Derm Flashcards
cutaneous wound repair
-coagulation
-inflammatory phase
-proliferative-migratory phase (tissue formation)
-remodeling phase
diascopy
tests blanching
ABCDE
asymmetry
border
color
diameter
evolution
lentigines
-sun spot
2 steps in establishing morphology of any given skin condition
-1. careful visual and tactile inspection
-2. application of correct descriptors
lesion shape
Nummular/Discoid/Round: all describe coin-shaped lesions
Annular: ring-shaped
Arcuate: shaped like an arc.
Serpiginous: wavy like a snake
Figurate/Polycyclic: lots of different ring shapes, rings within rings
Retiform/Reticulate: web or net-like.
Mammillated ‘nipple like’: bumpy, like a cobblestone road
Umbilicated: centrally indented
Targetoid: lesions with a bulls-eye, or concentric rings or varying colors
distribution
Discrete/Scattered: lesions are separate from one another
Clustered (Agminated): grouped together in a bunch but not running together
Coalescing: grouped and starting to merge into one another
Focal: just in one anatomic location
Generalized: over the ENTIRE body
nails grow
0.1mm/daily
primary lesions
-Macule, patch: Flat, color change only
-Papule, plaque: raised, palpable
-Vesicle, bulla: serous fluid-filled space in epidermis -> bulla is large vesicle
-Wheal: an edematous papule or plaque -> urticaria
-Nodule, tumor: raised lesion deeper in skin -> nodule is smaller
-tumor >5cm
-Pustule, furuncle (nonflucuent), abscess (fluccuent): pus-filled space
-Cyst: a sac-like nodule that has an epithelial lining containing fluid or debris
-petechiae is the smaller purpura (>.5cm)
secondary lesions
-Result from changes in primary lesions -> Traumatic injury to the skin or other external factors
-scale- dead skin
-lichenification- rubbing, itching, skin irritation
-keloid
-scar
-excoriation- loss of epidermis, scratch
-fissure- crack
-erosion- after rupture of vesicle or bulla
-ulcer- loss of dermis
-crust- dried fluid
-atrophy- stretch mark
annular
-circular rashes with central clearing
distribution vs configuration
-distribution- location
-configuration- means how the lesions are arranged or relate to each other
clubbed fingers
-float
-warm fingers, redish tinge
-nail curves down- spoon
-lung cancer
-heart defect- congenital
-lung infections
-anemia
schamroths sign
-diamond window between fingers
-sign of clubbing
spooned nails
-koilonychia
-nails curve inwards
-soft and thin
-causes- autoimmune, genetics, vitamin deficiency
-iron deficiency anemia- MC
central nail ridge
-vertical ridges in nails
-typically associated with aging
-assoc with diabetes, vit deficiency
central nail canal
-median nail dystrophy- midline split in nail plate of thumb nails
-typically caused by trauma
-topical steroids have proven to be effective
nail pitting
-holes (shallow or deep) on nails
-Punctate depressions
-can have white appearance
-causes:
-psoriasis and autoimmune condition
-topical steroid and light therapy
beau’s lines
-horizontal lines/grooves in nails
-depression
-illness, trauma to nail bed impedes nail growth -> or vit deficiency
-chronic conditions- diabetes, hypothyroidism
mee’s lines
-white bands on fingers
-transverse
terry lines
-proximal nail is white and reddened distal nail
-liver disease, usually cirrhosis, heart failure, and diabetes
-ground glass
felon nail
-trauma to nail
-infection affecting soft tissue near nail
-on the finger pad (distal pulp)
-abscess distal pulp
hair shedding
Hair shedding at the roots is common in
telogen affluvium and alopecia areata.
Hair breaks along the shaft suggest
damage from hair care or tinea capitis
seborrheic dermatitis
Bilaterally symmetric erythematous
patches on central cheeks and
eyebrows, some with overlying
greasy scale;
tinea cruris
Bilateral erythematous, geographic
patches with peripheral scaling, on
inner thighs bilaterally, sparing the
scrotum;
basal cell carcinoma
-oval pink pearly papule with
-overlying telangiectasias
-Pink patch that does not heal
-May have focal scaling
pityriasis rosea- heralds patch
heralds patch- Single, oval, flat-topped superficial
erythematous to skin-colored plaque
pityriasis rosea- Multiple round to oval scaling
violaceous plaques
Spider Angioma
Single spider angiomas are
normal and are common on the
face and chest; also seen in
pregnancy and liver disease
Petechia/Purpura vs Ecchymosis
-petechia/purpura- can be due to bleeding disorder
-do not blanch
-palpable purpura- vasculitis
-ecchymosis- trauma, changes color
Alopecia Areata
-sudden onset of patchy hair loss
habit tic deformity
-depression of the central nail with a “Christmas tree” appearance from small
horizontal depressions, resulting from repetitive trauma from rubbing the index finger over
the thumb or vice versa
Onycholysis vs Onychomycosis
-nail trauma -> white distal to proximal
-painless
-separation
-onychomycosis- nail thickening due to fungus
ulcer
-stage 1- red and does not blanch
-stage 2- partial thickness loss
-stage 3- full thickness loss
-stage- full loss with muscle, tissue, tendon involvement
actinic keratosis
-turns to SCCC
-scaly
-dry
ABCDE
-asymmetry
-border irregular
-color
-diameter > 6mm
-evolving -> most sensitive
acanthosis nigricans
-dark, velvety patches in body folds and creases.
-obese or diabetes
-rarely, warning sign of cancerous tumor in an internal organ, such as the stomach or liver
-armpits, groin, and neck
-hyperpigmentation
psoriasis
-pitting
-extensor surfaces
splinter hemorrhages
endocarditis
subungual melanoma
Melanonychia
-under the nail cancer
-dark streaking on nail seen
paronychia
An infection of the tissue folds around the nails.
