Dermatology Flashcards
7 key questions when getting derm history:
1- When? (Onset)
2- Where? (Site of onset)
3- Foes it itch or burn? (Symptoms)
4- Has it spread? How? ( pattern of evolution)
5- How have individual lesions changed? (Evolution)
6- Provocative factors? (Heat, cold, sun, exercise, travel history, drugs, pregnancy,season)
7- Previous treatments? (Topical or systemic)
Other aspects for derm history taking (7)
1- Demographics (age, race occupation)
2- Constitutional symptoms (acute illness syndrome) (Chronic illness syndrome)
3- General history of the present illness
4- Past medical history (surgery, illnesses, hospitalization. Allergies, medications, social habits. Hx of atopy asthma, hay fever, eczema. Family medical history)
5- Social history (occupation, hobbies, exposures, travel, injection drugs)
6- Sexual history
7- Review of symptoms/systems
Physical examination (3)
1- General appearance
2- Vital signs
3- Skin
All of the skin should be examined, including what? (5)
1- Mucus membranes
2- Hair and scalp
3- Nail plate, nail fold, nail body
4- Peripheral lymph nodes
5- Genital area
Name 7 primary skin lesions
Macule (less than 1cm)
Patch (more than 1cm)
Papule
Plaque
Nodule
Vesicule
Bulla
Name 8 secondary lesions
1- Erosion
2- Ulcer
3- Fissure
4- Atrophy
5- Excoriation
6- Crust
7- Scale
8- Lichenfication
Define a macule
Flat discoloration less than (any color) 1 cm. Not palpable. Should blanch under pressure.
If a macule does not blanch under pressure, what is it?
Purpuric
Define a patch
Circumscribed flat area of discoloration more than 1 cm in diameter. Not palpable. Any color. Blanches under pressure.
Define a papule
Elevated small solid raised palpable bump. Generally 5-10mm in diameter.
Describe a pustule
Small located inflamed pus filled, lesion.
Up to 1cm in diameter.
Describe plaque
Small raised abnormal patch of tissue. 5-10mm in diameter.
Describe a nodule
Growth of abnormal tissue. At least 1cm in diameter. Palpable.
Describe a wheal.
Hive. Rounded flat top. Red red oedematous. Erythematous blanchable.
Describe vesicle and Bullae. Difference between the two.
Fluid filled sacs. Vesicle 5-10mm. Bullae >10mm.
Describe a cyst.
Sac like pocket. Filled with something. Usually more than 5mm in diameter.
Define erosion
Breakdown outer layer of skin- epidermis only. Usually d/t trauma.
Define ulcer.
Open sore d/t poor blood flow.
Define fissure
Small linear crack in skin.
Define atrophy.
Degeneration or thinning of skin.
Define excoriation
Abrasion from scratching.
Define crusts.
Outer coating formed from drying of a bodily exudate
Define scales
Loss of outer layer of epidermis in large scale like flakes.
Define Lichenification.
Thickened and hardened area of skin.
Define petechia.
Nonblanchable puncate foci of hemorrhage into dermis.
Define purpura.
Larger area of hemorrhage that may be palpable.
Difference between hematoma and ecchymosis.
Solid collection of blood.
Telangiectasia
Small dilated blood vessels.
Define burrow.
Like a work inside your skin.
Define comedome.
White and back head. Horny plug filling of pilosebaceous duct.
Name ABCDE of melanoma.
Asymmetry
Border
Color
Diameter
Evolution
Lesion on a photoexposed part of body, asymptomatic, not healing since at least 3 months. What am I?
Basal cell carcinoma.
Often ulcerated or hyperkeratosic. Chronic wound or erythematosquamous plaque. Photoexposed area. What am I?
Squamous cell carcinoma
Erythématosquamous, poorly delimitated on photo exposed area. Not cancerous.
Actinic Keratosis
Describe the characteristic presentation of Tinea corporis.
Pruritic, annular, erythematous patch or plaque that grows centrifugally. As rash spreads outwards, centreal clearing develops.
First line treatment of tinea corporis.
Topical imidazoles and allylamines.
Name 6 common diseases that cause annular lesions.
1- Erythema migrans
2- Erythema multiforme
3- Lichen planus
4- Tinea corporis
5- Pityriasis rosea
6- Plaque psoriasis
Name the Characteristic rash of lyme disease.
Erythema migrans.
What antibiotic do you prescirbe to someone with erythema migrans?
Doxycycline, amoxicillin or cefuroxime.
Describe plaque psoriasis lesions.
Pruritic, sharply demarcated, ertyhematous and round or ovoid with silver plaques that bleed easily with trauma.
What is erythema multiforme?
Hypersensitivity reaction to infections or drugs.
Describe erythema multiforme lesions.
Multiple raised, annular, target-like lesions with central erythema.
Lichen planus: Describe lesion.
Vialaceous, flat topped papules with fine white or gray reticular laxy lines on top of the rash.
Ddx for Acne
1- Rosacea
2- Folliculitis
3- Seborrheic dermatitis
4- Acne d/t medication or cosmetics
5- Miliaria
Ddx for cellulitis (5)
1- Statis dermatitis
2- Deep vein thrombosis
3- Contact dermatitis
4- Erythema nodosum
5- Panniculitis
Counselling for cellulitis (5)
1- Symptoms should improve within 24-48hrs of start of ATB treatment
2- RTC if no response after 72 hrs of tx
3- Rest, elevate, ice affected limb
4- Normal for skin to weep, flake or crack,
5- Must alleviate predisposing factors to prevent reccurent infection
