Intro to Dermatology Flashcards

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1
Q

What is the initial approach to a dermatological complaint?

A
  • Examined first before history taken
  • Diagnostic accuracy > when objective examination is approached without preconcieved ideas
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2
Q

What is a general skin exam? Focused? Detailed?

A
  • General: examine all skin surfaces- undress patient when applicable
  • Focused: exam in area of concern
  • Detailed: examine the individual lesions
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3
Q

What are components of the skin exam in addition to the skin itself?

A
  • Mucous membranes
  • Genital and anal region
  • Hair and nails
  • Lymph nodes
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4
Q

When seeing a lesion what are you looking for?

A
  • Type of lesion
  • Color
  • Margination
  • Consistency
  • Shape
  • Arrangement
  • Distribution
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5
Q

What is a macule?

A
  • Flat, nonpalpable lesions usually <10 cm in diameter
  • Represent change in color and are not raised or depressed compared to skin surface
  • Patch is large macule
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6
Q

What is a papule

A
  • Elevated lesion usually <5 mm in diameter that can be felt or palpated
  • Examples = nevi, warts
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7
Q

What is a plaque?

A
  • Palpable lesion >10 mm in diameter that are elevated or depressed compared to skin surface
  • May be flate topped or rounded ie psoriasis and granuloma annulare
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8
Q

What is a nodule?

A
  • Firm lesion that extends into dermis or subcutaneous tissue > 5 mm
  • EX: cysts, lipomas, fibromas
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9
Q

What is a vesicle?

A
  • Small, clear, fluid-filled blisters <10 mm in diameter
  • Vesicles are characteristic of herpes infections, acute allergic contact dermatitis, and some autoimmune blistering disorders
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10
Q

What is a bulla?

A
  • Clear fluid-filled blisters >10 mm in diameter
  • May be caused by burns, bites, irritant, or allergic contact dermatitis, and drug reactions
  • Classic autoimmune bullous diseases - pemphigus vulgaris and bullous pemphigoid
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11
Q

What is a pustule?

A
  • Vesicle that contains pus
  • Common in bacterial infections and folliculitis and may arise in some inflammatory disorders including pustular psoriasis

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12
Q

What is urticaria?

A
  • Wheals or hives characterized by elevated lesions caused by localized edema
  • Wheals are pruritic and red
  • Wheals = common manifestation of hypersensitivity to drugs, stings or bites, autoimmunity, physical stimuli ie temp, pressure, sunlight
  • Typically lasts <24 hr
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13
Q

What is a scale?

A
  • Heaped up accumulation of horny epithelium
  • Occur in disorders such as psoriasis, seb derm, fungal infections
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14
Q

What is a crust?

A
  • Dried serum, blood, or pus
  • Can occur in inflammatory or infectious skin diseases
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15
Q

What are erosions?

A
  • Open areas of skin that result from loss of part or all of the epidermis
  • Can be traumatic or occur with inflammatory or infectious skin disease
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16
Q

What is an excoriation?

A

Linear erosion caused by scratching, rubbing, or picking

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17
Q

What is an ulcer?

A
  • Due to loss of epidermis and at least part of dermis
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18
Q

What are causes of ulcers?

A
  • Venous stasis dermatitis
  • Physical trauma with or without vascular compromise
  • Infections
  • Vasculitis
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19
Q

What is petechiae?

A
  • Nonblanchable punctate foci of hemorrhage
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20
Q

What are causes of petechiae?

A
  • Platelet abnormalities (thrombocytopenia, platelet dysfunction)
  • Vasculitis
  • Infections (meningococcemia, rocky mountain spotted fever, rickettsioses)
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21
Q

What is purpura?

A

Larger area of hemorrhage that may be palpable

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22
Q

What are causes of purpura?

A
  • Leukocytoclastic vasculitis has palpable purpura
  • Coagulopathy
  • Ecchymoses
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23
Q

What is atrophy?

A
  • Thinning of the skin, which may appear dry and wrinkled, resembling cigarette paper
24
Q

What can cause atrophy?

A
  • Chronic sun exposure
  • Aging
  • Inflammatory and neoplastic skin diseases, ie cutaneous T cell lymphoma and lupus erythematosus
  • Long term topical corticosteroid use
25
Q

What are scars?

