melasma [most common in pregnant]
  5. post-inflammatory
  6. drug rxn
  7. acanthosis nigricans
  8. cafe-au-lait
  9. melanoma [malignant]
  10. tinea versicolor
48
Q

What is hypermelanosis diffuse?

What is the 7 things on the DDx?

A

Increased pigmentation of a person diffusely.

  1. tanning w/ UV
  2. scleroderma
  3. Addisons
  4. porphyria [increased heme]
  5. hemochromatosis
  6. wilson’s disease
  7. arsenic ingestion
49
Q

What 9 things present with nodules WITHOUT inflammation?

A
  1. basal cell carcinoma
  2. lipoma
  3. sarcoidosis
  4. amyloidosis
  5. metastatic carcinoma
  6. xanthoma [cholesterol buildup. EXCLUDES eruptive]
  7. gout
  8. keratocanthoma
  9. rheumatoid nodule
50
Q

What 6 things present with nodules WITH inflammation?

A
  1. acne vulgaris
  2. erythema nodosum
  3. vasculitis
  4. pyogenic abscess
  5. deep fungal infection
  6. leprosy
51
Q

What 5 things present with purpura WITHOUT inflammation?

A
  1. senile
  2. thrombocytopenia
  3. kaposi sarcoma
  4. amyloidosis
  5. scurvy
52
Q

What 2 things present with purpura WITH inflammation?

A
  1. vasculitis

2. bacterial sepsis

53
Q

Describe nodulo-ulcerative lesions.

What is on the DDx?

A

papules, nodules, and/or plaques WITH ulcerations

  1. basal cell carcinoma
  2. squamous cell
  3. stasis ulcer
  4. pyoderma gangrenosum
  5. mycosis fungoides [cutaneous T cell lymphoma]
  6. syphilis [primary]
  7. chancroid
  8. arthropod bite

Multisystems (29 decks)

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