Derm Exam

Question 1

What are the components of the derm exam (3)?

Answer 1

Skin, hair, and nails

Question 2

Describe the four functions of skin?

Answer 2

1. Protects body from microorganisms and radiation
2. Controls body temperature
3. Synthesizes vitamin D
4. Provides a boundary for fluids

Question 3

What is a primary lesion?

Answer 3

First recognizable skin lesion

Question 4

What is a secondary lesions?

Answer 4

evolves from a primary lesion either because of natural history or infection

Question 5

What are the three layers of skin?

Answer 5

Epidermis, dermis, and subcutaneous fat

Question 6

Describe the two types of hair.

Answer 6

Vellus hair - short, fine, and unpigmented

Terminal hair - coarse, thick, and pigmented

Question 7

What are the 3 growth phases of hair?

Answer 7

Catogen - transitional phase

Telogen - resting phase

Anagen - growth phase

Question 8

What is nail clubbing and it’s possible etiologies?

Answer 8

Rounding of the nails, they also present as soft and spongy. Possible causes include cirrhosis, lung cancer, chronic hypoxia, and heart disease. Could also be congenital.

Question 9

What is psoriasis of the nails?

Answer 9

Nails become dimpled with small pits. May also become thickened.

Question 10

What are Mee’s lines and what do they indicate?

Answer 10

White bands traversing the width of the nail. Indicate exposure to poisonous substances or renal failure.

Question 11

What are Beau’s lines and what do they indicate?

Answer 11

Deep grooved lines that run the width of the nail. May indicate a history of chronic or acute illness.

Question 12

What are the four pigments responsible for normal skin color and their causes?

Answer 12

Yellow - carotene

Brown - Melanin

Red - Carboxyhemoglobin

Bluish-red - De-oxyhemoglobin

Question 13

What are the six characteristics of skin which should be noted?

Answer 13

Color, moisture, temperature, texture, mobility/turgor, lesions

Question 14

Small, flat spot less than 1 cm

Answer 14

Macule

Question 15

Flat lesion greater than 1 cm

Answer 15

Patch

Question 16

Raised lesion less than 1 cm

Answer 16

Papule

Question 17

Raised lesion greater than 1 cm

Answer 17

Plaque

Question 18

Small firm lesions which goes deeper than a papule. Greater than 0.5 cm

Answer 18

Nodule

Question 19

Nodule filled with material, liquid or semi-solid. Typically encapsulated.

Answer 19

Cyst

Question 20

Fluid filled lesions less than 1 cm. Can be singular or in clusters.

Answer 20

Vesicles

Question 21

Fluid filled lesion greater than 1.0 cm

Answer 21

Bulla

Question 22

Superficial, localized area of skin. Blanches with pressure.

Answer 22

Wheal

Question 23

Flaking of dead, exfoliated skin.

Answer 23

Scale

Question 24

Dried residue of skin with exudates such as pus, serum, or blood

Answer 24

Crust

Question 25

Thickening of the epidermis and roughing of the skin. Usually due to rubbing or scratching.

Answer 25

Lichenification

Question 26

Linear lesions from scratching

Answer 26

Excoriation

Question 27

A linear crack in the skin

Answer 27

Fissure

Question 28

A deep loss of epidermis

Answer 28

Ulcer

Question 29

Describe basal cell carcinoma

Answer 29

Arises from the basal layer of the epidermis. Grows slowly and rarely metastasizes. Nicknamed “rodent ulcer.”

Question 30

Describe squamous cell carcinoma.

Answer 30

Arises from the surface layer of the epidermis. Can metastasize.

Question 31

Describe melanoma

Answer 31

Arises from melanocytes, and can metastasize to any organ.

Question 32

What are the ABCDE’s of melanoma screening?

Answer 32

A = asymmetry

B = borders, irregular

C = colors, especially blue or black

D = diameter, greater than 0.6 cm

E = elevation

Question 33

Describe a basal cell carcinoma lesion.

Answer 33

Small pearl white, dome shaped papule with telangiectasias. Center can ulcerate –> Rodent Ulcer