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CMT > Intro to Derm > Flashcards

Intro to Derm Flashcards

1
Q

Terminology

What are primary lesions?

A

associated with specific causes on previously unaltered skin, occur as initial reactions to the internal or external environment.

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2
Q

Terminology

9 most common primary lesions

A
  1. macule
  2. patch
  3. papule
  4. nodule
  5. plaque
  6. pustule
  7. vesicle
  8. bulla
  9. wheal
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3
Q

Primary Lesions

define macule

A
  1. flat, non-palpable lesion
  2. less than 1 cm in size
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4
Q

Primary Lesions

define patch

A
  1. flat, non-palpable lesion
  2. greater than 1 cm in size

macule, but bigger!

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5
Q

Primary Lesions

define papule

A
  1. raise, palpable, solid lesion
  2. proliferation of cells in the epidermis and/or dermis
  3. less than 1 cm in size
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6
Q

Primary Lesions

define nodule

A
  1. raised, palpable, solid lesion
  2. located mid-deep dermis

papule, but deeper!

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7
Q

Primary Lesions

define pustule

A
  1. raised lesion
  2. contains purulent fluid
  3. less than 1 cm in size
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8
Q

Primary Lesions

define vesicle

A
  1. raised, circumscribed lesion
  2. contains clear to yellow tinged serous fluid
  3. less than 1 cm in size
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9
Q

Primary Lesions

define bulla

A
  1. raised, circumscribed lesion
  2. contains clear to yellow-tinged serous fluid
  3. greater than 1 cm in size

vesicle but bigger!

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10
Q

Primary Lesions

define plaque

A
  1. raised, palpable flat-topped lesion
  2. can be formed by confluent papules
  3. greater than 1 cm in size
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11
Q

Primary Lesions

define wheal

A
  1. localized edema
  2. variety of sizes, typically elevated (papules and plaques)
  3. transient, < 24 hrs
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12
Q

Secondary Lesions

what are secondary lesions?

A

lesions that are characteristically brought about by modification of the primary lesion either by the individual with the lesion or through the natural evolution of the lesion in the environment.

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13
Q

Secondary Lesions

7 most common secondary lesions?

A
  1. ulceration
  2. erosion
  3. excoriation
  4. fissure
  5. scales
  6. crusts
  7. lichenification
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14
Q

Secondary Lesions

define ulceration

A
  1. full-thickness loss of epidermal and dermal skin
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15
Q

Secondary Lesions

define erosion

A
  1. loss of superficial epidermis

essentially an unhooded bulla

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16
Q

Secondary Lesions

define excoriation

A
  1. superficial abrasion of the skin
  2. results from scratching, rubbing, digging, and/or squeezing of skin
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17
Q

Secondary Lesions

define fissure

A
  1. vertical loss of epidermis extending through epidermal and dermal skin

think deep cracks in skin

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18
Q

Secondary Lesions

define scales

A
  1. flakes/plates of compacted, desquamated layers of stratum corneum

peely skin?

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19
Q
A
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20
Q

Secondary Lesions

define crusts

A
  1. collection of cellular debris, dried serum, dried blood on skin’s surface
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21
Q

Secondary Lesions

define lichenification

A
  1. thickened, rough skin
  2. typically due to chronic inflammation or irritation

callus?

22
Q

Lesions

which lesions are flat?

5 (not all covered earlier)

A
  1. macule
  2. patch
  3. telangiectasis
  4. petechia
  5. purpura
23
Q

Lesions

which lesions are raised?

6

A
  1. papule
  2. plaque
  3. nodule
  4. vesicle/crust/scale
  5. bulla
  6. wheal
24
Q

Lesions

which lesions are deep?

4

A
  1. ulcer/erosion
  2. fissure
  3. burn injury
  4. excoriation
25
Q

Dermatologic Therapies

Most common OTC products?

