Exam One Questions/Definitions

Question 1

Raised, fluid filled lesion larger than a vesicle

Answer 1

Bulla

Question 2

Crack or break in the skin

Answer 2

Fissure

Question 3

Flat, colored spot
<1 cm
Non-palpable

Answer 3

Macule

Question 4

Solid, raised lesion extending into dermis or subcutaneous tissue
often indicative of systemic disease
>5mm-2cm in diameter

Answer 4

Nodule

Question 5

Superficial layer of skin that provides protection

Answer 5

Epidermis

Question 6

Deeper layer of skin that provides firmness and elasticity; contains sweat glands

Answer 6

Dermis

Question 7

Thickness of skin

Answer 7

Varies from 8mm at soles of feet to 1mm at eyelid

Question 8

Subcutaneous tissue

Answer 8

(Fat); Lies beneath the skin and outside the fascia and contains arteries, veins, and nerves

Question 9

Layers of epidermis (outer to inner)

Answer 9

Stratum corneum - layered, dead, shedding cells
Granular cell layer
Spinous cell layer
Basal cell layer - active layer, rapidly multiplying cells, melanocytes

Cells migrate up from basal cell later, collect keratin protein, become flat and scaly (squamous epithelium) at the stratum corneum

Question 10

Components of dermis

Answer 10

Sweat glands/dilated of BV help cool body
Sebaceous (oil) glands lubricate skin and help maintain barrier to water, chemicals, etc
Dermis has nerve endings of the skin
Vit D synthesis from sun exposure
Ridges (papilla) at top of dermis = fingerprints
Muscle contraction of erector pili (goosebumps)

Question 11

Subcutaneous layer function

Answer 11

Insulation and energy storage

If fat collects to fast or too much, collagen and elastin fibers in dermis get stretched, causing dimpling of the skin (“cellulite”)

Question 12

Physical exam general

Answer 12

Visualize skin signs: type, shape, arrangement, distribution (10-20x magnification)

Dermascope

Palate (soft, hard, scaly, temp, tender, mobility)

General appearance

Consider lab and special exam: direct culture, fungal 10% KOH, gram stain, tzanck smear, biopsy, woods lamp, patch testing, etc, blood, X-ray, UA, stool

Question 13

Small, circular, raised lesion at the surface of skin (epidermis)
<5mm in diameter

Answer 13

Papule

Question 14

Palpable solid elevated lesion in epidermis >5mm in diameter

Answer 14

Plaque

Question 15

Raised lesion containing pus; often in a hair follicle or sweat pore
<5mm in diameter

Answer 15

Pustule

Question 16

Lesion resulting from destruction of the skin and perhaps subcutaneous tissue

Answer 16

Ulcer

Question 17

Small, fluid-filled raised lesion of serous fluid in epidermis; blister or bleb
<5mm in diameter

Answer 17

Vesicle

Question 18

Smooth, rounding, slightly aided area often associated with itching; seen in urticaria sun as resulting from allergy

Answer 18

Wheal

Question 19

Non palpable
localized change in skin color >1cm in diameter

Answer 19

Patch lesion

Question 20

Solid elevated lesion extending into dermis or subcutaneous tissue >2cm in diameter

Answer 20

Tumor

Question 21

Localized accumulation of serous fluid in epidermis
>5mm in diameter

Answer 21

Bullae

Question 22

Fluid filled or solid mass in skin extending into dermis or subcutaneous tissue

Answer 22

Cyst

Question 23

Purpura v vascular dilation glass slide test for red lesion

Answer 23

Redness remains under pressure = purpuric
Redness disappears = erythematous, due to vascular dilation

Question 24

Seborrheic keratosis RF

Answer 24

AD
>30, avg 61

Question 25

Most common benign skin neoplasms

Answer 25

Seborrheic keratosis Nevi

Question 26

Seborrheic keratosis Malignancy potential

Answer 26

None

Question 27

Seborrheic keratosis sx

Answer 27

Lesions on head, neck, trunk, extremities Flesh colored, tan, brown, black Oval/round “Pasted on” papule or plaque, may be greasy or scaly Well circumcised border 2mm-3cm+ Older lesions more raised, darker Slow growing Can become irritated from skin

Question 28

Types of Seborrheic keratosis

Answer 28

Rough type - verrucous, crumbly, dry, cracked, accentuation of hair follicles Smooth type - smooth dome-shaped surface with tiny, round 1mm white or black horny cysts/pearls imbedded in surface

Question 29

Seborrheic keratosis Tx

Answer 29

None required, cosmetic removal If its an all black lesion without horn cysts > shave biopsy to confirm

Question 30

Dermatosis papulosa nigra sx

Answer 30

Doesn’t cause any ulcerations, scaling, crusting 1-5mm in diameter, 1-3mm high Start in adolescence as smooth bumps, gradually become rougher with time May also grow in size and # with age

Question 31

RF skin tags

Answer 31

Second decade, >50 Metabolic syndrome

Question 32

Skin tag appearances

Answer 32

Acrochordon (obesity, DM, metabolic syndrome), cutaneous papilloma, soft fibroma Soft, skin colored to slightly pigmented 1-10mm Hyperpigmentation esp in darker skin Pedunculated papule Axilla, neck, groin, eye, mouth When irritated may appear necrotic

Question 33

Dermatofibroma RF/causes

Answer 33

Unknown etiology Thought to be fibrous rxn to trauma, infection, insect bites Multiple Dermatofibromas with untreated SLE

Question 34

Dermatofibroma sx

Answer 34

3-10 mm Slightly elevated Scaly Rarely seen with other skin lesions Dimple sign; central dimpling of lesion when pinched between thumb and index fingers

Question 35

Keloid vs hypertrophic scar

Answer 35

Keloid - enlargement of scar WITHIN BOUNDARY of original scar Hypertrophic - beyond the boundary

Question 36

RF keloids

Answer 36

10-30 Darker skin Trauma

Question 37

Tx keloids

Answer 37

Silicone based gel therapy Corticosteroids Acupuncture Steroids Etc