History & Physical of Derm Patient

Question 1

What are the 4 general characteristics of skin lesions that you need to consider?

Answer 1

Type**most important
Arrangement
Distribution
shape

Question 2

what is the difference btwn a primary and a secondary lesion?

Answer 2

primary lesion- changes in skin directly caused by disease

secondary lesion- changes to the primary lesions or from external causes

Question 3

name the non-palpable small primary lesions.

Answer 3

macule (0.5cm)

Question 4

name the palpable solid primary lesions.

Answer 4

papule (1cm)

plaque- coalescence of papules

Question 5

Name the fluid-filled lesions.

Answer 5

vesicle (< 0.5cm)

bulla (>0.5cm)

Question 6

If vesicles/bulla occur in the subepidermal layer, what is the disease that occurs in the subepidermal layer?

Answer 6

bullous pemphigoid

Question 7

If vesicles/bulla occur in the subepidermal layer, what is the disease that occurs in the subcorneal layer?

Answer 7

impetigo

Question 8

If vesicles/bulla occur in the subepidermal layer, what is the disease that occurs in the subgranular layer?

Answer 8

friction blister

Question 9

If vesicles/bulla occur in the subepidermal layer, what is the disease that occurs in the spongiotic layer?

Answer 9

contact derm and acute T. pedis

Question 10

name the pus-filled lesions/ vesicles.

Answer 10

pustule 0.5cm

Question 11

what is a cyst?

Answer 11

(primary lesion) that originates from invagination of epidermis into dermis

Question 12

what is a wheal?

Answer 12

raised, erythematous papule or plaque that represents short-lived dermal edema

Question 13

what is telangiectasia?

Answer 13

dilated superficial blood vessels as a result of long-term steroid use

Question 14

what is a papilloma?

Answer 14

upward proliferation of dermal papilla

Question 15

what is extravasated blood called?

Answer 15

purpura

Question 16

what is a small circumscribed punctate foci of extravasation (0.3cm) called?

Answer 16

petechiae

Question 17

what is a larger confluent area of extravasation (>0.5cm) called?

Answer 17

ecchymosis

Question 18

what is a hematoma?

Answer 18

area of massive bleeding into skin and underlying tissues

Question 19

what is lichenification?

Answer 19

(secondary lesion) caused by prolonged rubbing or itching of skin that leads to exaggerated normal skin lines

Question 20

what is a crust?

Answer 20

(secondary lesion) dried exudate of body fluids that may either be yellow or red

Question 21

what is an erosion?

Answer 21

loss of epidermis WITHOUT an associated loss of dermis

Question 22

what is an ulcer?

Answer 22

loss of epidermis AND dermis

Question 23

what is an excoriation?

Answer 23

linear erosions taht may be covered by crust and are caused by scratching
Ex. venous stasis dermatitis

Question 24

a linear arrangement is seen in what diseases?

Answer 24

poison ivy

Koebner phenomenon as seen in psoriasis

Question 25

a freckle is an example of what kind of lesion?

Answer 25

macule

Question 26

vitiligo is an example of what kind of lesion?

Answer 26

patch (or macule)

Question 27

a wart is an example of what kind of lesion?

Answer 27

papule

Question 28

a pimple is an example of what kind of lesion?

Answer 28

pustule

Question 29

paronychia is an example of what kind of lesion?

Answer 29

abscess

Question 30

describe an annular arrangement. give an example of derm disease that follows this arrangement.

Answer 30

round or circular with central clearing

Ex. tinea pedis

Question 31

describe an iris (target) arrangement. give an example of derm disease that follows this arrangement.

Answer 31

bulls eye lesion ; annular with central internal activity zone
Ex. erythema multiforme

Question 32

what does an arciform shape mean?

Answer 32

partial circle

“think arc”

Question 33

what does a serpiginous shape mean?

Answer 33

meandering

Ex. cutanea larva migrans

Question 34

what does a gyrate shape mean?

Answer 34

connecting arcs

Question 35

what does zosteriform shape mean/

Answer 35

follows dermatomal pattern

*recall that herpes zoster follows a dermatomal pattern