Derminology

Question 1

Primary Lesions

Answer 1

A physical alteration of the skin considered to be caused directly by the disease process

Question 2

Macule lesions characteristics

Answer 2

flat, less than .5 cm

Question 3

Patch (lesion) characteristics

Answer 3

Flat, >0.5 cm

Question 4

Papule (lesion) characteristics

Answer 4

Raised, domed or flat-top, less than .5 cm

Question 5

Pustule (lesion) characteristics

Answer 5

Raised, domed, less than .5 cm

Question 6

Nodule (lesion) characteristics

Answer 6

Raised, domed, >0.5 cm

Question 7

Plaque (lesion) characteristics

Answer 7

Raised, flat-top, >0.5 cm

Question 8

Vesicle (lesion) characteristics

Answer 8

Blister, less than .5 cm

Question 9

Bulla (lesion) characteristics

Answer 9

Blister, >0.5 cm

Question 10

Erosion (lesion) characteristics

Answer 10

• Denudation (stripped of covering) of epidermis

- Non-scarring

Question 11

Ulcer (lesion) characteristics

Answer 11

• Denudation (stripped of covering) of dermis

- Scarring

Question 12

Wheal

Answer 12

edematous (condition characterized by excess watery fluid collecting in cavities of body); transient plaque

Question 13

Secondary Features

Answer 13

changes due to external factors, such as scratching, trauma, infection, or changes caused by healing

Question 14

Scale

Answer 14

• Thickening of the stratum corneum
• Adherent
• White, fine
• Yellow, greasy
• Hyperkeratotic

Question 15

Crust

Answer 15

• Dried endogenous material
• Serous
• Hemorrhagic
• Honey-colored

Question 16

Excoriation

Answer 16

Linear erosions from scratching

Question 17

Lichenification

Answer 17

• thickening of the skin with accentuation of skin markings

- occurs with CHRONIC scratching or rubbing

Question 18

Fissure

Answer 18

Linear crack in the skin

Question 19

Petechiae

Answer 19

• Pinpoint red-brown macules due to intradermal hemorrhage

- Non-blanching

Question 20

Palpable Purpura

Answer 20

• Intradermal hemorrhagic papules and plaques

- Non-blanching

Question 21

Non-blanching

Answer 21

Lesions do not fade with direct pressure

Question 22

Epidermal atrophy

Answer 22

• “Cigarette paper” wrinkling
• Red brown color
• Telangiectasias (visible blood vessels)

Question 23

Dermal atrophy

Answer 23

• Skin surface is depressed

- May or may not be associated with epidermal atrophy

Question 24

Off-white (hypopigmented)

Answer 24

Decreased pigment

Question 25

White (depigmented)

Answer 25

Complete loss of pigment

Question 26

Erythematous (red)

Answer 26

Inflammation or vascular (blood vessels)

Question 27

Brown/black

Answer 27

Melanin (pigment)

Question 28

Blue

Answer 28

Melanin (pigment) deposited deeper in skin

Question 29

Yellow

Answer 29

Sebaceous (oil gland) tissue or intracellular lipids

Question 30

Ovoid (shape)

Answer 30

Oval

Question 31

Targetoid

Answer 31

Resembles a bullseye

Question 32

Annular

Answer 32

Round with central clearing

Question 33

Linear

Answer 33

May occur due to external factors or with conditions that follow developmental skin lines

Question 34

Polycyclic

Answer 34

Annular lines are coalescing

Question 35

Sharply circumscribed

Answer 35

Sharp cutoff between normal and affected skin | -Suggests a more superficial process

Question 36

Diffuse (ill-defined)

Answer 36

- Edges are blurred | - Suggests a deeper process, such as inflammation of the fat (panniculitis)

Question 37

Scalloped

Answer 37

- When the blisters break, the edges are in close proximity and they leave behind a scalloped border - This is very helpful in making diagnosis of HSV infection

Question 38

Geometric

Answer 38

- Most rashes are round in shape | - Square eruptions or those that follow a pattern of an external object suggest contact dermatitis

Question 39

Serpiginous

Answer 39

-Wavy, snake-like border

Question 40

Stellate

Answer 40

- Angulated edges | - May suggest process is due to scratching or a condition affecting the underlying vasculature

Question 41

Blaschkoid

Answer 41

-Swirling patterns due to post zygotic mutation of melanocytes or keratinocytes

Question 42

Christmas tree

Answer 42

Long axis of the plaques follows line from superior and medial to inferior and lateral, mimicking the branches of a Xmas tree

Question 43

Dermatomal (Zosteriform)

Answer 43

- Linear bands that start and end at the midline on the trunk - Reflect the nerve supply to the skin - Herpes zoster (shingles) is unilateral and occurs in a band-like configuration

Question 44

Koebnerized

Answer 44

Koebnerization is a linear collection of lesions arising from external trauma -Classically occurs in psoriasis

Question 45

Reticulate (Retiform)

Answer 45

- Net-like pattern | - It may reflect the underlying vascular supply to the skin

Question 46

Photodistribution

Answer 46

Involves sun exposed skin | Spares behind the ears, under the chin and the anterior neck (shaded areas)

Question 47

Seborrheic Distribution

Answer 47

- Scalp - Brows - Glabella (b/t brows) - Alar creases (creases of the nose) - Chin - Postauricular sulcus (behind ears) - Sternal chest - Axillae - Groin

Question 48

Indurated

Answer 48

Firm to palpation

Question 49

Fluctuant

Answer 49

Compressible denoting underlying fluid or pus

Question 50

Burrow

Answer 50

Wavy or linear track typical of scabies infection

Question 51

Impetiginized

Answer 51

- Presence of honey-colored crust | - Used to describe wounds secondarily infected with Staph

Question 52

Necrotic

Answer 52

- Black, adherent crust called eschar | - Suggests overlying tissue is dead

Question 53

Pedunculated

Answer 53

Narrower at the base of the lesion

Question 54

Translucent (pearly)

Answer 54

- Shiny and see through | - Typical of basal cell skin cancers

Question 55

Umbilicated

Answer 55

Central depression | Classic for mollluscum

Question 56

Verrucous

Answer 56

Rough, warty surface