Introduction + Skin lesions Flashcards

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1
Q

Gross structure of the skin

A

Epidermis
Dermis
Hypodermis/ Subcutis

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2
Q

Structure of epidermis

A

Corneal layer - anuclear keratinocytes
Clear layer - only thick skin
Granular layer - keratinocytes with granules
Spinous layer - keratinocytes with spine like projections
Basal layer - stem cells

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3
Q

Cells of epidermis

A

Melanocytes - in the basal layer, produce melanin
Keratinocytes - throughout epidermis, store melanin
Merkel cells - mechanoreceptors, basal layer
Langerhans cells - dendritic cells, basal and spinous layer

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4
Q

Structure of dermis

A

Papillary layer - loose CT, Meissner corpuscles

Reticular layer - dense CT, Pacinians corpuscles, sebaceous glands, hair follicles, sweat glands, blood vessels

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5
Q

Structure of hypodermis/subcutis

A

Adipocytes, blood vessels, nerves

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6
Q

Anatomy of nail

A
  • cornified plate - compact, smooth, transparent, colorless
  • translucent nail bed vessels = pink color
  • matrix onychoblasts - determined nail growth
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7
Q

Anatomy of hair

A
  • Hair bulb
  • Root sheath
  • Hair shaft
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8
Q

Sebaceous glands are located throughout the skin, EXCEPT:

A

Palms and soles

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9
Q

Eccrine vs. Apocrine sweat glands

A

Eccrine - functioning from birth, all over the body (most common in palms, soles and forehead)

  • ducts open in pore at skin’s surface
  • “watery sweat”

Apocrine - functioning from puberty, most common in armpit and anogenital region

  • ducts open into hair follicles
  • “fatty sweat”
  • odorless but when decomposed by bacteria on skin a “body odor” is created
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10
Q

Macule

A
  • flat, circumscribed, non-palpable
  • just a change of color
  • Macule - <1cm
  • Patch - >1cm
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11
Q

Types of Macula

A
  1. Vascular
    - damaged vessels, if you pinch it - it disappears
    - Roseola (viruses, allergy, medication),
    - Erythema (hand-size)
    - Erythroderma (redness ALL over the body)
  2. Hemorrhagic
    - if you pinch it - it doesn’t disappear
    - Petechia - most common causes: vomiting, vasculitis, viral infections
    - Ecchymosis
    - Suggillation
  3. Pigmented
    - white - ex: vitiligo
    - hypopigmented - leukoderma (fungi, scarring, syphillis)
    - hyperpigmented - congenital (freckles, nevi) or acquired (UV rays, aging)
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12
Q

Papule

A
  • elevated, solid, palpable lesions
  • <1cm
  • causes: epidermal cell proliferation, dermal cell proliferation, accumulation of metabolic products in dermis
  • warts, psoriasis, molluscum contagiosum, lichen planus, acne, nevus, xantomas
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13
Q

Plaque

A
  • circumscribed, palpable lesion
  • > 1cm
  • may result from convalescence of papules
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14
Q

Nodules

A
  • elevated, solid, palpable
  • > 1cm
  • primarily in dermis and subcutis
  • keratoacanthoma, basal cell carcinoma, skin sarcoidosis, acne, gout
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15
Q

Wheel (urticaria)

A
  • transient elevation due to edema
  • pale center, erythematous ring
  • smooth surface
  • itchy dermal skin swelling

-if urticaria last for more than 24h –> biopsy to exclude vasculitis urticaria

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16
Q

Vesicle

A
  • circumscribed lesion - <1cm
  • contain fluid (clear, serous, hemorrhagic)
  • “small blister” - herpes simplex, herpes zoster
17
Q

Bulla

A
  • circumscribed lesion - >1cm
  • contains liquid (clear, serous, hemorrhagic)
  • “large blister”
18
Q

Pustule

A
  • circumscribed lesion that contain pus

- follicular or subcorneal type

19
Q

Crust

A
  • dried serum, pus, blood on the skin

- vesicle, bulla –> crust

20
Q

Scale

A
  • visible accumulation of keratin
  • silvery (polygonal), powdery (pityriasis versicolor), greasy, gritty, polygonal
  • Collarette of scale - fine white scale at the edge of an inflammatory lesion (resolving folliculitis, pityriasis rosacea)
21
Q

Erosions

A
  • loss of either portion or entire epidermis

- may arise from pustule blisters, bullae, vesicles

22
Q

Excoriation

A
  • loss of epidermis and portion of dermis due to scratching or exogenous injury
  • linear or punctuate
23
Q

Ulcer

A

-full thickness loss of epidermis and at least portion of dermis

24
Q

Lichenification

A
  • results from chronic inflammation of the skin which causes skin thickening and hardening
  • primarily: long irritation, ex: scratching
  • secondary: separate papules merge
25
Q

Fissure and Rhagade

A
  • fissure: superficial skin tears
  • rhagade: deeper skin tears reaching dermis
  • occurs when skin looses elasticity and bends
26
Q

Scar

A
  • newly formed CT which fills previous skin defect

- no hair follicles, glands, no normal color

27
Q

Function of the skin

A
  • protection - barrier
  • immunology
  • thermoregulation
  • metabolism
  • esthetic
  • sensory
  • resorption
  • secretion
28
Q

Diascopy

A

-put a transparent glass on the lesion - press on it - a bit brownish = inflammation is very deep