Descriptions Of Skin Lesions Flashcards

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1
Q

What is included in describing skin findings?

A

primary/secondary lesions
number
size
shape
color
texture
location
configuration
“classic features”

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2
Q

Primary Lesions may be:

A

flat
raised
depressed

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3
Q

Types of Primary Lesions

A

macule
patch
papule
plaque
nodule
vesicle
bulla (plural: bullae)
pustule
erosion
ulceration
wheal
ecchymosis
petechiae
purpura

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4
Q

Macule

A

flat (non-palpable)
<1 cm
color change only!
not filled with any material
color can very

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5
Q

What are examples of macules?

A

freckles, hypopigmentation, hyperpigmentation

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6
Q

Patch

A

flat
≥ 1 cm
color change only!
not filled with any material

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7
Q

Papule

A

raised but may have depressed portion (center)
superficial (arising from epidermis)
<1 cm
contents: solid (NO fluid inside)
color can vary
may be dome-shaped, flat topped
distribution can vary: group, dispersed

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8
Q

Plaque

A

raised or depressed
≥ 1 cm
contents: solid (NO fluid inside)
well defined (easy to see)
can form when papules coalesce

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9
Q

coalesce

A

merge together

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10
Q

Nodule

A

raised
≥ 1 cm
solid or fluid contents
larger and deeper than papule (can extend into dermis or subQ)
can result from inflammatory infiltrates, neoplasms, or metabolic deposits

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11
Q

Vesicle

A

raised
<1 cm
fluid contents: clear, serous, hemorrhagic)
dome-shaped or flaccid
top layer often thin
arise from cleavage at superficial level
at superficial level the layers are separating –> think blister!
well defined

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12
Q

serous fluid

A

clear yellow

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13
Q

hemorrhagic fluid

A

blood

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14
Q

what vesicle has erythema surrounding it? (erythema at the base)

A

varicella, chicken pox

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15
Q

Bulla (Bullae: plural)

A

raised
≥ 1 cm
fluid contents (clear, serous, hemorrhagic
arise from cleavage at superficial level
well defined lesions

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16
Q

flaccid bullae

A

sunk back down

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17
Q

tense bullae

A

ready to pop

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18
Q

Pustule

A

raised
<1 cm
fluid (pus)
superficial
sometimes hair follicle is involved

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19
Q

purulent

A

pus

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20
Q

folliculitis

A

small pustules with erythematous halos

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21
Q

pustular psoriasis

A

widespread pustules on an erythematous base

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22
Q

Erosion

A

depressed
any size
no contents (b/c loss of tissue)
focal loss of epidermal tissue (no loss of dermis, superficial)
heal without scarring
seen in inflammatory conditions
may be secondary lesions (bulla popped)

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23
Q

ulceration

A

depressed
any size
no contents (loss of tissue)
loss of epidermis and at least a portion of the dermis
deeper than erosion
leaves a scar
may be secondary lesions

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24
Q

wheal

A

swelling with skin
circumscribed (clear borders)
irregular: size and shape can change
transient (<48 hrs)
produced by cutaneous edema
red to pale in color
frequently itch
THINK HIVES!!!

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25
Q

circumscribed

A

well-defined and distinct from surrounding parts

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26
Q

ecchymosis

A

bruise
multiple colors
>3 mm

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27
Q

petechiae

A

deep red/reddish purple
1-3mm (pinpoint)
round and flat
can occur on mucous membranes too (in mouth)

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28
Q

purpura

A

deep red/reddish purple
larger than petechiae
can be irregularly shaped
may be palpable

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29
Q

What 3 primary lesions are due to blood leaving the vessels and do not blanch when pressure applied?

