Derm Exam Flashcards
What are the components of the derm exam (3)?
Skin, hair, and nails
Describe the four functions of skin?
- Protects body from microorganisms and radiation
- Controls body temperature
- Synthesizes vitamin D
- Provides a boundary for fluids
What is a primary lesion?
First recognizable skin lesion
What is a secondary lesions?
evolves from a primary lesion either because of natural history or infection
What are the three layers of skin?
Epidermis, dermis, and subcutaneous fat
Describe the two types of hair.
Vellus hair - short, fine, and unpigmented
Terminal hair - coarse, thick, and pigmented
What are the 3 growth phases of hair?
Catogen - transitional phase
Telogen - resting phase
Anagen - growth phase
What is nail clubbing and it’s possible etiologies?
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.
What is psoriasis of the nails?
Nails become dimpled with small pits. May also become thickened.
What are Mee’s lines and what do they indicate?
White bands traversing the width of the nail. Indicate exposure to poisonous substances or renal failure.
What are Beau’s lines and what do they indicate?
Deep grooved lines that run the width of the nail. May indicate a history of chronic or acute illness.
What are the four pigments responsible for normal skin color and their causes?
Yellow - carotene
Brown - Melanin
Red - Carboxyhemoglobin
Bluish-red - De-oxyhemoglobin
What are the six characteristics of skin which should be noted?
Color, moisture, temperature, texture, mobility/turgor, lesions
Small, flat spot less than 1 cm
Macule
Flat lesion greater than 1 cm
Patch
Raised lesion less than 1 cm
Papule
Raised lesion greater than 1 cm
Plaque
Small firm lesions which goes deeper than a papule. Greater than 0.5 cm
Nodule
Nodule filled with material, liquid or semi-solid. Typically encapsulated.
Cyst
Fluid filled lesions less than 1 cm. Can be singular or in clusters.
Vesicles
Fluid filled lesion greater than 1.0 cm
Bulla
Superficial, localized area of skin. Blanches with pressure.
Wheal
Flaking of dead, exfoliated skin.
Scale
Dried residue of skin with exudates such as pus, serum, or blood
Crust
Thickening of the epidermis and roughing of the skin. Usually due to rubbing or scratching.
Lichenification
Linear lesions from scratching
Excoriation
A linear crack in the skin
Fissure
A deep loss of epidermis
Ulcer
Describe basal cell carcinoma
Arises from the basal layer of the epidermis. Grows slowly and rarely metastasizes. Nicknamed “rodent ulcer.”
Describe squamous cell carcinoma.
Arises from the surface layer of the epidermis. Can metastasize.
Describe melanoma
Arises from melanocytes, and can metastasize to any organ.
What are the ABCDE’s of melanoma screening?
A = asymmetry
B = borders, irregular
C = colors, especially blue or black
D = diameter, greater than 0.6 cm
E = elevation
Describe a basal cell carcinoma lesion.
Small pearl white, dome shaped papule with telangiectasias. Center can ulcerate –> Rodent Ulcer