ICM - Skin/Nails/Head Pathology Images

Question 1

Answer 1

Terry’s Nails. Mostly white with a distal band of reddish brown. Cause - Aging, Chronic disease such as cirrhosis

Question 2

Answer 2

Psoriasis. Plaque. Elevated, palpable, > 1 cm.

Question 3

Answer 3

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

Question 4

Answer 4

Atopic dermatitis - Lichenification. Thickening and roughening of the skin, usually from rubbing. Increased visibility of skin markings.

Question 5

Answer 5

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

Question 5

Answer 5

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

Question 5

Answer 5

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

Question 7

Answer 7

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

Question 8

Answer 8

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

Question 9

Answer 9

Hemorrhagic bullae

Question 10

Answer 10

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

Question 11

Answer 11

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

Question 12

Answer 12

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

Question 14

Answer 14

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

Question 15

Answer 15

Rheumatoid nodules. Less than 0.5 cm, Deeper than a papule, Height greater than width.

Question 17

Answer 17

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

Question 17

Answer 17

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

Question 18

Answer 18

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

Question 19

Answer 19

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

Question 20

Answer 20

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

Question 21

Answer 21

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

Question 22

Answer 22

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