Dermatology Overview Flashcards
What is a primary lesion?
- may be present at birth or result of disease, allergic reaction or enviornmental agents
- a primary lesion in one disease may be a secondary lesion in another
What is this primary lesion?
- flat, even with the surface level of surrounding skin
- perceptible only as an area of color different from the surrounding skin
- touch it and cant tell its different from any other part of skin
- smaller than 0.5 cm

Macule
What is this primary lesion?
- solid, elevated lesion less than 0.5 cm in size
- a significant portion projects above the plane of the surrounding skin

Papule
What is this primary lesion?
- similar to a macule
- flat area of skin or mucous membranes with a different color from its surrounding
- larger than 0.5 cm, and it may have a fine, very thin scale
- Larger version of a macule

Patch
What is this primary lesion?
- Solid, plateau-like elevation that occupies a relatively large surface are in comparison with its height above the normal skin level
- diameter larger than 0.5 cm

Plaque
What is this primary lesion?
- fluid-filled cavity or elevation smaller than or equal to 0.5cm
- the fluid in the cavity exerts equal pressure in all directions to give rise to a spherical shape

vesicle
What is this primary lesion?
- measures larger than 0.5 cm
- the fluid in the cavity exerts equal pressure in all directions to give rise to a spherical shape

Bulla (Blister)
What is this primary lesion?
- solid, round or ellipsoidal, palpable lesion
- diameter larger than 0.5 cm

Nodule
- tumor, also sometimes included under the heading of nodule, is a general term for any mass, benign or malignant
What is this primary lesion?
- swelling of the skin that is characteristically evanescent, disappearing within hours
- also known as hives or uticaria
- the result of edema produced by the escape of plasma through vessel walls in the upper portion of the dermis
- may be tiny papules or giant plaques, and they may take the form of various shapes (round, oval, serpiginous, or annular), often in the same patient
- disapears on its own
- scratch skin and it stays–>but eventually will go away

Wheal
What is this primary lesion?
- Encapsulated cavity or sac line with a true epithelium that contains fluid or semisolid material (cells and cell products such as keratin)
- spherical or oval shape results from the tendency of the contents to spread equally in all directions

cyst
What is a secondary lesion?
- changes in the skin result from primary skin lesions
- can be natural progression, or result of patient manipulating (picking) the primary lesion
- a defect in which the epidermis and at least the upper (papillary) dermis have been destroyed

Ulcer
What is this secondary lesion?
- flat plate or flake arising from the outermost layer of the stratum corneum

Scale, Desquamation
What is this secondary lesion?
- hardened deposits that result when serum, blood, or purulent exudate dries on the surface of the skin
- the color is a yellow-borwn when formed from dried serous secretion
- turbid yellowish-green when formed from purulent secretion
- reddish-black when formed from hemorrhagic secretion

Crust
- removal of the crust may reveal an underlying erosion or ulcer
- Honey crusted lesion
What is this secondary lesion?
- moist, circumbscribed depressed lesion that results from loss of a portion or all of the viable epidermal or mucousal epithelium
- may result from trauma, detachment of epidermal layers with maceration, rupture of vesicles or bullae, or epidermal necrosis

- Erosions
- do not scar unless become secondarily infected
- this can be the beginning of a bed sore
- drug rxs, burns
What is this secondary lesion?
- Surface excavations of epidermis that result from scratching

Excoriation
What is this secondary lesion?
- Proliferation of fibrous tissue that replaces previously normal collagen after a wound or ulceration breaches the reticular dermis

Scar
What is this secondary lesion?
- Reactive thickening of the epidermis, with changes in the collagen of the underlying superficial dermis
- These changes produce a thickened skin with accentuated markings, which may resemble tree bark
- from excessive itching

Lichenification
- Diminution in the size of a cell, tissue, organ, or part of the body.
- An atrophic epidermis is glossy, almost transparent, paper thin and wrinkled, and may not retain normal skin lines.
- Paper like appearance of skin
- get common skin tears
- as our collagen depletes

Atrophy
- Deep, necrotizing folliculitis with suppuration.
- Presents as an inflamed follicle-centered nodule usually greater than 1 cm with a central necrotic plug and an overlying pustule
- Several furuncles may coalesce to form a carbuncle.

