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Dermatology > Derm Terms > Flashcards

Derm Terms Flashcards

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Dermatology Board Prep flashcards
1
Q

What things should we keep in mind when doing a derm history?

A
  • when and where the lesions began - how they spread - how they changed - are they pruritic (itchy)? painful? - is this the first episode? - contactants, environmental exposures, travel hx
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2
Q

What’s the system frequently used in a derm description?

A

TAD type arrangement distribution

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3
Q

What is the main determinant of a derm dx?

A

primary lesions

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4
Q

How are basic types of lesions categorized?

A
  • raised vs. flat
  • small (gen 5mm) v. large
  • clear-fluid filled v. pus-filled
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5
Q

macule (defn)

A
  • A circumscribed, flat lesion
  • differs in color from the surrounding skin
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6
Q

What are some things that can produce a macule?

A
  • vasodilation (e.g. erythema)
  • blood pigments (e.g. ecchymosis)
  • excess melanin (e.g. melasma)
  • deficient melanin (e.g. vitiligo)
  • exogenous pigment (e.g. tattoo)
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7
Q

plaque (defn)

A
  • A raised lesion with MORE LATERAL dimension (surface area) than height (elevation above the skin)
  • sometimes the result of clustering of papules
  • has the feel of a “thickened” area of skin
  • usually 2 cm or more
  • e.g. psoriasis
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8
Q

patch (defn)

A
  • any portion of skin markedly different in appearance or character from its surroundings.
  • Some dermatologists restrict its use to large macules (>5mm); others use it to refer to relatively thin, but large plaques.
  • Most feel that accurate description can almost always be better served by the more precise terminology, e.g. large macule, or thin plaque.
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9
Q

papule (defn)

A
  • SOLID, circumscribed ELEVATED lesion <5mm (small)
  • can involve epidermis, dermis, or both
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10
Q

What is a papule often caused by?

A
  • accumulation of inflammatory cells
  • proliferation of neoplastic cells or
  • deposit of metabolic by-products
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11
Q

What is an example of a papule that predominantly involves epidermis?

A

warts

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12
Q

What is an example of a papule that involves both dermis and epidermis?

A

lichen planus

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13
Q

nodule (defn)

A
  • similar to a papule (i.e. solid, circumscribed, elevated lesion) but BIGGER - 5mm-5cm
  • may be seen as elevation or can be palpated
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14
Q

Which layers can a papule involve?

A

epidermis, dermis, or both

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15
Q

Which layers can a nodule involve?

A
  • epidermis and dermis
  • dermis and subQ fat
  • subQ fat alone
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16
Q

What may a nodule consist of?

A
  • edema
  • inflammation
  • granulomas
  • neoplastic cells
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17
Q

tumor (defn)

A
  • solid mass >5 cm
  • usually extends deeply into skin
  • may be inflamm, non-inflamm, benign or malignant

** careful with using this term so as not to scare your patients!!

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18
Q

vesicle (defn)

A
  • SMALL (<5mm), circumscribed, RAISED lesion that contains FLUID (ex: pompholyx or many early-onset herpes blisters)
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19
Q

bulla (pl bullae) (defn)

A
  • LARGER (>5mm) vesicle (i.e. RAISED, FLUID-FILLED)
  • aka blister
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20
Q

What are some examples of bullae?

A
  • acute contact dermatitis
  • friction blister
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21
Q

pustule (defn)

A
  • yellow-white PUS-filled VESICLE
  • usually within follicle
  • NO surrounding capsule (unlike a cyst)
  • usu roof is nothing more than bit of epidermis still hanging on (whereas with a cyst there is a true circumferential wall)
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22
Q

What is the difference between a pustule and a cyst?

A
  • pustule: no surrounding capsule, roof is a little epidermis still hanging on
  • cyst: has a capsule, true circumferential wall
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23
Q

What should we keep in mind when using the term maculopapular?