A
  • Areas of fibrosis that replace normal skin after injury
  • Some become hypertrophic or thickened and raised
  • Keloid = hypertrophic scars extending past wound margin
26
Q

What is a telangiectasia?

A
  • Foci of small, permanently dilated blood vessels that may occur in areas of sun damage, rosacea, systemic diseases, or inherited diseases, or after long term therapy with topical fluorinated corticosteroids
27
Q

What is a cyst?

A
  • Cavity containing liquid or solid or semisolid materials
  • Either superficial or deep
  • Appears superficial and often dome shaped
  • May be skin colored, yellow, red or blue
28
Q

What are the ABCDEs of melanoma?

A

A: asymmetry
B: border
C: color
D: diameter (larger than a pencil eraser 1/4 inch or 6 mm)
E: evolution (evolve in size, shape, color, elevation, crusting, itching)

29
Q

What does asymmetry mean?

A

Do the 2 sides match?
Is it grouped or scattered?

30
Q

What is under border?

A

Well defined or ill defined?
Regular or irregular?

31
Q

What is considered a concern for color?

A

Multiple colors

32
Q

How can the distribution/diameter of a skin lesion be described?

A
  • Localized
  • Generalized
  • Linear
  • Dermatomal
  • Extensor
  • Flexor
  • Intertriginous
  • Confluent
  • Morbilliform

Is the diameter >6 mm? HIGH RISK

33
Q

How is elevation/enlargement described?

A

Is it elevated? Is the elevaation regular or irregular?
Has the lesion grown or changed? How quickly?

34
Q

What is annular?

A

Ring shape

35
Q

What is nummular?

A

Looks like coins

36
Q

What is polycyclic?

A

Incomplete rings coalescing

37
Q

What is arcuate?

A

Arc shaped

38
Q

What is reticular?

A

Lacy or net like

39
Q

What is geographic?

A

Large and vary greatly with borders

40
Q

What is serpiginous?

A

Wavy pattern

41
Q

What is targetoid?

A

Resembles a target

42
Q

What is whorled?

A

Marble like

43
Q

How can you describe the extent of a lesion?

A

Isolated, localized, generalized, universal

44
Q

How can you describe the pattern of a lesion?

A

Symmetric, exposed areas, sites of pressure, intertriginous area, follicular localization

45
Q

What are constitutional symptoms of acute illness?

A
  • Headaches
  • Chills
  • Fever
  • Weakness
46
Q

What are constitutional symptoms of a chronic illness?

A
  • Fatigue
  • Weakness
  • Anorexia
  • Weight loss
  • Malaise
47
Q

What is I on the FItzpatrick skin type scale?

A
  • Pale skin, light or red hair, prone to freckles
  • Burns very easily and rarely tans
  • At greatest risk of developing skin cancer an needs to protect preferably with clothing
48
Q

What is II on the Fitzpatrick skin type scale?

A
  • Fair skin, light hair, blue or brown eyes
  • Some have dark hair but still fair skin
  • Usually burn but may gradually tan
  • At the greatest risk of developing skin cancer. Need to protect skin, preferably with clothing
49
Q

What is III on the Fitzpatrick skin type scale?

A
  • Light olive skin with dark hair and brown or green eyes. Burns with long exposure to the sun but generally tans quite easily
  • Should protect themselves against strong sunshine
50
Q

What is IV on the Fitzpatrick skin type scale?

A
  • Brown eyes and dark hair
  • Burns with very lengthy exposures but always tans easily
  • Should protect themselves in strong sunshine
51
Q

What is V on the Fitzpatrick skin type scale?

A
  • Naturally brown skin, brown eyes and dark hair
  • Burns only with excessive exposure to the sun. Skin easily darkens further
  • Protect themselves when outdoors in the sun for a long time
52
Q

What is VI on the Fitzpatrick skin type scale?

A
  • Black skin with dark brown eyes and black hair
  • Burns only with extreme exposure to the sun
  • Skin very easily darkens further
  • Protect themselves when outdoors in the sun for a long time
53
Q

What is dermoscopy?

A

Hand lens with built in lighting and magnification

54
Q

What is diascopy?

A

Firmly pressing a glass slide over lesion to determine capillary dilation or blood extravasation

55
Q

What is a Woods lamp?

A

UV long wave light (black light)

56
Q

How can a biopsy be performed?

A

Shave/punch/excisional