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Physical Dx > Intro To Derm > Flashcards

Intro To Derm Flashcards

1
Q

What are the 3 layers of the skin?

A

Epidermis, dermis, and subcutaneous (hypodermis)

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2
Q

What layer of skin are the blood vessels, hair follicles, sweat glands, apocrine glands, and sebaceous glands in?

A

The dermis

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3
Q

List the 5 layers of the epidermis in order.

A

Stratum corneum, stratum lucidum, stratum granulosum, stratum spinosum, and stratum basale

(mnemonic = Californians Like Girls in String Bikinis)

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4
Q

List the 4 types of cells in the epidermis

A

Keratinocytes, melaocytes, Meckels cells, and langerhans cells

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5
Q

What type of epidermis cell does basal and squamous cell carcinoma occur in?

A

Keratinocytes

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6
Q

What type of epidermis cell does melanoma occur in?

A

Melanocytes

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7
Q

What layer of the epidermis does Keratinization occur in?

A

Stratum granulosum

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8
Q

List from most superficial to deep the layers of the dermis.

A

Papillary dermis, reticular dermis, and ground substance

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9
Q

What layer of the skin are the fibroblasts, macrophages, and adipose tissue in?

A

The hypodermis

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10
Q

Where are eccrine glands most abundant?

A

Palms, soles, and forehead (but also present over most of the body)

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11
Q

What do eccrine glands do?

A

Releases odorless salt and water to keep the body cool

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12
Q

Where are apocrine glands most abundant?

A

Axillary and genital regions

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13
Q

What do apocrine glands do?

A

These are traditional sweat glands, they release a thick clear odorless fluid.

** Bacteria that lives on the skin break down apocrine secretions which leads to body odor **

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14
Q

What are apocrine glands triggered by?

A

The nervous system- stress, exercise, hormones, and emotions

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15
Q

What are vellus hairs? Ex of where they are located

A

Short and fine hairs

Ex) hair on forehead

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16
Q

What are terminal hairs? Ex of where they are located

A

Long and thick hair

Ex) scalp and axillary hair

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17
Q

What are the functions of the skin?

A

Protect from trauma and infection, prevent fluid loss, regulate body temperature, provide sensory information, and produce vitamin D

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18
Q

How do you assess skin turgor?

A

Pinch a section of skin on the forearm and it should return to place immediately

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19
Q

What does nummular mean?

A

Coin shaped

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20
Q

What does annular mean?

A

Round with active margins and central clearing

Ex) tinea infections

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21
Q

What does dermatomal mean?

A

It follows a nerve segment. Seen in herpes or varicella zoster

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22
Q

What are target lesions?

A

Pink macules with purple central papules.

ex) seen in erythema multiforme

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23
Q

What kind of shape does phytophotodermatitis have?

A

Linear

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24
Q

What is a morbilliform rash?

A

A measles like rash - erythematous maculopapular lesions that become confluent on the face and body

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25
Q

What does it mean if a rash blanches?

A

If you press on the rash, the redness goes away

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26
Q

What are the ABCDEs of melanoma?

A 
A- asymmetry
B- Borders
C- color
D- Diameter
E- Evolution or elevation
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27
Q

What are primary lesions?

A

Lesions that arise from previously normal skin

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28
Q

What are secondary findings in regards to lesions?

A

Secondary findings arise from changes in primary lesions, usually due to exogenous factors or changes

Ex) scratching, infection, rubbing, crusting

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29
Q

Describe a macule.

A

A flat, non-palpable, less than 1 cm in diameter circumscribed color change

Ex) freckles

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30
Q

Describe a patch.

A

A flat, non-palpable, greater than 1 cm in diameter hypo or hyperpigmented spot. Can have an irregular shape.

Ex) Cafe Au Lait spots

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31
Q

What are the two types of primary lesions that are flat and non-palpable?

A

Macules and patches

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32
Q

What are the 3 types of primary lesions that are superficial elevations causes by free fluid?

A

Vesicles, bulla, and pustules

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33
Q

What are the 5 types of primary lesions that are palpable, elevated, solid masses?

A

Papules, plaques, nodules, tumors, and wheals

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34
Q

Describe a papule.

A

A palpable, firm, less than 1 cm in diameter, circumscribed lesion. Can be flesh colored, red, or brown.

Ex) seborrheic keratosis

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35
Q

Describe a plaque.

A

Elevated, firm, palpable, and greater than 1 cm in diameter.

Ex- Psoriasis

36
Q

Describe a nodule.

A

Elevated, circumscribed, and often greater than 1.5cm in diameter. Deeper and more firm than a papule. Can be compressible, soft, or rubbery to palpation

Ex) epidermoid cyst

37
Q

Describe a tumor.

A

A large nodule that is deeper in the dermis. Greater than 2cm in diameter.

Ex) lipoma

38
Q

Describe wheals.

A

Irregular and transient superficial edema.

Ex) hives

39
Q

Describe vesicles.

A

Elevated and well circumscribed, fluid containing lesions. Less than 1 cm in diameter.

Ex) chicken pox- dew drops on a rose petal

40
Q

Describe bulla.

A

Elevated, well circumscribed, serous fluid filled lesions that are greater than 1 cm in diameter.

Ex) bulbous pemphigoid

41
Q

Describe a pustule.

A

Elevated, superficial, well circumscribed, pus filled lesion.

Ex) folliculitis

42
Q

What is a furuncle?

A

An infection of a single hair follicle. AKA boil.

Often caused by staph aureus

43
Q

What is a carbuncle?

A

Infection of multiple hair follicles. Can form abscess and require I&D. Often caused by Staph aureus

44
Q

Are furuncles and carbuncles primary or secondary lesions?

