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PCM I > Derm Exam - Steve > Flashcards

Derm Exam - Steve Flashcards

1
Q

Appendages of skin

A

hair, nails, sebaceous glands, sweat glands

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2
Q

Dermatologc language

A

Primary lesion: first recognizable skin lesion

Secondary lesion: evolve from primary lesion due to natural history or disorder (eg crusts in chicken pox) or because of scratching or infection

Distribution: referst to where on body lesions are found (if you have multiple lesions)

Distinguishing characteristics: based on epidemiology, size or associated systemic or lab findings

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3
Q

Hair tyes

A

–Vellus hair – short, fine, inconspicuous and usually unpigmented (peach fuzz).
–Terminal hair – coarser, thicker and pigmented. Example: - scalp, eyebrows, pubic region.

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4
Q

3 growth phases of hair

A

–Catagen phase – transitional phase – 3%
–Telogen phase – resting phase – 10-15%
–Anagen phase – Growing phase – 85-90%

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5
Q

What is shown in this picture?

A

Nail Pits

Psoriasis – Small pits in the nails.

Nail may thicken.

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6
Q

What is this symptom called?

A

Clubbing – rounding of the

nail. Soft and spongy.

Etiologies:

Congenital

Chronic hypoxia

Heart disease

Lung cancer

Hepatic cirrhosis

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7
Q

What is this deformity of the nail called? What can bring it on?

A

Beau’s Lines

Emerge from the proximal nail folds, may follow an acute or

chronic illness, chemotherapy.

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8
Q

What is this called?

A

Mee’s Lines

(longitudinal lines)

Emerge from the proximal nail folds, may follow an acute or

chronic illness, chemotherapy.

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9
Q

What is this condition?

A

Onychomycosis

Fungal nail.

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10
Q

Name the condition!

A

Subungual Hematoma

Trauma to the nail.

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11
Q

What causes the following skin colors?

–Brown -
–Yellow –
–Red -
–Bluish-red -

A

–Brown - Melanin
–Yellow – Carotene, Jaundice (bilirubin)
–Red - Carboxyhemoglobin–(CO poisoning), Polycythemia
–Bluish-red - De-oxyhemoglobin–(cyanosis)

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12
Q

What caused this?

A

Carbon monoxide poisoning

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13
Q

What are we looking at here?

A

Jaundice

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14
Q

What are we looking for in the skin portion of the derm exam?

A

–Color
–Moisture
–Temperature
–Texture
–Mobility and Turgor
–Lesions

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15
Q

What are the affected surfaces? What condition is this typical of?

A

Extensor surfaces, psoriasis

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16
Q

What are the affected surfaces? What condition commonly presents this way?

A

Flexor surfaces, atopic dermatitis

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17
Q

What condition is depicted here? What type of skin lesion is this an example of?

A

Vitiligo

Macule – small flat spot, less than

1.0 cm

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18
Q

Name that skin condition! What type of skin lesion is this an example of?

A

Café-au-lait spots

Patch – flat spot or lesion greater then 1.0 cm.

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19
Q

Name the skin condition! What type of lesion is this?

A

Psoriasis

Papule – a raised lesion up to

1.0 cm

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20
Q

What type of lesion is this? What is the classic appearance?

A

Plaque – a raised lesion greater

than 1.0 cm

Silver look is classic

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21
Q

What is this called? What type of lesion is it an example of?

A

Dermatofibroma

Nodule – firm, hard lesion, deeper than a papule, greater than 0.5 cm

22
Q

These lesion questions are legion! What the heck is this? What type of lesion?

A

Inclusion cyst

Cyst – nodule filled with material, liquid or semi-solid.

Often encapsulated.

23
Q

What type of lesion is this? What is the condition we are looking at?

A

Herpes zoster

Vesicles – fluid filled lesions less

than 1.0 cm.

Single or in clusters.

24
Q

What caused this? What is this lesion called?

A

Insect bite

Bulla – fluid filled lesion grater

than 1.0 cm.

25
Q

Name the condition and lesion type!

A

Urticaria

Wheal – superficial localized raised area of skin.

Blanche with pressure.

26
Q

Condition and lesion type again…

A

Pustule – open lesions filled with pus.

Acne

27
Q

Condition and lesion type!

A

Ichthyosis vulgaris

Scale – flaking of dead exfoliated epidermis.

28
Q

Condition and lesion type

A

Impetigo

Crust – dried residue of skin exudates such as serum, pus or blood.

29
Q

Lesion type?

A

Lichenification – thickening of the epidermis and roughing of the skin surface often from rubbing or scratching.

30
Q

What lesion type? What phenomena is associated with this?

A

Excoriation – linear erosions caused by scratching.

Koebner phenomena – skin trauma from scratching may cause new lesions

31
Q

Condition and lesion type?

A

Tinea pedis

Fissure – a linear crack in the skin

32
Q

Condition? Lesion type?

A

Stasis ulcer

Ulcer – a deeper loss of epidermis

33
Q

What is the pattern shown here?

A

Linear

Epidermal Nevus

34
Q

PAttern and condition?

A

Cluster

Herpes Simplex

35
Q

Pattern and condition?

A

Geographic

Mycosis fungoides

36
Q

Pattern and condition?

A

Serpiginous

Tinea corporis

37
Q

Pattern and condition?

A

Annular

Tinea faciale

38
Q

What type of pattern is this?

A

Heliotrope

Over and around the eyelids

39
Q

The image on the left is a fungus, on the right is herpes. What are the key elements shown in each picture, and what is the test used to identify each?

A

Fungus

KOH prep of infected skin for fungus

Cellular debris and fungal hyphae

Herpes

Tzanck smear

Multinucleated giant cells

40
Q

List some key aspects of
•Basal Cell Carcinoma

A

–80% of the skin cancers
–Arise from the basal layer of the epidermis
–Grow slowly, rarely metastasize
–“rodent ulcer”

41
Q

List some key points on
•Squamous Cell Carcinoma

A

–16% of the skin cancers
–Arise from the upper layer of the epidermis
–Can metastasize

42
Q

What is the ABCDE screening protocol for melanoma?

A
  • A for asymmetry
  • B or irregular borders, especially ragged, notched or blurred
  • C for variation or change in color, especially blue or black
  • D for diameter ≥ 6mm or different from others, especially changing, itching or bleeding
  • E for elevation or enlargement
43
Q

Name that lesion!

A

Basal Cell Carcinoma

Pearly white, domed shaped papule with telangiectasias.

Center can ulcerate, “rodent ulcer”.

44
Q

Name that lesion!

A

Basal cell cancer “rodent ulcer”.

45
Q

Name that lesion!

A

Squamous Cell Carcinoma

Commonly found on head, neck or hands.

May develop from a precursor actinic keratoses.

46
Q

Name the lesion!

A

Malignant Melanoma

47
Q

What are these guys? What is the treatment? What concerns should you discuss with the patient regarding this treatment?

A

Malignant melanoma

Treatment: Usually a deep and wide excision, can be deforming.

48
Q

What can impetigo lead to?

A

Kidney problems

49
Q

What is geographic mycosis fungoides?

A

Not a fungus… It is actually a T cell lymphoma of the skin.

50
Q
A

PCM I (10 decks)

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