Describing Skin Lesions Lecture Powerpoint Flashcards
This better be easier than nephrology damn it
Skin lesion morphology definition
The form and structure of a skin lesion
It is important to inspect the skin using both ___ and ___ inspection and describe findings using correct descriptive terms
Visualization (using tangential lighting, etc), tactile sensation (checking for blanching, feeling for bumps)
Primary skin lesion vs secondary skin lesion
Primary are physical changes to the skin considered to be directly resultant from the disease process, secondary are evolved from primary lesions or caused by external forces such as scratching, trauma, infection or healing
Example of primary skin lesion vs secondary skin lesion
Bug bite causing papule is primary skin lesion, excoriations from scratching the itchy bite is a secondary skin lesion
Macule definition
A flat, unpalpatable circumscribed discoloration from normal skin <1cm
Patch definition
A flat, inpalpatable circumscribed discoloration from normal skin >1cm
What condition is this and what type of morphology does it demonstrate?
Vitiligo, patch
Papule definition
A discreet, solid, elevated skin lesion of varying color <1cm
Plaque definition
A discreet, solid, elevated skin lesion of varying color >1cm
A way to tell if a plaque is in fact raised above the skin surface
Shine a light tangentially and inspect from side for a shadow
What condition is this and what type of morphology does it have?
Psoriasis, plaque
Cyst definition
A closed cavity or sac with fluid or semisolid material <1cm
Nodule definition
A closed cavity or sac with fluid or semisolid material >1cm
Sometimes a large nodule is referred to as a…
…tumor
Cysts and nodules can occur in these dermatological layers (3)
Epidermis
Dermis
Hypodermis
Wheal definition
An area of edema in the upper epidermis presenting uniquely as a raised, erythematous lesion
What are these lesions called?
Wheals
Crust definition
A hardened layer of serum, blood, and purulent exudate appearing lesion on the skin
What condition is this and what morphology is it classified as?
Impetigo, crust
Scale definition
A build up of excess stratum corneum creating hard, dry plaques
Lichenification Definition
Accentuation of normal skin lines thru thickening of skin, often the result of chronic scratching
What secondary lesion morphology is this resulting from atopic dermatitis scratching?
Lichenification
Burrows definition
Linear tunnels appearing in the epidermis as result of a parasite digging into the skin
Where is scabies often seen, where is it almost never seen?
Often seen in skin folds particularly webbing of toes and fingers, almost never seen above the neck except rarely in infants
What condition is this and what type of morphology does it display?
Scabies infection, burrows
Vesicle definition
A fluid filled lesion <1cm
Bullae definition
A fluid filled lesion >1cm
What morphology is this skin lesion?
Vesicle
What morphology is this skin lesion?
Bulla
What is the condition and morphology associated of the image?
HSV, vesicles
Pustule definition
A fluid, pus filled skin lesion <1cm
Abscess defintion
A fluid and pus filled lesion >1cm
What is the condition and morphology associated with this image?
MRSA infection, abscess
A lot of people mistake a MRSA infection as a…
…spiderbite
Furuncle definition
A boil, a skin abscess typically caused by staph infection that invades a hair follicle and surrounding tissue
Carbuncle definition
Clusters of boils (furuncles) connected subcutaneously from typically MRSA infected hair follicles
What morphology is this skin lesion?
Furuncle
Erythema definition
Localized increased blood flow to the skin causing a red appearance
Erythroderma definition
Generalized increased blood flow to all of epidermis resulting in red coloration
How do we tell the difference between erythema and ecchymoses?
If it blanches, it is still contained in the vessel and is erythema (increased blood flow), if it doesn’t, it has spilled out of the vessel and is a bruise
What condition is this and what morphology is the skin displaying?
Roseacea, erythema
Telangiectasias defintion
Small, permanent dilated superficial blood vessels on the skin, sometimes a sign of hepatic disease but often environmental exposure
What disease state is this?
Basal cell carcinoma
Ecchymosis definition
A type of purpura, nonblanchable rupturing of small capillaries beneath the skin resulting in accumulation of blood in the surrounding tissues often appearing dark blue in color
Purpura definition
Blood spots or skin hemorrhages, class of purple colored spots recognizable on the skin including ecchymoses and petachiae
What morphology is this skin lesion?
Ecchymosis
Petechiae definition
A type of purpura, small 1-2mm nonblanchable macules of tiny hemorrhages under the skin
Palpable purpura definition
Raised palpable discoloration due to vasculitis in the skin creating nonblanchable blood filled lesions
Henoch-schonlein purpura definition
A rare inflammatory disorder of small blood vessels most commonly occuring in children resulting in disseminated purpura in lower extremities
What condition is this?
Henoch schonlein purpura
Atrophy definition (derm), what is an example of what causes it?
A weakning and thinning of skin layers appearing as a sunken lesion
Often due to repeated activity such as insulin injections in the same spot
Fissure definition
Sharp linear crack in the epidermis resulting in sunken in lesion appearance
What is this condition and when is it often seen?
anal fissure, often seen with constipation
What dermatologic condition is this called?
Atrophy of the epidermis
Erosion definition
A localized loss of epidermal epithelium and part of dermis that upon healing does not scar over
Ulcer definition
A circumscribed loss of epidermis that heals with scarring of tissue
Ulcerations often appear underneath…
….vesicles or bullae or other raised skin lesions
Eschar definition
Hardened crust and plaque covering an ulcer of necrotic tissue, giving it a characteristic black appearance
Gangrene definition
Black, dead, necrotic tissue
What morphology is this lesion?
Ulcer
What condition is this lesion?
Erosion
What condition is this lesion?
Eschar
Scar definition
Permanent fibrotic changes that occur following damage to the dermis of the skin
Keloid definition
Exaggerated connective tissue response to injured skin that extends beyond the original wound’s edges, some form them and others do not, recurrent in almost all cases
What condition is this skin lesion?
Keloid
Striae definition
Stretch marks, irregular areas of skin due to distension from extreme weight gain or loss
Acral distribution definition
On the tips of fingers, toes, ears
Dermatomal distribution definition and what is its other name?
Along a dermatome on the skin, zosterform
Intertriginous distribution definition
Within skin folds and creases
Lymphangitis distribution definition
Following along a lymph channel of the extremities
Photodistributed distribution definition
Along the skin lines exposed to sunlight
Glove and stocking distribution definition
Hands and feet only
What distributuion is this?
Acral
What distribution is this?
Intertriginous
Configuration definition
How skin lesions are organized and related to one another
Annular configuration definition
ring shaped
Arciform configuration definition
Arc shaped
Polycyclic configuration definition
Coalescing rings and arcs
Reticular configuration definition
Net like
Targetoid configuration definition
Bullseye appearance
Color considerations when classifying a lesion
- single or multicolored
- hyper or hypopigmented
- what color
