Derm Exam Clinical Signs, Techniques, And Tests Flashcards
Auspitz Sign
When Slight scratching of a scaly lesion reveals pinpoint bleeding within lesion
Nikolsky Phenomenon
When the epidermidis is dislodged from the dermis by sharing pressure, resulting in erosion and a red base.
Koebner Phenomenon
When a skin lesion appears at the site of trauma or injury.
Hand lens
Magnification (7x)
Woods Lamp
Black light, detects subtle color changes in melanin pigmentation
Diascopy
Firmly pressing a slide against the skin to determine whether the redness is due to capillary dilation (erythema; blanches, or extravasation of blood (purpura; no blanching)
Dermoscopy
Hand lens with a built-in lighting and magnification (10-30x). Permits, noninvasive, inspection of epidermidis and beyond. Helpful in distinguishing between benign and malignant patterns of growth.
Skin allergy tests
Patch testing, Prick testing
Acetowhitening
Application of vinegar. Genital verruca/verrucae will appear white
Culture and Sensitivity
Can be taken from skin cells, blood, or sputum. Can confirm bacteria, virus, or fungus and direct Antimicrobial therapy.
KOH Exam
Distinguishes fungal infections (looking for budding yeast and/or hyphae).
Tzanck smear
Scraping and ulcers base to look for giant multi nucleated cells (not common anymore)
Scabies test (skin scraping)
Unroofing a lesion or burrow to find mites, ova, or feces on microscopy.
Biopsy types
Shave, punch, excisional
Moh’s Procedure
Skin sparing procedure used often for the face to remove malignancies in the most efficient way possible. Performed in an outpatient setting utilizing skin mapping.
What information should be included in a prescription?
Clinic Info, Patient info (with DOS), Drug info, SIG (instructions), Quantity, # of refills, substitutions, provider name (w/ signature)
What information should be included with Drug Info on a prescription?
Name, strength, formulation
what information should be included with SIG on an Rx?
Dose, route, frequency, length/duration of treatment, indication
What is an example of a medication that generally should not have refills?
ABx
Write an Rx for 6 days of prn ibuprofen (w/o refills).
Rx: Ibuprofen 200 mg tablets
SIG: Take 1 200 mg tablet by mouth every 6 hours as needed for 6 days for fever.
Qty: 30 (24 with a few extra)
What are some health history questions you could ask for a derm issue?
Constitutional symptoms
PMH: Recent illnesses, allergies, atopic Hx, transfusions, or other skin issues
SoH: smoking, alcohol, substance abuse. Travel, occupation, exposures, sexual Hx
FHx: skin cancer, psoriasis, atopy
What are some color changes that may present on the skin?
Hypo/hyperpigmentation, depigmentation, erythema, pallor, jaundice, cyanosis