A

Primary

45
Q

What are the types of secondary lesions?

A

Crust, scale, fissure, erosion, ulcers, excoriation, atrophy, and lichenification

46
Q

Describe crusting.

A

Dried residue of serum, pus, or blood on the surface of skin.

Ex) impetigo

47
Q

What is scale? What layer of the skin does this accumulate from?

A

Hyperkeratosis and Accumulation of stratum corneum due to increased proliferation and/or delayed desquamation

Ex) psoriasis

48
Q

What is a fissure?

A

A linear crack in the skin that results from drying, skin thickening, and loss of elasticity. Often painful and on the hands

49
Q

What are erosions?

A

Partial or sometimes complete loss of the epidermis. Can be moist, oozing, or a crusted lesion.

Ex) pemphigus foliaceus

50
Q

What is an ulcer? What layers does it involve?

A

A deep defect with loss of at least the entire epidermis plus superficial dermis.

Ex) Venous ulcer

51
Q

What are excoriations?

A

Exogenous injury to all or part of the epidermis. Usually due to scratching and may be linear or rounded

Ex) neurotic excoriations

52
Q

What is epidermal atrophy?

A

Thinning of the epidermis leading to wrinkling and shiny appearance

53
Q

What is dermal atrophy?

A

Loss of dermal collagen and or elastin leading to depression

54
Q

What is lichenification?

A

Thickening of this epidermis and increased visibility of skin markings.

Ex) lichen simplex chronicus

55
Q

What are the 7 vascular lesions?

A

Petechiae, purpura, ecchymosis, spider angiomas, cherry angiomas, telangiectasias, and hemangiomas

56
Q

Describe petechiae.

A

Deep red/purple round and irregular lesions that are non-blanchable. Less than 0.5cm in diameter

57
Q

When is petechiae often seen?

A

Infections and bleeding disorders

58
Q

Describe purpura.

color/size/shape/blanchable or not

A

Deep red/purple round and irregular lesions that are non-blanchable. Greater than 0.5cm in diameter

59
Q

When is purpura often seen?

A

Infectious and bleeding disorders

60
Q

What is ecchymosis?

A

Bruising. Represents blood outside of vessels due to trauma or bleeding disorders

61
Q

Describe spider angiomas.

color/size/shape/blanchable or not

A

Small Fiery red lesions with a central body and surrounding erythema with radiating legs. *Blanches with pressure.

62
Q

Where are on the body are spider angiomas normally seen?

A

Face, neck, arms, and upper trunk.

63
Q

What populations are spider angiomas frequently seen on?

A

Usually develops in otherwise healthy women and children. Also often seen with liver disease and pregnancy

64
Q

Describe cherry angiomas.

color/size/shape/blanchable or not

A

Bright red papules that range from 1 to 6 mm in size. Can be flat or raised. Non pulsatile and *non blanchable.

65
Q

What are telangiectasias?

color/blanchable or not

A

Permanently dilated superficial cutaneous blood vessels. Red to blue-violet in color. Blanchable.

66
Q

When are telangiectasias typically seen?

A

Basal cell carcinomas, sun damaged skin, and rosacea

67
Q

What is a hemangioma? When is it common?

A

A benign vascular neoplasm that represents the most common tumor of infancy

68
Q

Describe the presentation of a hemangioma.

A

A red irregular lesion secondary to dilation of dermal capillaries. Starts as a macular patch, but can progress to a plaque or nodule.

69
Q

What are the 4 categories of skin disease?

A

Papulosquamous, nodular, vesiculobullous, and maculopapular

70
Q

What is an example of a papulosquamous lesion?

A

Psoriasis

71
Q

What are the 5 Ps of lichen planus?

A 
Pruritic
Polygonal
Purple
Planar
Papules
72
Q

What are nodular lesions? Examples?

A

Benign and malignant epidermal and dermal nodules.

Ex) cherry angiomas, epidermoid cysts, and nevi

73
Q

What is the presentation of squamous cell carcinoma?

A

Isolated keratotic, erodes papule or nodule that is located in sun exposed areas

74
Q

Describe the presentation of basal cell carcinoma.

A

Pearly nodules in sun exposed areas. Associated with central ulcerizations and telangiectasias

75
Q

What type of lesions are viral exanthems and drug eruptions typically?

A

Maculopapular lesions

76
Q

Describe clubbing on the nail.

A

Rounded bulbous nail base with a spongy feel

77
Q

How do you diagnoses clubbing of the nail?

A

Ask patient to flex fingers of both hands and bring index fingers together until distal phalanges are touching. If the diamond space between the nails is gone (Positive schamroths sign) the patient has clubbing

78
Q

What are beaus lines?

A

Transverse depressions secondary to trauma or acute illness. The lines will grow out.

79
Q

What are paronychias?

A

Inflammation of the proximal and lateral nail folds

80
Q

What is onychocryptosis?

A

An ingrown toenail. Usually on big toe the nail grows into the dermis. Can be infected.

81
Q

What are terry’s nails?

A

Nails that are mostly white with a distal band of reddish brown. Lunula is gone.
Characteristic “ground glass” appearance

82
Q

What is leukonychia?

A

Trauma to the nails causing areas of white discoloration

83
Q

What is koilonychia?

A

Spoon shaped, concave nail

84
Q

What is onycholysis?

A

Painless separation of the nail plate from the nail bed.

85
Q

What is onychomycosis?

A

Fungal infection of the nail bed, plate, or matrix.

86
Q

What is nail pitting?

A

Small punctuate depressions in the nail caused by nail matrix inflammation.

87
Q

What does positive schamroths sign indicate?

A

Clubbing

Physical Dx (14 decks)

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