ICM_EXAM1_SKIN Flashcards
List and describe the significance of the 4 skin pigments
- Melanin- (melanocytes/basale/sun)
- Carotene (yellow pigment-vitA precursor)
- Oxyhemoglobin (bright red in capillaries, increased flow=blushing, decreased bf= pale)
- Deoxyhemoglobin (cyanosis)
ID patient w/ cyanosis
- 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
ID patient with Jaundice
yellow skin/sclera- babies (use phototherapy)
Blanchable lesions
- Urticaria (hives)
- Wheal
Non-Blanchable lesions
- Hemorrhagic lesions:
PETECHIAE, PALPABLE PURPURA from vasculitis - Cherry angiomas
Skin exam for temperature, texture, turgor
- temp- dorsum of hand
- texture- smooth/soft
- Turgor- forearm pinch (thigh in elderly)-quick rebound
Avoid using back of hand
Acne Vulgaris- presentation & distribution
- Elevated, filled with pus
2. Distribution: Upper chest, back, face
Atopic Dermatitis- 2 Types; presentation & distribution
- Excoriation: Abrasion/scratch
- 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
Pityriasis Rosea
- Thin flake of exfoliated epidermis
Distribution:
Anterior: Chest, abdomen, upper legs.
Posterior: upper back to butt cheecks
CHRISTMAS TREE PATTERN
PSORIASIS
Elevated, palpable >0.5 cm
Anterior/posterior fingers
Anterior knee, posterior elbow, superior to but crack,
Posterior head
Seborrheic Dermatitis
- Scaly patches and redness
Central chest (sternal area). Entire head
Dermatomal lesions:- example
Follow a nerve segment
Shingles (Herpes Zoster)
Target appearance
Erythema Multiforme
Umbilicated
Looks like it has indentations in it
Molluscum contagiosum
Discoid
Coin shaped, No Central clearing
Nummular eczema
Annular
Round, active margins w/ central clearing
Tinea corporis (ring worm)
Herpes zoster distribution/shape/arrangement
Shingles- Dermatomal
Psoriasis (distribution/example)
Extensor surfaces/ gluteal cleft
Acne Vulgaris
face back chest
Atopic dermatitis
Eczema
Flexor surfaces
Pityriasis rosaea
Christmas tree pattern
Seborrheic dermatitis
Scalp
Molluscum contagiosum
Umbilicated
Nummular eczema
Discoid
Tinea corporis
Ringworm- Annular
Erythema multiforme
Targetoid
Define the primary skin lesions
3 categories and name each type (10 types)
Arise from normal skin
- Circumscribed, flat, nonpalpable
- MACULE or PATCH - Palpable, elevated solid masses
- PAPULE, PLAQUE, NODULE, TUMOR, WHEAL - Superficial elevations by free fluid
- VESICLE, BULLA, PUSTULE
Define the secondary skin lesions 3 categories and related types (10 types)
Result from changes in primary lesions
- loss of skin surface
- EROSION, ULCER, FISSURE - Material on skin surface
- CRUST, SCALE - Miscellaneous lesions
- LICHENIFICATION, EXCORATION, ATROPHY, SCAR, BURROW
ABCDEF’s of Malignant Melanoma
Asymmetry Borders irregular Color variegated diameter >6mm Evolution Funny looking
Anatomy of the nail
Lateral fold Proximal fold free edge Lunula Cuticle Nail plate
Trichotillomania
Pulling/plucking/twisting hair
shafts broken
children/psychosocial stress
Alopecia Areata
Autoimmune
Smooth bald spot
No broken hairs
One solid patch
Tinea Capitis
Round scaling patches
Hair broken off close to surface of scalp
FuNgLe infection
Atopic dermatitis and Psoriasis Where Found?
Atopic dermatitis- Flexor surfaces
Psoriasis- Extensor surfaces
Flat - Non-palpable circumscribed
Macule (frecks)
Flat- non-palpable circumscribed > 0.5cm
Patch (cafe au lait-birthmark, vitiligo-like spots on a cow)
Palpable, elevated solid masses
Papule (Warts, Nevi- “moles”)
Palpable elevated solid masses >0.5cm
Plaque (psoriasis)
Palpable elevated solid masses >0.5cm-
deeper than papule
Height > width
Nodule- (lipomas or rheumatoid nodules)
Palpable, elevated solid masses >2cm-
Large nodule
deepest
Tumor- Hemangioma
- Palpable Elevated solid masses
- Irregular, transient, superficial edema
- Blanches
Wheal (urticaria-hives, allergic reaction)
Superficial elevations by free fluid
Vesicle
Superficial elevations by free fluid
>0.5 cm Serous Filled
Bulla (blisters/2nd deg burns)
Superficial elevations by free fluid
Elevated, filled with pus
Pustule (acne, ant bites)
Loss of superficial epidermis (ruptured blister)
Erosion
Deeper loss of epidermis and dermis
can bleed- heals with scarring
Ulcer
Linear crack from epidermis to dermis
Fissure (eczema, tinea pedis, angular chelitis)
Material on skin- dried residue or serum, pus or blood
CRUST
Material on skin- thin flake of exfoliated epidermis
SCALE