Derm Flashcards
Macule
- area of skin color change
- no elevation/depression
Patch
large macule
Papule
- elevated
- less than 5mm
- isolated or grouped
Nodule
- elevated
- larger than papule (6mm)
- epidermis, dermis, or subcutaneous
Tumors
-large nodule
Plaque
- plateau like elevation
- greater than 5mm
Wheal
- rounded or flat topped
- red papule or plaque
Vesicle
- circumscribed
- elevated
- fluid filled
- dome shaped
- umbilicated
- less than 0.5 cm
Bulla
- large vesicle
- greater than 0.5 cm
Pustule
- circumscribed
- purulent exudate (papules w/ pus)
Cyst
-cavities with a lining contain a liquid or semisolid
Telangietasia
dilated superficial vessel
Exoriation
liner skin erosion from scratching
Lichenification
- thickening increased skin markings
- chronic inflammation from irritation
Edema
water in tissue
Scale
deal epidermal cells still attached to skin
Crust
scab
Fissure
deep skin split
Erosin
- loss of epidermis
- no scarring
Ulceration
- loss of epidermis into dermis
- w/wo scarring
Atropy
skin thinning
Scar
abnormal fibrous tissue
Auspitz
take off scale and get pinpoint bleeding
Nikosky
pushing on blister makes it bigger
Koebner
minor trauma more lesions
Photopatch test
for photoallergy
Patch test
for allergy
Dermatographism
write on skin and get lesion
Diascopy
Indications: to differentiate types of lesions
Risk: none
Costs: cheap
Procedure: using a microscope slide on the skin to see if it blanches
Dermoscopy/Dermatoscopy
- 10x magnification of skin
- user friendly
- inexpensive
- standard in dermatology offices
- May become popular in primary care
Aceto whiteing
Indications: to differentiate warts from other lesions - typically cervix
Procedure: soak lesion with acetic acid for 5 minutes
Risk: none
Cost: cheap
Gram stain
Indications: to ID and confirm presence of bacteria
Procedure: obtain specimen and following staining technique (blue G+ and red G-)
Benefits: rapid
Cost: $20
Culture
-Gold standard
Indications: to ID/confirm type of pathogen
Procedure: obtain a sample (x2) and incubate
Risk: little
Disadvantage: takes a couple days
Cost: $50
Potassium Hydroxide Prep
-KOH prep
Indications: direct microscope view of hair, nail, skin for fungal elements
-dissolves anything that doesn’t have a cell wall
Procedure: obtain specimen, add one drop of 10-20% KOH, cover, heat/cool, and examine
Risks: minimal
Benefits: quick, cheap, easy
Photo therapy
For: hard to control eczema, psoriasis, vitiligo, chronic pruritis
Risk: skin irritation/burning, risk of skin cancer
Cost: multiple office visits
Photodynamic therapy
-UVA irradiation w/ pretreatment with systemic psoralen
For: skin cancers, acne
Procedure: add the chemical and treat with light. Neoplastic cells take up more
Limitations: not for metastatic cancer
Cost: $2000-3000
Tzank smear
Indications: rapid identification of herpes (simplex, varicella, zoster)
Procedure: obtain and fix specimen, add 5% methylene blue, dry and look for multinucleated keratinocyes
Risks: minimal
Benefits: quick and easy
Wood’s light exam
Indication: non-invasive procedure to identify tinea capitas, pseudomonas, corneal abrasions
Procedure: UV light used to illuminate area
Risks: none
Benefits: quick and easy
Cost: cheap
Skin biopsy
Gold standard
Risks: surgical procedure
Punch: full thickness skin specimens
Shave: shave off top of lesion
Cryosurgery
Indications: tx of benign skin lesions: warts, seborrheic keratosis, and actinic keratosis
MOA: liquid nitrogen creates intracellular ice to destroy cells
Risk: can be painful and possible nerve damage
Cost: $200
Does not give tissue sample for bx
Hyfercator/electrocautery
Indications: warts, acrochordons, actinic keratoses
Risk: scarring, nerve damage, burns, pain, pigment alteration. Don’t use in pt w/ pacemakers
No biopsy sample
Cost: pricey
