Exam 1: Dermatology Flashcards
Macule
Lesion is flat and small <1 cm
Ex: Mobiliform drug eruption, tinea versicolor, Benign melanocytic nevi, malignant melanoma
Patch
Lesion is flat and large >1 cm
Ex: seborrheic dermatitis, vitiligo, tinea cruris
Papule
Lesion is raised, small <1 cm, and not fluid filled
Ex: Basal cell carcinoma, skin tags, molluscum contagiosum, guttate psoriasis
Plaque
Lesion is raised, large >1 cm, but not fluid filled
Ex: Plaque psoriasis, atopic dermatitis, herald patch of pityriasis rosea, nummular dermatitis
Vesicle
Lesion is raised, small <1 cm, and filled with fluid
Ex: herpes Simplex virus, herpes zoster or shingles, rhus dermatitis or allergic contact dermatitis from poison ivy
Bulla
Lesion is raised, large >1 cm, and filled with fluid
Ex: Bullous fixed drug eruption, insect bites, and inherited skin fertility disorder
Good descriptions of skin findings include what 8 elements?
NUMBER- Solitary or multiple; estimate of total number
SIZE- Measured in millimeters or centimeters
COLOR- Including erythematous if blanching; if non-blanching, vascular-like cherry angiomas and vascular malformations, petechiae, or Purpera
SHAPE- Circular, oval, annular, nummular, or polygonal
TEXTURE- Smooth, flashy, verrucous or warty, keratotic; greasy if scaly
PRIMARY LESION- flat, a macule or patch; a papule or plaque; or fluid filled, a vesicle or bulla (May also be erosions, ulcers, nodules, ecchymosis, petechiae, and palpable Purpera)
LOCATION- Including measured distance from other landmarks
CONFIGURATION- Grouped, annular, linear
Blanching lesions
Are erythematous and suggest inflammation
Scaly can be ____, ____, or _____.
Include examples
1-Greasy (seborrheic dermatitis or seborrheic keratosis)
2-Dry and fine (tinea pedis)
3-Hard and keratotic (actinic keratosis or SCC)
Alopecia
Hair loss. Can be diffuse, patchy, or total.
The most common cause of diffuse hair thinning:
Male and female pattern baldness
What type of alopecia should be referred to a dermatologist?
Scarring alopecia
Sparse hair is seen in what condition?
Hypothyroidism
Fine, silky hair is seen in what condition?
Hyperthyroidism
What is the ABCDE – EFG rule and what does it stand for?
It is a method to teach clinicians and patients about features suspicious for melanoma. If 2 people or more of these are present, risk for melanoma increases and biopsy should be considered.
ASSYMETRY – of one side of mole compared to the other
BORDER IRREGULARITY – especially if ragged, notched, or blurred
COLOR VARIATIONS – more than 2 colors, especially blue-black, white (loss of pigment d/t regression), or red (inflammatory reaction to abnormal cells)
DIAMETER greater than 6 mm - approximately the size of a pencil eraser
EVOLVING- or changing rapidly in size, symptoms, or morphology
ELEVATED
FIRM to palpation
GROWING progressively over several weeks
Is a homogeneous blue color in a blue nevus concerning for melanoma?
No. Blue or black color within a larger pigmented lesion is concerning for melanoma.
Early melanomas may be ____, and many benign lesions are ______. (Sizes)
Early melanomas may be <6 mm and many benign lesions are >6mm.
What are signs of chronic sun damage?
Numerous solar lentigines on the shoulder and upper back,
Many melanocytic nevi,
Solar elastosis (yellow, thickened skin with bumps, wrinkles, or furrowing),
Cutis rhomboidalis nuchae (leathery thickened skin on the posterior neck), and
Actinic Purpera.
What is the best defense against skin cancers?
Avoid ultraviolet radiation exposure by limiting time in the sun, avoiding midday sun, using sunscreen, and wearing some protective clothing with long sleeves and hats with white brims. Avoid indoor tanning, especially children, and teens, and young adults.
Hair shedding at the roots is common in what two conditions?
Telogen affluvium and alopecia areata
Hair breaks along the shaft suggest what?
Damage from hair care or tinea capitis
What are causes of generalized itching, without apparent rash?
Dry skin, pregnancy, uremia, jaundice, lymphomas and leukemia, drug reactions, and less commonly polycythemia vera and thyroid disease.
Pallor indicates _____
Anemia
Cyanosis can indicate:
Decreased oxygen in the blood or decreased blood flow in response to a cold environment