Furuncle
- Localized accumulation of purulent material so deep in the dermis or subcutaneous tissue that the pus is usually not visible on the surface of the skin
- Pink, erythematous, warm, tender, fluctuant nodule
- so deep it doesnt have a white head

Abscess
- Wavy, threadlike tunnel through the outer portion of the epidermis excavated by a parasite

Burrow
- Scabies burrow under the skin
• represents the blanchable pink to red color of skin or mucous membrane that is due to dilatation of arteries and veins in the papillary and reticular dermis

Erythema
- Extravasation of red blood from cutaneous vessels into skin or mucous membranes
- Results in reddish-purple lesions
- The application of pressure with two glass slides or an unbreakable clear lens (diascopy) on a reddish-purple lesion is a simple and reliable method for differentiating redness due to vascular dilatation (erythema) from redness due to extravasated erythrocytes or erythrocyte products (purpura).
- Non-blanching
- more systemic issues going on

Purpura
- Purpura less than 1 cm in diameter
- can see these in eyes from increase pressure and capillaries bursting
Petechiae

- Persistent dilatations of small capillaries in the superficial dermis that are visible as fine, bright, non-pulsatile red lines or net-like patterns on the skin
- very common
- spider veins

Telangiectasia
- Hair follicle infundibulum that is dilated and plugged by keratin and lipids

Comedo (Comedone)
- When open to the surface of the skin with a visible keratinaceous plug, the lesion is referred to as an open comedo.
- The black color of the comedo is due to the oxidized sebaceous content of the infundibulum (“blackhead”)
- A closed infundibulum in which the follicular opening is unapparent accumulates whitish keratin and is called a closed comedo. (“whitehead)
- Hyperkeratotic conical mass of cornified cells arising over an abnormally differentiating epidermis
- not cancerous or harmful

Horn
- Deposits of calcium in the dermis or subcutaneous tissue may be appreciated as hard, whitish nodules or plaques, with or without visible alteration of the skin’s surface
- built up calcium but not harmful
- usually around sun damaged area
- but can occur anywhere

Calcinosis
- Linear loss of continuity of the skin’s surface or mucosa that results from excessive tension or decreased elasticity of the involved tissue.
- Frequently occur on the palms and soles where the thick stratum corneum is least expandable
- skin breaks open
- over dryness leads to decreased elaticity

Fissure
- Excessive accumulation of scale (hyperkeratosis) that results in a yellowish thickening of the skin
- Usually on the palms or soles, that may be inherited (abnormal keratin formation) or acquired (mechanical stimulation)
- overworked area of skin

Keratoderma

- Linear depressions of the skin that usually measure several centimeters in length and result from changes to the reticular collagen that occur with rapid stretching of the skin
- skin grows too quickly
- rapidly expanding of skin
- stretch marks

Striae

- Tract connecting deep suppurative cavities to each other or to the surface of the skin
- everything is connected and channeling

Sinus
What is this distribution of lesion?
- Ring shaped
- Edge of lesion differs from center
- Raised
- Scaly
- Differing color

Annular
What is this distribution of lesion?
- Coin shaped
- Uniform morphology from edges to center

Nummular
What is this distribution of lesion?
- Coalescing circles, rings or incomplete rings

Polycyclic
What is this distribution of lesion?
- Arc-shaped
- Often incomplete formation of annular lesion
- not completely formed yet so can be a precursor to anular

Arcuate
What is this distribution of lesion?
• Resembling straight line

Linear
What is this distribution of lesion?
- Net-like or lacy in appearance
- Somewhat regularly spaced rings or partial rings
- Sparing of intervening skin

Reticular
What is this distribution of lesion?
- Serpentine or snake-like

Serpiginous
What is this distribution of lesion?
- Target-like
- At least 3 distinctive zones
- usually seen with lyme disease

Targetoid
What is this distribution of lesion?
- Like marble cake
- Two distinct colors interspersed in a wavy pattern

Whorled