Lecture 1: Intro to Derm Flashcards
Why is physical examination before history taking best for derm?
Diagnostic accuracy is higher when there is no preconceived ideas
Melanoma ABCDEs
- Asymmetry
- Border irregularity
- Color (multiple)
- Diameter > 6mm
- Evolving over time
Ugly duckling sign
Lesion graph/algorithm
Describe a macule.
- Flat, nonpalpable < 10mm
- Change in color
- Large macule = patch
A mat is flat
Describe a papule.
- Elevated lesion < 5mm
- Palpable
- Nevi, warts
Palpable papules
Describe a plaque.
- Palpable lesions > 10mm
- Flat topped, rounded, elevated, or depressed
- Psoriasis, granuloma annulare
Describe a nodule.
- Firm lesion extending into dermis/subC tissue
- Cysts, lipomas, fibromas
Describe a vesicle.
- Small, clear, fluid-filled blister < 10mm
- Herpes, acute allergic contact dermatitis, autoimmune
Describe a bulla.
- Clear, fluid filled blister > 10mm
- Burns, bites, irritant/contact, drug rxns
- Classic autoimmune: pemphigus vulgaris & bullous pemphigoid
A Large vesicle = bulla
Describe a pustule.
- Contains pus
- Bacterial infections, pustular psoriasis
Describe urticaria.
- Wheals/hives, elevated lesions with localized edema
- Wheals: Pruritic and red
- HSR to drugs, stings, bites, autoimmune, and sometimes temp/pressure/sunlight
- Lasts < 24h
Describe a scale.
- Heaped up accumulation of horny epithelium
- Psoriasis, seb derm, fungal infections
Describe crust.
- Dried serum, pus, or blood
- Inflammatory or infectious skin diseases like impetigo
Describe erosions.
- open areas of epidermis
- Trauma or inflammatory/infectious
- Excoriation: linear erosion due to scratching.
Describe ulcers.
- Loss of epidermis and part of dermis
- Venous stasis dermatitis, physical trauma, infections, vasculitis
Describe petechiae.
- NON-blanchable punctate foci of hemorrhage.
- Plt abnormalities, vasculitis, meningococcemia, RMSF, rickettsial diseases
Describe purpura.
- large area of hemorrhage
- Palpable sometimes
- Palpable purpura is the hallmark sign of leukocytoclastic vasculitis
- Often indicates coagulopathy
- Large purpura = bruise/ecchymoses
What drug use can induce skin atrophy?
Long-term use of topical corticosteroids
What is a keloid?
Hypetrophic scar extending beyond border
Describe telangiectases
- Foci of small, permanently dilated blood vessels
- Sun damage, rosacea, systemic sclerosis, long-term use of fluorinated corticosteroids
Describe a cyst.
- Cavity with liquid/solid
- Dome shaped, superficial appearing
- Skin colored, yellow, red, or blue
What falls under atopic history?
- Asthma
- Hay fever/allergic rhinitis
- Eczema
Image of Fitzpatrick skin types
The darker you are, the less the risk of developing skin cancer
What fitzpatrick skin types are most susceptible to skin cancer?
- Type 1: Pale, gingers/blondes
- Type 2: Fair, light-colored, blue/brown eyes
What are dermoscopy and diascopy?
- Dermoscopy: Hand-held lens with built-in lighting and magnification
- Diascopy: Glass slide pressed over lesion to determine capillary dilation (erythema) or blood extravasation (purpura)
