ICM_EXAM1_SKIN

Question 1

List and describe the significance of the 4 skin pigments

Answer 1

1. Melanin- (melanocytes/basale/sun)
2. Carotene (yellow pigment-vitA precursor)
3. Oxyhemoglobin (bright red in capillaries, increased flow=blushing, decreased bf= pale)
4. Deoxyhemoglobin (cyanosis)

Question 2

ID patient w/ cyanosis

Answer 2

• C- blue/purple fingertips/fingernails
• Perioral around infant lips/mouth after birth/24-48hours goes away

Central cyanosis: blue/purple face & eyelids & lips- congenital heart disease

Question 3

ID patient with Jaundice

Answer 3

yellow skin/sclera- babies (use phototherapy)

Question 4

Blanchable lesions

Answer 4

• Urticaria (hives)

- Wheal

Question 5

Non-Blanchable lesions

Answer 5

1. Hemorrhagic lesions:
   PETECHIAE, PALPABLE PURPURA from vasculitis
2. Cherry angiomas

Question 6

Skin exam for temperature, texture, turgor

Answer 6

1. temp- dorsum of hand
2. texture- smooth/soft
3. Turgor- forearm pinch (thigh in elderly)-quick rebound

Avoid using back of hand

Question 7

Acne Vulgaris- presentation & distribution

Answer 7

1. Elevated, filled with pus

2. Distribution: Upper chest, back, face

Question 8

Atopic Dermatitis- 2 Types; presentation & distribution

Answer 8

1. Excoriation: Abrasion/scratch
2. Lichenification: thickening/roughening of skin from rubbing (skin markings become more visible)

Distribution: (flexion surfaces): Inferior aspect of posterior neck, Folds of elbow, posterior knee

Question 9

Pityriasis Rosea

Answer 9

1. Thin flake of exfoliated epidermis

Distribution:
Anterior: Chest, abdomen, upper legs.
Posterior: upper back to butt cheecks

CHRISTMAS TREE PATTERN

Question 10

PSORIASIS

Answer 10

Elevated, palpable >0.5 cm

Anterior/posterior fingers
Anterior knee, posterior elbow, superior to but crack,
Posterior head

Question 11

Seborrheic Dermatitis

Answer 11

1. Scaly patches and redness

Central chest (sternal area). Entire head

Question 12

Dermatomal lesions:- example

Answer 12

Follow a nerve segment

Shingles (Herpes Zoster)

Question 13

Target appearance

Answer 13

Erythema Multiforme

Question 14

Umbilicated

Answer 14

Looks like it has indentations in it

Molluscum contagiosum

Question 15

Discoid

Answer 15

Coin shaped, No Central clearing

Nummular eczema

Question 16

Annular

Answer 16

Round, active margins w/ central clearing

Tinea corporis (ring worm)

Question 17

Herpes zoster distribution/shape/arrangement

Answer 17

Shingles- Dermatomal

Question 18

Psoriasis (distribution/example)

Answer 18

Extensor surfaces/ gluteal cleft

Question 19

Acne Vulgaris

Answer 19

face back chest

Question 20

Atopic dermatitis

Answer 20

Eczema

Flexor surfaces

Question 21

Pityriasis rosaea

Answer 21

Christmas tree pattern

Question 22

Seborrheic dermatitis

Answer 22

Scalp

Question 23

Molluscum contagiosum

Answer 23

Umbilicated

Question 24

Nummular eczema

Answer 24

Discoid

Question 25

Tinea corporis

Answer 25

Ringworm- Annular

Question 26

Erythema multiforme

Answer 26

Targetoid

Question 27

Define the primary skin lesions

3 categories and name each type (10 types)

Answer 27

Arise from normal skin

1. Circumscribed, flat, nonpalpable
   - MACULE or PATCH
2. Palpable, elevated solid masses
   - PAPULE, PLAQUE, NODULE, TUMOR, WHEAL
3. Superficial elevations by free fluid
   - VESICLE, BULLA, PUSTULE

Question 28

Define the secondary skin lesions 3 categories and related types (10 types)

Answer 28

Result from changes in primary lesions

1. loss of skin surface
   - EROSION, ULCER, FISSURE
2. Material on skin surface
   - CRUST, SCALE
3. Miscellaneous lesions
   - LICHENIFICATION, EXCORATION, ATROPHY, SCAR, BURROW

Question 29

ABCDEF’s of Malignant Melanoma

Answer 29

Asymmetry
Borders irregular
Color variegated
diameter >6mm
Evolution
Funny looking

Question 30

Anatomy of the nail

Answer 30

Lateral fold
Proximal fold
free edge
Lunula
Cuticle
Nail plate

Question 31

Trichotillomania

Answer 31

Pulling/plucking/twisting hair
shafts broken
children/psychosocial stress

Question 32

Alopecia Areata

Answer 32

Autoimmune
Smooth bald spot
No broken hairs
One solid patch

Question 33

Tinea Capitis

Answer 33

Round scaling patches
Hair broken off close to surface of scalp
FuNgLe infection

Question 34

Atopic dermatitis and Psoriasis Where Found?

Answer 34

Atopic dermatitis- Flexor surfaces

Psoriasis- Extensor surfaces

Question 35

Flat - Non-palpable circumscribed

Answer 35

Macule (frecks)

Question 36

Flat- non-palpable circumscribed > 0.5cm

Answer 36

Patch (cafe au lait-birthmark, vitiligo-like spots on a cow)

Question 37

Palpable, elevated solid masses

Answer 37

Papule (Warts, Nevi- “moles”)

Question 38

Palpable elevated solid masses >0.5cm

Answer 38

Plaque (psoriasis)

Question 39

Palpable elevated solid masses >0.5cm-
deeper than papule
Height > width

Answer 39

Nodule- (lipomas or rheumatoid nodules)

Question 40

Palpable, elevated solid masses >2cm-
Large nodule
deepest

Answer 40

Tumor- Hemangioma

Question 41

1. Palpable Elevated solid masses
2. Irregular, transient, superficial edema
3. Blanches

Answer 41

Wheal (urticaria-hives, allergic reaction)

Question 42

Superficial elevations by free fluid

Answer 42

Vesicle

Question 43

Superficial elevations by free fluid

>0.5 cm Serous Filled

Answer 43

Bulla (blisters/2nd deg burns)

Question 44

Superficial elevations by free fluid

Elevated, filled with pus

Answer 44

Pustule (acne, ant bites)

Question 45

Loss of superficial epidermis (ruptured blister)

Answer 45

Erosion

Question 46

Deeper loss of epidermis and dermis

can bleed- heals with scarring

Answer 46

Ulcer

Question 47

Linear crack from epidermis to dermis

Answer 47

Fissure (eczema, tinea pedis, angular chelitis)

Question 48

Material on skin- dried residue or serum, pus or blood

Answer 48

CRUST

Question 49

Material on skin- thin flake of exfoliated epidermis

Answer 49

SCALE