A

ecchymosis
petechiae
purpura

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30
Q

stratum corneum

A

dead keratinized cells
outer layer of the epidermis

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31
Q

secondary lesions

A

scale
crust
lichenification
erosion
ulcer
excoriation
scar
atrophy
fissure

32
Q

scale

A

excessive accumulation of stratum corneum
flakes: can be large, tiny, adherent, loose
Think psoriasis

33
Q

crust

A

dried exudate of body fluids

34
Q

serous crust

A

yellow

35
Q

hemorrhagic curst

A

red
dried blood

36
Q

superficial crust

A

glistens; “honey-colored”

37
Q

epidermal crust

A

thick and adherent

38
Q

Impetigo

A

honey colored crusted plaque
erosions thick, crusted plaques

39
Q

lichenification

A

distinctive skin thickening
accentuated skin-fold markings
result of chronic scratching/rubbing
CHRONIC rather than acute

40
Q

What two lesions can be both primary and secondary?

A

erosion: bulla that unroofs
ulcer: nodule that ulcerates

41
Q

Excoriation

A

linear, angular erosion
may be covered by crust
caused by scratching

42
Q

Scar

A

can change appearance over time
skin change secondary to trauma/inflammation (fibrous tissue - collagen being deposited)
may be erythematous, hypopigmented, hyperpigmented
hair follicles may be destroyed

43
Q

Define atrophy

A

layers of skin not growing

44
Q

Atrophy

A

acquired loss of substance
ex: loss of epidermis –> shiny quality with “cigarette paper” wrinkling
ex: loss of the dermis or subQ –> depressed lesion
underlying vessel may be revealed

45
Q

fissure

A

linear lesion (crack)
found in skin or mucosa (anal)
result of excessive tension or decreased elasticity

46
Q

Number

A

solitary or multiple
count if possible (less than a dozen)

47
Q

size

A

measure with ruler
use mm or cm

48
Q

how to determine size of oval-shaped lesion

A

measure the long axis first, then measure perpendicular to the long axis

49
Q

How to determine size of multiple lesions?

A

note the size ranges

50
Q

possible shapes of lesions

A

circular
oval
annular
nummular
polygonal
acruate
reticular
serpiginous

51
Q

annular

A

ring-like, with a central clearing
color/texture more prominent at the edge

52
Q

nummular

A

coin-like, no central clearing

53
Q

polygonal

A

varied, non-geometric shape

54
Q

acruate

A

arc-shaped; result of incomplete formation of annular lesion

55
Q

reticular

A

net-like or lacy

56
Q

serpiginous

A

serpentine or snake-like

57
Q

color

A

tan, light brown, dark brown
erythematous (red); erythematous lesions blanch with pressure
skin-colored or flesh-colored

58
Q

what is an important question when talking about color of lesion?

A

is the color consistent throughout the lesion? is it uniform?

59
Q

demarcation

A

is the edge of the lesion sharply (well) defined, or does it blend into the surrounding skin?

60
Q

Texture

A

palpate the lesion to determine texture

61
Q

What are types of textures?

A

smooth
fleshy
verrucous/warty
scaly (fine, (hyper)keratotic, greasy)

62
Q

fine scaly

A

dry, but not keratotic

63
Q

(hyper)keratotic Scaly

A

hard, “crustier”

64
Q

location/distribution

A

be specific and use anatomical terms

65
Q

location

A

can also include measured distance from anatomic landmarks

66
Q

What are things to think about for distribution?

A

photodistributed
acral
truncal
extensor vs. flexor
intertriginous
generalized vs. localized

67
Q

photodistributed

A

on sub-exposed areas

68
Q

acral

A

distal locations (hands, feet, wrists, ankles)

69
Q

truncal

A

on the trunk

70
Q

intertriginous

A

in skin folds

71
Q

generalized

A

all over the body

72
Q

localized

A

specific location

73
Q

configuration

A

grouped
linear
scattered (no pattern)
dermatomal

74
Q

classic features

A

buzz words
include descriptions of lesions that are pathognomonic for a particular disease

75
Q

examples of classic features

A

Christmas tree distribution (back)
grouped vesicles on an erythematous
stuck-on, verrucous appearance