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DXM 2 > Dermatology Exam > Flashcards

Dermatology Exam Flashcards

1
Q

8 Steps in The Skin Exam:

A
  1. Preparation - pt gowned, lighting adequate
  2. Examination - carefully examine entire skin surface
  3. Palpate - palpate lesions to determine elevation
  4. Texture - Determine texture of lesions
  5. Scale - Scalpel blade used to check for scale; can be examined microscopically if fungal infection is suspected
  6. Size - measure/record measurements of lesions
  7. Diascopy - Differentiate between blanching erythema and non-blanching purpura by pressing with a glass slide
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2
Q

Flat lesions:

A

Macule, Patch

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3
Q

Smooth, raised lesions:

A

Cyst, Nodule, Papule, Plaque

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4
Q

Surface change lesions:

A

Crust, Scale

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5
Q

Fluid-filled lesions:

A

Bullae, Pustule, Vesicle

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6
Q

Red blanchable lesions:

A

Erythema, Erythroderma, Telangiectasia

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7
Q

Purpuric lesions:

A

Ecchymosis, Petechiae, Palpable Purpura

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8
Q

Sunken lesions:

A

Atrophy, Erosion, Ulcer

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9
Q

Necrotic lesions:

A

Eschar, Gangrene

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10
Q

Ddx for lesions on the head:

A

Syringoma: tiny bumps around lower eyes
Alopecia areata: balding
Dermatomyositis: Erythema on upper eyelid
Herpes simplex virus: cold sores on mouth

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11
Q

Ddx for lesions on the neck:

A

Cutis rhomboidalis nuchae - “quilt-looking” neck
Acne keloidalis nuchae - acne at base of skull/upper neck
Poikiloderma of civatte - red/brown rash on anteromedial neck
Acanthosis nigricans - Dark, velvety patches in the folds of the neck.

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12
Q

Ddx for lesions on the chest:

A

Steroid acne - pimples diffusely covering the chest
Nipple dermatitis - scaly, erythematous nipple
Darier’s disease - erythematous crusting of the chest
Drug-induced photosensitive reaction - diffuse erythema across the sternum

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13
Q

Ddx for lesions on the abdomen:

A

Morphea - red plaque scattered across the abdomen
Striae - stretch marks
Pityriasis rosea - diffuse pustules across the abdomen (usually starts with one large lesion)
Atopic dermatitis - eczema

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14
Q

Ddx for lesions on the arms:

A

Lichen planus - autoimmune disease where skin immune system attacks skin/ mucous membranes and creates purple, itchy, flat-topped bumps.
Keratosis pilaris - small acne-like bumps on the skin
Actinic keratosis - rough scaly patch, caused by sun exposure
Prurigo nodularis - Large, itchy, symmetrically distributed lesions that cause pain and discomfort

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15
Q

Ddx for anogenital lesions:

A

Condyloma acuminatum - genital warts (HPV)
Lichen sclerosus et atrophicus - thin, white patches of skin in genital area
Herpes simplex virus - pustulous lesions on genitals
Tinea cruris - fungal infection (jock itch)

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16
Q

Ddx for hand lesions:

A

Psoriasis - severely peeling fingernails
Scabies - Contagious, caused by burrowing skin mite
Secondary syphilis - rash on palms/soles
Dyshidrotic dermatitis - tiny, fluid-filled blisters on palms/fingers

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17
Q

Ddx for leg lesions:

A

Henoch-Schonlein Purpura (HSP) - diffuse petechiae; usually seen in children < 7
Livedo reticularis - Purple, net-like pattern of skin discoloration on the legs
Erythema induratum - nodular vasculitis (tuberculid skin erruption)
Stasis dermatitis - skin inflammation caused by fluid build up

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18
Q

Ddx for foot lesions:

A

Cutaneous larva migrans - parasitic “hookworm” infection; red, twisting lesions
Tinea pedis - “athlete’s foot” fungal infection
Plantar wart
Pitted keratolysis - patchy erosion of the bottom of the foot

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19
Q

Define acral distribution of skin lesions:

A

Involves the distal aspects of the head (ears, nose) and the extremities (hands, fingers, feet, toes).

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20
Q

Define dermatomal distribution of skin lesions:

A

Involves the area of skin supplied with sensory innervation by a particular nerve root. These do not cross the midline of the body.