8 things

A
  1. emollients
  2. anti-seborrheic agents
  3. anti-fungals
  4. anti-bacterials
  5. anti-inflammatories
  6. anti-itch
  7. acne/anti-aging
  8. anti-histamines
26
Q

Dermatologic Therapies

common prescription products

9

A
  1. antibiotics
  2. corticosteroids
  3. anti-fungals
  4. topical calcineurin inhibitors
  5. retinoids
  6. oral contraceptives
  7. spironolactone
  8. isotretinoin
  9. biologics
27
Q

Dermatologic Procedures

Describe woods lamp evaluation

A
  1. use of black light to aid in the sx of skin lesions
  2. most commonly used for evaluation of vitiligo and tinea infections
  3. hold lamp 10 to 12 cm from skin to dx

rarely used in practice

28
Q

Dermatologic Procedures

Describe a microscopic evaluation

what preps used when

A
  • potassium hydroxide (KOH): useful for fungal infections
  • mineral oil prep: useful for mites (scabies)
29
Q

Dermatologic Procedures

when to consider for culture?

bacterial vs viral

A
  1. bacterial: consider for open wounds, pustules, cystic lesions, rashes
  2. viral: consider if vesicles are present
30
Q

Dermatologic Procedures

what is most common injection given?

A

intralesional corticosteroids

31
Q

Dermatologic Procedures

which instruments result in the destruction of superficial skin lesions?

2 instruments

A
  1. electrodessication
  2. curettage
32
Q

Dermatologic Procedures

process for electrodessication & curettage

3 steps

A
  1. curette over lesion in all 4 directions
  2. cauterize skin w/ safety margin
  3. repeat process for 3 passes
33
Q

Dermatologic Procedures

what are shave biopsies used for?

A

superficial skin lesions to confirm diagnosis

34
Q

Dermatologic Procedures

describe healing process for shave biopsies

A
  • no stitches required
  • wound forms a scab that heals in 1-3 wks
35
Q

Dermatologic Procedures

what does a punch biopsy do that a shave biopsy doesn’t?

A

give full thickness sample of the skin

36
Q

Dermatologic Procedures

how is a punch biopsy done?

A
  • disposable, round stainless steel blade is rotated through the skin
  • typically 3, 3.5, 4 mm punches are used
37
Q

Dermatologic Procedures

describe healing process for punch biopsy

A
  1. suture may be used to control bleeding but it’s not necessary
  2. increased likelihood of suture as biopsy diameter increases
38
Q

Dermatologic Procedures

who performs excisional biopsies?

A

dermatologists or dermatologic surgeons

39
Q

Dermatologic Procedures

describe an excisional biopsy

A

the complete removal of a skin lesion w/ a margin of surrounding tissue taken to minimze recurrence

40
Q

Dermatologic Procedures

what does MOHS offer?

A

complete histologic analysis of the tumor margins while permitting maximal conservation of tissue

41
Q

Dermatologic Procedures

what are the indications for MOHS?

4 things

A
  1. location
  2. aggressive malignancy subtypes
  3. large tumors/tumors w/ defined borders
  4. recurrent tumors
42
Q

Dermatologic Procedures

which locations would be indicative of need for MOHS?

4

A
  • face (nose, eyes, ears, lips)
  • scalp
  • hands
  • groin
43
Q

Dermatologic Procedures

which malignancy subtypes would be indicative of needing an MOHS?

4

A
  1. infiltrative
  2. sclerosing
  3. mopheaform
  4. micronodular
44
Q

Dermatologic Procedures

When do you use patch testing?

A

to determine if a pt has a contact sensitivity to a given allergen (testing for type IV hypersensitivity reactions)

45
Q

Dermatologic Procedures

describe the process of patch testing

what’s applied, what is looked for, when to read?

A
  1. small patches of common suspected antigens applied to clean skin
  2. 48 hrs later, skin is read for evidence of erythema, induration, or blistering
  3. the test can be re-read over the next 2-5 days as some rxns are delayed
46
Q

Dermatologic Procedures

describe cryotherapy

A

the application of liquid nitroden directly to the skin for short durations of time

47
Q

Dermatologic Procedures

what does cryotherapy result in?

A

destruction of the superficial layers of the skin

48
Q

Dermatologic Procedures

what is the result of cryo-destruction from cryo therapy?

A

blister-like lesion that transforms into an eschar

49
Q

Dermatologic Procedures

how long until an eschar sheds off the skin?

A

2-4 wks

50
Q

Dermatologic Procedures

care before/after treatment?

A
  1. no local anesthetic required, generally well tolerated procedure
  2. minimal wound care
51
Q

you should never do a superficial shave biopsy if you are considering what as a differential?

A

melanoma

CMT (78 decks)

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