A
  • true maculopapular rash is relatively rare
  • NO such thing as a maculopapule (can’t have a single lesion that is both macule and papule but could see both types of lesions present)
  • ex of a more precise description: predominantly brown macules and rare round pink papules)
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24
Q

telangiectasia

A
  • a MACULE
  • linear, punctate, or sometimes arborizing THIN blood vessel
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25
Q

wheal

A

aka hive

  • can be papule OR plaque
  • TRANSIENT, PINK ELEVATION of the skin
  • often surrounded by a red flare
  • pores looked stretched like surface of orange (“peau d’ orange”) b/c of edema fluid
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26
Q

What is a synonym for wheal?

A

hive

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27
Q

comedo (pl comedones)

A
  • a PAPULE
  • plugged, dilated pore
  • often called blackhead (“open” comedo) or whitehead (“closed” comedo)
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28
Q

open comedo

A

blackhead

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29
Q

closed comedo

A

whitehead

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30
Q

cyst

A
  • a NODULE (5mm-5cm) or TUMOR (>5cm)
  • semisolid or fluid-filled mass
  • surrounded by a capsule
  • usually located deeply
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31
Q

abscess

A
  • a NODULE (5mm-5cm)
  • localized collection of PUS in a cavity formed by disintegration or necrosis of tissue
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32
Q

What things should we pay attention to when describing primary lesions?

A
  • color - size - shape - # - depth - tenderness - temperature - consistency
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33
Q

ex of shapes used to describe lesions

A
  • round - oval - umblicated - dome-shaped - flat-topped - polygonal - iris/target - acuminate - filiform - serpiginous
34
Q

acuminate (defn)

A

pointed

35
Q

filiform

A

threadlike

36
Q

serpiginous

A

snake-like

37
Q

ex of consistencies used to describe lesions

A
  • hard - firm - soft - fluctuant - boggy
38
Q

What might each of the following consistencies suggest? - hard - firm - soft - fluctuant - boggy

A
  • hard: Calcium, bone, foreign body, dermatofibroma
  • firm: dense dermal process (most common consistency)
  • soft: skin tag, lipoma
  • fluctuant: abscess
  • boggy: kerion
39
Q

secondary lesion

A
  • primary lesion altered by scratching (excoriations) or that has simply evolved (ex: most open area - erosion - left behind when blister breaks)
  • provide important dx clues
40
Q

common and important secondary features include:

A
  • scales - atrophy - burrow - fissure - erosion - ulcer - excoriation - fibrosis - oozing - crust - lichenification - scar - poikiloderma - sclerosis - sinus
41
Q

scales

A
  • excessive accumulation of loosely adherent keratin, a flat plate or flake of stratum corneum
  • usually seen in papules & plaques, or when eruptions resolve
42
Q

Furfuraceous/Branny

A

Scales that are fine & loose * Characteristic of tinea versicolor and pityriasis rosea

43
Q

Ichthyotic

A
  • Scales that are large & polygonal * Characteristic of a group of inherited and acquired disorders of keratinization, termed the ichthyoses
44
Q

Silvery/Micaceous

A
  • Scales characteristic of parakeratosis, especially psoriasis; parakeratosis refers to nuclei retention in stratum corneum * Characteristic of psoriasis
45
Q

Greasy

A
  • Scales that are yellowish and moist * Characteristic of seborrheic dermatitis
46
Q

Collarette

A
  • A fine peripherally-attached & centrally-detached scale at the edge of an inflammatory lesion * Usually seen when a vesicle or a pustule is resolving
47
Q

Desquamation

A
  • Superficial shedding or peeling of the epidermis * Seen with resolution of a primary dermatosis, e.g. an exanthematous drug eruption
48
Q

atrophy

A
  • Thinning of the skin
  • appreciated best by palpation
  • Characterized by loss of normal skin markings
  • May affect epidermis, dermis OR subcutaneous fat
  • May be fine wrinkles & increased translucency unless sclerosis is associated.
49
Q

burrow

A

a small tunnel in the skin that houses a parasite such as scabies mite.

