ICM - Skin Abnormals

Question 1

Fine, short, nonpigmented adult hair. Growth not affected by hormones.

Answer 1

Vellus Hair,

Question 1

Trauma to nails causing areas of white discoloration. Cause: Trauma, Repeated manicuring

Answer 1

Leukonychia

Question 2

Up to 1.0 cm, Filled with serous fluid

Answer 2

Vesicle

Question 2

Loss of superficial epidermis. Heals without scarring. Examples: Ruptured blister

Answer 2

Erosion

Question 3

ABC’s of Malignant Melanoma

Answer 3

A – asymmetry B – borders (irregular) C – color (variegated) D – diameter > 6mm E – evolution Some add: F – “funny looking”

Question 4

Pressue Sore staging

Answer 4

Level 1 though four. Two is into subcutaneous, three into muscle, four down to bone.

Question 4

Transverse depressions secondary to trauma or systemic illness. Lines grow out with the nail 1mm every 6-10 days

Answer 4

Beau’s Lines

Question 5

Fungal infection of nail bed, plate or matrix. Cause: Occlusive footwear, locker room exposure

Answer 5

Onychomycosis

Question 6

Red, irregular lesion secondary to dilation of dermal capillaries. May start as a macule or patch, then progress to nodule. Example: “Strawberry hemangioma”

Answer 6

Hemangioma

Question 6

Rounded, bulbous nail base. Feels spongy. Causes: Chronic hypoxia, Congenital heart disease, Lung cancer

Answer 6

clubbing

Question 6

Painless separation of the nail plate from the nail bed. Causes: - Most common: trauma to long finger nails. Other: psoriasis

Answer 6

Onycholysis

Question 8

Elevated, Filled with pus. Examples: Fire ant bites (photo), Acne.

Answer 8

Pustule

Question 10

Flat, non-palpable, <1 cm in diameter, Variable color. Example: Freckles

Answer 10

Macule

Question 11

A thin flake of exfoliated epidermis. Example: Dandruff, Pityriasis rosea

Answer 11

Scale

Question 11

80% of all skin cancers. Sun-exposed head/neck. classic pearly papules + telangectasias; sometimes rolled borders. grow slow; almost never metastasize.

Answer 11

Basal cell carcinoma

Question 12

Definition: Flat, non palpable, > 1 cm in diameter. Examples: Café au lait spots, Vitiligo

Answer 12

Patch

Question 13

Mostly white with a distal band of reddish brown. Cause: Aging, Chronic disease such as cirrhosis

Answer 13

Terry’s Nails

Question 14

Autoimmune hair loss. Smooth; no broken hairs

Answer 14

Alopecia Areata

Question 15

HARRM Risk Factors for Melanoma

Answer 15

History of previous melanoma. Age > 50. Regular dermatologist absent. Mole changing. Male gender

Question 17

Abrasion or scratch mark. May be linear or rounded. Usually due to scratching. Examples: Scabies, Atopic dermatitis, Dry skin, Cutting, Skin picking.

Answer 17

Excoriation

Question 19

Deeper loss of epidermis and dermis. May bleed, Heals with scarring. Example: Decubitus/Pressure sores.

Answer 19

Ulcer

Question 19

Acute or chronic inflammation of the proximal & lateral nail folds. Nail folds swollen, reddened, & tender. Cause - Frequent immersion in water, Nail biting

Answer 19

Paronychia

Question 20

Deep red/purple-red lesions < 0.5 cm. Non-blanchable. Represent blood outside of vessel. Seen with infections and bleeding disorders

Answer 20

Petechiae

Question 22

Irregular, transient, superficial edema. Examples: Hives (Urticaria), Allergic reaction

Answer 22

Wheal

Question 23

Up to 1 cm, Palpable. Examples: Warts, Nevi (moles)

Answer 23

Papule

Question 23

Additional Melanoma Risk Factors

Answer 23

\>50 common moles. \>1-4 atypical or unusual moles. Red or light hair. Actinic lentigines (sun spots). Heavy sun exposure / severe childhood burns. Light eye/skin color (freckles/burns easy. FMHx of melanoma

Question 23

Round scaling patches. Hair broken off close to surface of scalp Usually caused by fungal infection

Answer 23

Tinea Capitis

Question 24

Elevated, palpable, \> 1 cm. Examples:, Psoriasis

Answer 24

Plaque

Question 25

Greater than 1.0 cm, Filled with serous fluid. Examples: 2nd degree burns. Blisters.

Answer 25

Bulla

Question 27

Bright –red papules, 1-3 mm size. Seen on the trunk. Don’t blanch. Associated with aging

Answer 27

Cherry Angiomas

Question 29

Fine, irregular red lines secondary to dilation of capillaries. Seen with basal cell carcinomas, sun damaged skin, rosacea

Answer 29

Telangectasias

Question 30

Thinning of skin with loss of normal skin markings. Skin looks shinier and more translucent. Examples: Stretch marks / striae (photo). Topical steroid use.

Answer 30

Atrophy

Question 32

Purple lesions of variable size. Fade to green, yellow, brown. Represent blood outside of vessels due to trauma or bleeding disorder

Answer 32

Bruising

Question 33

INGROWN TOENAIL, Usually involving the large toe. Nail grows into the dermis. Cause: Improperly cutting nails, Tight shoes

Answer 33

Onychocryptosis

Question 34

Dried residue of serum, pus, or blood.

Answer 34

Crust

Question 35

Deep red/purple-red lesions \> 0.5 cm. Nonblanchable. Example: Vasculitis, Henoch schonleinpupura, ITP

Answer 35

Purpura

Question 36

\> 0.5 cm, Deeper than a papule, Height \> width. Example: Rheumatoid nodules, Lipomas

Answer 36

Nodule

Question 38

Central body with radiating legs. Seen with liver disease; may be normal.

Answer 38

Spider Angiomas

Question 39

Thickening and roughening of the skin, usually from rubbing. Increased visibility of skin markings.

Answer 39

Lichenification

Question 40

Hair loss from pulling, plucking, twisting hair. Hair shafts broken and varying lengths. More common in children, psychosocial stress

Answer 40

Trichotillomania

Question 41

Linear crack, or break, from the epidermis to the dermis Examples: Eczema, Tinea pedis, Angular cheilitis

Answer 41

Fissure

Question 42

16% of skin cancers. Crusted hyperkeratotic; inflammed or ulcerated appearing. Rare metastasis

Answer 42

Squamous cell carcinoma

Question 43

A large nodule, Deeper in the dermis, \>2 cm

Answer 43

Tumor