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21
Q

Define intertriginous distribution of skin lesions:

A

Involves skin creases and folds. Includes involvement of the axillae, crural fold, gluteal crease, and possibly the inframammary fold.

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22
Q

Define lymphangitic distribution of skin lesions:

A

Appears along the path of lymph channels of the leg or arm.

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23
Q

Define photodistributed distribution of skin lesions:

A

Follows sun-exposed skin. Areas of involvement include forehead, upper ears, nose, cheeks, upper lip, neck, forearms, and dorsum of the hands.

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24
Q

Define scattered distribution of skin lesions:

A

Skin lesions occurring across many body locations; can appear to be distributed randomly or haphazardly.

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25
Q

Define symmetric distribution of skin lesions:

A

Skin lesions found symmetrically on the extremities can be indicative of diagnoses with many etiologies, including infectious, metabolic, genetic, and inflammatory causes.

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26
Q

Define widespread distribution of skin lesions:

A

Involves entire, or almost entire, body.

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27
Q

What shape is an annular lesion?

A

Ring-shaped

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28
Q

What shape is an arcuate lesion?

A

Arc-shaped

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29
Q

What shape is an grouped lesion?

A

Clustered

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30
Q

What shape is an linear lesion?

A

Straight line

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31
Q

What shape is an polycyclic lesion?

A

Coalescing circles, rings, or incomplete rings

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32
Q

What shape is an reticular lesion?

A

Net-like

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33
Q

What shape is an scattered lesion?

A

Irregularly distributed

34
Q

What shape is an serpiginous lesion?

A

Snake-like, or serpent-like in shape

35
Q

What shape is an targetoid lesion?

A

Shaped like a target

36
Q

What shape is an whorled lesion?

A

Stirred appearance

37
Q

What is eczematous dermatitis?

A

Most common inflammatory skin d/o; several forms: contact dermatitis, allergic contact dermatitis, atopic dermatitis

38
Q

What is folliculitis?

A

Inflammation/infection of the hair follicle and the surrounding dermis

39
Q

What is a furuncle (boil)?

A

A deep-seated infection of a pilosebaceous unit. Usually caused by staphylococcus aureus.

40
Q

What is cellulitis?

A

Diffuse, acute infection of the the skin and subcutaneous tissue. Majority of cases caused by Streptococcus pyrogens or Staphylococcus aureus.

41
Q

What is tinea (dermatophytosis)?

A

Group of non-candidal fungal infections that involves the stratum corneum, nails, or hair.

42
Q

What is pityriasis rosea?

A

Self-limiting inflammation of unknown cause. Non-contagious; often occurs in adults during spring time.

43
Q

What is psoriasis?

A

Chronic, recurrent disease of keratinocyte proliferation. Multifactorial origin with a genetic component and immune regulation.

44
Q

What is rosacea?

A

Chronic inflammatory skin d/o. Most often occurs in fair-skinned persons.

45
Q

What is herpes zoster (shingles)?

A

Varicella-zoster viral (VZV) infection; dormant viral particles from varicella infection in the posterior spinal ganglia or cranial sensory ganglia become activated and spread along the nerves.

46
Q

What is herpes simplex?

A

Infection by HSV; type 1 - oral infection; type 2 - genital infection. Crossover infections have become common.

47
Q

What is lyme disease?

A

Tick-borne disease that can result in a multisystemic infection. 3 stages: early localized, early disseminated, and late disease.

48
Q

What are drug eruptions?

A

Cutaneous reactions to medications. Rash usually accompanied by pruritis.

49
Q

What is acanthosis nigricans (AN)?

A

Non-specific reaction pattern associated with obesity, certain endocrine syndromes, or malignancies, or as an inherited d/o.

50
Q

What is basal cell carcinoma?

A

Most common form of skin cancer that arises from the basal layer of the epidermis. Occurs most frequently on exposed parts of the body.

51
Q

What is squamous cell carcinoma?

A

Second most common form of skin cancer. Malignant, arises in the squamous epithelium, and occurs most commonly in sun-exposed areas.

52
Q

What is a malignant melanoma?

A

Lethal form of skin cancer that develops from melanocytes. Exact cause is unknown.

53
Q

What is a Kaposi sarcoma (KS)?

A

A neoplasm of the endothelium and epithelial layer of the skin. Caused by Kaposi sarcoma herpes virus 8; commonly associated with HIV.