50
Q

fissure

A

a crack in the epidermis

51
Q

erosion

A
  • SUPERFICIAL loss of epidermis - NOT associated with scarring - often accompanies vesicles, bullae or pustules
52
Q

ulcer

A
  • a DEEP erosion resulting from loss of epidermis AND PART OF DERMIS - often heals with a scar
53
Q

excoriation

A
  • LINEAR erosion caused BY SCRATCHING - may be superficial OR deep
54
Q

fibrosis

A

formation of excessive fibrous tissue

55
Q

oozing

A
  • accumulation of moist sebum, serum, cellular & bacterial debris over a damaged epidermis - often overlies erosion and is seen in vesicles, bullae, and pustules
56
Q

crust

A
  • accumulation of dried sebum, serum, cellular & bacterial debris over a damaged epidermis - often overlies erosion and is seen in vesicles, bullae, and pustules
57
Q

lichenification

A
  • Thickened skin with accentuated surface markings caused by chronic rubbing, and scratching - can resemble the bark of a tree
58
Q

Scar

A

Replacement by fibrous tissue of another tissue that has been destroyed by injury or disease.

59
Q

3 major types of scars

A
  • hypertrophic: elevated with excess growth of fibrous tissue - atrophic: thin & wrinkled - cribriform: scar is perforated with multiple small pits
60
Q

Poikiloderma

A

association of HYPERpigmentation, HYPOpigmentation, atrophy, AND telangiectasia ALL in one skin lesion - seen in some cutaneous lymphomas.

61
Q

Sclerosis

A
  • diffuse or circumscribed induration of the subcutaneous tissues - may involve dermis when overlying epidermis may be atrophic
62
Q

Sinus

A
  • a tract leading from a suppurative cavity to the skin surface or between cystic or abscess cavities
63
Q

Koebnerization

A
  • skin lesions appearing on lines of trauma - may result from either a linear exposure or irritation
64
Q

ex of derm dx with linear arrangement

A
  • contact dermatitis - dermatitis artefacta - psoriasis - lichen planes - warts
65
Q

linear arrangement can be due to . . .

A
  • exogenous agents (Koebernization) - internal anatomic of dev structures - embryonal dev lines in the skin - blood or lymphatic vessels
66
Q

annular arrangements can be due to . . .

A
  • centrifugal extension of infection from point of inoculation (Lyme disease, tinea corporis) - neoplastic process that leaves central scarring (basal cell carcinoma) - allergic process with refractory state in central area (annular urticaria)
67
Q

grouped arrangements can be due to . . .

A
  • exogenous origin (ex: insect bite) - nerve distribution (ex: herpes zoster) - inoculation (plantar warts)
68
Q

distributions of lesions on the body may be . . .

A
  • Symmetrical: affecting mirror-image portions of the body
  • Dermatomal: unilateral, along the course of a sensory nerve
  • Photodistributed: affecting sites that routinely receive solar radiation
  • Intertriginous: affecting warm, moist opposed sites
  • Flexors: affecting antecubital & popliteal fossae, skin folds
  • Extensors: affecting extensor aspects on limbs, including elbows and knees.
  • Random: no apparent pattern
  • Localized: clustered in an area such as scalp or groin
  • Generalized: diffuse, widespread
69
Q

Intertriginous distribution

A

affecting warm, moist opposed sites

70
Q

factors that impact distribution include

A
  • exogenous chemicals or microbes
  • UV exposure
  • blood supply
  • variation in epidermal appendages
  • variation in horny layer thickness
  • variation in microenvironment
  • variation in vessel permeability
71
Q

Agminate

A

clustered

72
Q

Annular

A

ring shaped with active edge and clear center

73
Q

Arcuate

A

arc shaped or incomplete circle

74
Q

Guttate

A

small droplet-like

75
Q

Herpetiform

A

closely grouped vesicles (herpes-like)

76
Q

Nummular

A

coin-shaped

77
Q

Pedunculated

A

on a stalk

78
Q

Reticulate(d)

A

resembling a net

79
Q

Retiform

A

arranged like a net

80
Q

Vermiculate

A

worm-like

81
Q

zosteriform

A

similar to shingles, following along a nerve dermatome

Dermatology (4 decks)

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