Derm Flashcards by david romano

What kind of barrier is the skin?

Physical and immunologic

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Largest organ of the body?

Skin

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What is the skin responsible for?

Temperature regulation, insulation and sensation

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Skin components include?

Epidermis, dermis, sweat glands, oil glands, hair, and nails, subcutaneous fat

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Layers of the skin starting at the bottom “basement”?

Basal cell, stratum spinosum, stratum granulosum, stratum corneum, epidermis (includes melanocytes and langerhans cells)

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What are the undifferentiated proliferating cells?

Basal cells

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What is above the basal cell layer?

Stratum spinosum

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What does the stratum spinosum contain?

Keratinocytes which produce keratin

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Above the stratum granulosum? What happens here?

Stratum granulosum. Cells differentiate here and acquire more keratin and become FLATTER.

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Found in the stratum granulosum, What is the cement that holds together the cells of the stratum corneum.

Polysaccharides, glycoproteins, and lipids.

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Top layer of the epidermis?

Stratum corneum

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What layer of the epidermis is the major physical barrier?

Stratum corneum

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What do the cells in the stratum corneum look like?

Large, flat, filled with keratin. Cells are stacked in vertical layers and vary in thickness depending on location.

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How many layers of the stratum corneum cells?

15-25 layers on most surfaces

100 layers on palms and soles

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Cells divide in what layer?

Basal cell layer

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Keratinization occurs in which layers

Stratum spinosum, granulosum, corneum.

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What are the pigment producing cells found in the basal cell layer? These cells provide protection from ultraviolet radiation.

Melanocytes

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“Soldiers of the skin”

Langerhans cells

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What cells are derived from bone marrow?

Langerhans cells

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What cells are identical to tissue macrophages and present antigens to lymphocytes?

Langerhans cells

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What layer of the skin contains nerves, blood vessels, and appendages?

Dermis

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What are the ranges in thickness of the dermis?

1-4 mm

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What are the skin appendages?

Eccrine sweat glands, 
apocrine sweat glands, 
hair follicle, 
sebaceous glands, 
nails

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What skin appendage is responsible for regulation of body temp?

Eccrine sweat glands

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What triggers the eccrine sweat glands?

Emotion and thermal stimuli.

How much sweat can the body secrete per day and how is sweat transported?

Up to 10 liters per day. Transported by a sweat duct located in the dermis, which then creates a path to the epidermis.

What appendage is responsible for body odor?

Apocrine sweat gland

What is apocrine sweat glands? Used for and location.

No useful purpose -body odor, odor is caused by bacteria Glands are located in the axillae and anogenital areas Apocrine glands are located deep in the dermis and reach the skin surface via the **hair follicle**.

Hair follicle job, location and types?

Protective, decorative, and the two types are: - vellus-short, fine, light colored. - terminal thick, coarse, darkly colored.

Hair growth (growth phase?)

Anagen phase

Hair growth (transition phase?)

Catagen phase

Hair growth (resting phase)

Telogen phase.

What are the oil glands?

Sebaceous glands

What do the sebaceous glands produce? It's an oily substance.

Sebum

Where and at what size are sebaceous glands?

Located where hair follicles are present and mainly the face and scalp. Size and activity are androgen control. Reach full size at puberty.

What are the nails made of?

Keratin. Formed from a matrix of dividing epidermal cells. Nails are hard, flat, and lie parallel to the skin. Grow .1 mm per day. Toenails grow at a slower rate.

What protects the nail matrix and contains the cuticle?

Proximal nail fold

What produces the nail plate and lies beneath the proximal nail fold?

Nail matrix

What does the epithelium of the nail bed adhere to?

Nail plate

What is the distal edge of the nail?

Hyponychium

What lies between the dermis and the fascia? And what is its function?

Subcutaneous fat. | - insulation, cushion, and energy.

History questions of a derm patient?

Age, sex, ethnicity. When did the problem start, where did it start, what areas are affected now, does it migrate, does the problem come and go or is it constant, have you had this before, any social contacts with a similar problem or rash, are there any associated symptoms itch or pain, what medications do you take- Rx, prn, Otc, how long have you been on these nmedications, what types of products do you use, any new products, have you seen anyone else for this problem, what treatments did you try and did they help, have you had blood testing done, any biopsies, obtain a past medical history, family history, social history, work duties, hobbies, athletics?

What do you need to do a physical exam of the skin?

Good eyesight, good lighting, magnifying glass, ruler, tape measurer, look everywhere! Take pictures.

When should you refer?

- always get opinion of supervising physician - if problem is underlying disease like cancer - rare diagnosis - surgical referral

What does a Macule look like?

- FLAT skin lesion | - different color than surrounding skin

What does a Papule look like?

Small raised skin lesions

What are comedones and what do they look like?

Blackheads and whiteheads | Descriptive acne term

What is a blister filled with clear fluid that is LESS than .5 cm?

Vesicle

What is a blister filled with clear fluid that is GREATER than .5 cm?

Bullae

What is a raised fluid filled lesion that is filled with purulent or cloudy fluid? "Pus inside"

Pustule

A lesion of dermal edema? (A hive)

Wheal

Raised marble like. | Diameter and depth greater than .5 cm

Nodule

Skin defect that completely erodes the epidermis and part of the dermis?

Ulcer

What happens when people scratch a lot. | It's a defense mechanism by the skin. Epidermal thickening. Visible and palpable.

Lichenification

"Skin tag" soft fleshy raised growth

Polyp

Linear tear in the epidermis | - eczema ( crack that can bleed)

Fissure

Visibly thickened stratum corneum, dry appearance

Scale

"Scab" dried liquid on the surface of the skin | Blood, serum, or pus

Crust

Loss of skin tissue | -sinking in of the skin

Atrophy

Elevated but lacking significant depth? | Diameter is greater than .5 cm

Plaque

Enlarged superficial blood vessels | - broken blood vessels at the skin

Telangectasia

Complete loss of pigment | - color cells of skin die

De pigmentation

Partial loss of pigment

Hypopigmentation

Excess pigment

Hyperpigmentation

Skin tension lines Useful when performing procedures Guide to produce the strongest scar and provide a better cosmetic outcome

Langer lines

Pruitis means?

Itching

Excoriation means?

Picking or scratching