54
Q

What is alopecia areata?

A

Sudden, rapid coin-shaped loss of hair, usually from the scalp or face. Any hair-bearing surface may be affected. Regrowth may begin in 1-3 months.

55
Q

What is scarring alopecia?

A

Replacement of hair follicles with scar tissue; results in permanent hair loss.

56
Q

What is traction alopecia?

A

Hair loss as a result of prolonged, tightly pulled hairstyles. Follicle is undamaged and hair loss is reversible.

57
Q

What is hirstuism?

A

Growth of terminal hair in women in the male distribution pattern on the face, body, and pubic areas.

58
Q

What is paronychia?

A

Inflammation of the paronychium; caused by invasion of bacteria/yeast between the nail fold and nail plate.

59
Q

What is onychomycosis?

A

Fungal infection of the nail.

60
Q

What are ingrown nails?

A

Nails that pierce the lateral nail fold and grow into the dermis.

61
Q

What is a subungual hematoma?

A

Trauma to the nail plate severe enough to cause immediate bleeding and pain (bruised fingernail)

62
Q

What is onycholysis?

A

Loosening of the nail plate with separation from the nail bed that begins at the distal groove.

63
Q

What is koilonychia?

A

Spoon nails; central depression of the nail with lateral elevation of the nail plate. Associated with iron deficiency anemia, syphilis, fungal dermatoses, and hypothyroidism.

64
Q

What are beau lines?

A

Transverse depressions in the nail beds; due to systemic d/o’s.

65
Q

What is white banding (Terry nails)?

A

Whitening of the proximal half to three-quarters of the nail bed. Associated with cirrhosis, chronic CHF, adult-onset DM, and age.

66
Q

What is psoriasis (nails)?

A

Chronic, recurrent disease of keratinocyte proliferation. Nail involvement usually occurs simultaneously with skin disease.

67
Q

What are warts?

A

Epidermal neoplasms caused by viral infection (HPV).

68
Q

What are digital mucous cysts?

A

Cyst-like structures at the base of nails that contain a jelly-like substance. Not connected to the joint space of the DIP.

69
Q

What is a polymorphic eruption of pregnancy?

A

Benign dermatosis that usually arises late in the third trimester of pregnancy. Pruritic rash that usually starts on the abdomen and spreads (periumbilical area is spared).

70
Q

What is seborrheic dermatitis?

A

Chronic, recurrent, erythematous scaling eruption localized in areas where sebaceous glands are concentrated.

71
Q

What is Millaria rubra “prickly heat”?

A

Caused by sweat retention from occlusion of sweat ducts during periods of heat/high humidity.

72
Q

What is impetigo?

A

Common, contagious, superficial skin infection. Lesion, typically on the face, that itches and burns. Vesicle/bulla that turns into a crust as it heals.

73
Q

What is acne vulgaris?

A

Most commonly reported in adolescents; scarring may be present from previous lesions.

74
Q

What is chickenpox (varicella)?

A

Acute, highly communicable disease common in children and young adults; caused by VZV. Pruritic rash that started on scalp and moved to extremities; sxs fever, HA, sore throat, and malaise. Vaccine available

75
Q

What is measles (rubeola)?

A

Measles virus infects by invasion of respiratory epithelium; both endothelial and epithelial cells are affected. Sxs: fever, conjunctivitis, stuffy nose, cough, followed by red, blotchy rash starting on face and spreading to the trunk/extremities. Vaccine available

76
Q

What is German measles (Rubella)?

A

Mild, febrile, highly communicable viral disease. Macular rash on the face/trunk that spreads and becomes papular. Spread through respiratory droplets.

77
Q

What is tricholtillomania?

A

Hair-pulling leading to loss of scalp hair; unconscious habit.

78
Q

Signs of physical abuse in kids:

A 
Bruises
Lacerations
Burns
Hair loss
Presence of anogenital warts in kids < 2 years
79
Q

What s stasis dermatitis?

A

Swelling and erythema of the extremities due to fluid build up within the tissues. Occurs in the LEs of patients with venous insufficiencies.

80
Q

What is actinic keratosis?

A

Atypical squamous cells confined to the epidermis; occurs secondary to chronic sun damage. Lesions may evolve into squamous cell carcinoma over time.

DXM 2 (1 decks)

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