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Neurology and Special Senses > Dermatological History and Examination > Flashcards

Dermatological History and Examination Flashcards

1
Q

What are you looking to find out from the presenting complaint?

A 
Nature, site and duration of issue
Initial appearance and changes
Symptoms - itch, pain
Aggravating/Relieving
Treatments?
Recent contact, stress, travel history, illness, sun exposure
Skin type
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2
Q

What things would you look at in the past medical history?

A

Atopy - asthma, hayfever, eczema

History of skin cancer & suspicious lesions

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3
Q

What other things do you ask about in a dermatological history?

A

Social history
Family history
Medication/Allergies
Impact on QoL

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4
Q

What is crucial when examining the skin?

A

Good exposure and lighting

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5
Q

What areas should you assess in a dermatological examination?

A

Hair
Scalp
Nails
Mucous membrane

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6
Q

What are the 4 principles when examining the skin?

A

Inspect
Describe
Palpate
Systematic check

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7
Q

How would you describe a skin lesion?

A

SCAM

S - size and shape
C - colour
A - associated secondary shape
M - Morphology and Margin

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8
Q

What features raise suspicion of melanoma in a pigmented lesion?

A

ABCD

Asymmetry
Border - irregular
Colours -2 or more within lesion
Diametre >6mm

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9
Q

What do you examine when palpating a lesion?

A 
Surface
Consistency
Mobility
Tenderness
Temperature
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10
Q

Where would you assess during a systematic check?

A

Nails
Scalp
Hair
Mucous membranes

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11
Q

What is pruritis?

A

Itching

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12
Q

What is a lesion?

A

An area of altered skin

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13
Q

What is a rash?

A

An eruption

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14
Q

What is a naevus?

A

A localised malformation of tissue structures

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15
Q

What is a comedone?

A

A plug in a sebaceous follicle containing altered sebum, bacteria and cellular debris

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16
Q

How can comedone present?

A

Open - blackheads

Closed - whiteheads

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17
Q

What terms can be used to describe the distribution of lesions?

A 
Generalised
Widespread
Localised
Flexural
Extensor
Pressure areas
Dermatomal
Photosensitive
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18
Q

What areas are considered pressure areas?

A

Sacrum
Buttocks
Ankles
Heels

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19
Q

What terms can be used to describe the configuration of a dermatological lesion?

A 
Discrete
Confluent - lesions merge
Linear
Target - concentric rings
Annular - a circle/ring
Discoid/Nummular - coin shaped/round
20
Q

What terms are used to describe the colour of a lesion?

A 
Erythema
Purpura - don't blanch 
Hypopigmented
Depigmented
Hyperpigmented
21
Q

What terms are used to describe the morphology of a lesion?

A 
Macule
Patch
Plaque
Papule
Nodule
Vesicle
Bulla
Pustule
Abscess
22
Q

What is a macule?

A

Flat area of altered colour

23
Q

What is a patch?

A

Larger flat area of discolouration (>2cm)

24
Q

What is a papule?

A

Palpable, raised lesion <0.5cm diameter

25
Q

What is a nodule?

A

Palpable, raised lesion >0.5cm diameter

26
Q

What is a plaque?

A

Palpable, scaling raised lesion >0.5cm diameter

27
Q

What is a vesicle?

A

Raised, clear fluid filled lesion <0.5cm diameter

28
Q

What is a bulla?

A

Raised, clear fluid filled lesion >0/5cm diameter

29
Q

What is a pustule?

A

Pus-containing lesion <0.5cm diameter

30
Q

What is an abscess?

A

Localised accumulation of pus in the dermis or subcutaneous tissue

31
Q

What are excoriations?

A

Loss of epidermis due to trauma - scratching

32
Q

What is lichenification?

A

Well defined, roughening of skin with exaggerated skin markings

33
Q

What are scales?

A

Flakes of stratum corneum

34
Q

What is crusting?

A

A rough surface consisting of died serum, blood, bacteria and cellular debris that has exuded through an eroded epidermis

seen in Impetigo

35
Q

What is a scar?

A

New fibrous tissue which occurs post wound healing

36
Q

What is the difference between a hypertrophic scar and a keloid scar?

A

Keloid - hyperproliferation beyond wound boundary

Hypertrophic - within wound boundary

37
Q

What is an ulcer?

A

Loss of epidermis and dermis

38
Q

What is a fissure?

A

Epidermal crack often due to excess dryness

39
Q

What are striae?

A

Linear area which progress from purple to pink/white with histological appearance of a scar

40
Q

What is alopecia?

A

Loss of Hair

41
Q

What is Hirsutism?

A

Androgen dependent hair growth in a female

42
Q

What is hypertrichosis?

A

Non-androgen dependent excessive hair growth

43
Q

What is clubbing? and what is it associated with?

A

Loss of angle between posterior nail fold and nail plate

Associated with - suppurative lung disease, cyanotic heart disease, IBD and can be idiopathic

44
Q

What is Koilonychia? What is it associated with?

A

Spoon shaped depression of nail plate

Associated with iron deficiency anaemia

45
Q

What is Onycholysis and what is it associated with?

A

Separation of distal end of nail plate from nail bed

Trauma, psoriasis, fungal nail infection, hyperthyroidism

46
Q

What is pitting and what is it associated with?

A

Punctate depression of nail plate

Psoriasis, eczema, alopecia areata

Neurology and Special Senses (28 decks)

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