Lecture 1: Intro to Derm

Question 1

Why is physical examination before history taking best for derm?

Answer 1

Diagnostic accuracy is higher when there is no preconceived ideas

Question 2

Melanoma ABCDEs

Answer 2

• Asymmetry
• Border irregularity
• Color (multiple)
• Diameter > 6mm
• Evolving over time

Ugly duckling sign

Question 3

Lesion graph/algorithm

Answer 3

Question 4

Describe a macule.

Answer 4

• Flat, nonpalpable < 10mm
• Change in color
• Large macule = patch

A mat is flat

Question 5

Describe a papule.

Answer 5

• Elevated lesion < 5mm
• Palpable
• Nevi, warts

Palpable papules

Question 6

Describe a plaque.

Answer 6

• Palpable lesions > 10mm
• Flat topped, rounded, elevated, or depressed
• Psoriasis, granuloma annulare

Question 7

Describe a nodule.

Answer 7

• Firm lesion extending into dermis/subC tissue
• Cysts, lipomas, fibromas

Question 8

Describe a vesicle.

Answer 8

• Small, clear, fluid-filled blister < 10mm
• Herpes, acute allergic contact dermatitis, autoimmune

Question 9

Describe a bulla.

Answer 9

• Clear, fluid filled blister > 10mm
• Burns, bites, irritant/contact, drug rxns
• Classic autoimmune: pemphigus vulgaris & bullous pemphigoid

A Large vesicle = bulla

Question 10

Describe a pustule.

Answer 10

• Contains pus
• Bacterial infections, pustular psoriasis

Question 11

Describe urticaria.

Answer 11

• Wheals/hives, elevated lesions with localized edema
• Wheals: Pruritic and red
• HSR to drugs, stings, bites, autoimmune, and sometimes temp/pressure/sunlight
• Lasts < 24h

Question 12

Describe a scale.

Answer 12

• Heaped up accumulation of horny epithelium
• Psoriasis, seb derm, fungal infections

Question 13

Describe crust.

Answer 13

• Dried serum, pus, or blood
• Inflammatory or infectious skin diseases like impetigo

Question 14

Describe erosions.

Answer 14

• open areas of epidermis
• Trauma or inflammatory/infectious
• Excoriation: linear erosion due to scratching.

Question 15

Describe ulcers.

Answer 15

• Loss of epidermis and part of dermis
• Venous stasis dermatitis, physical trauma, infections, vasculitis

Question 16

Describe petechiae.

Answer 16

• NON-blanchable punctate foci of hemorrhage.
• Plt abnormalities, vasculitis, meningococcemia, RMSF, rickettsial diseases

Question 17

Describe purpura.

Answer 17

• large area of hemorrhage
• Palpable sometimes
• Palpable purpura is the hallmark sign of leukocytoclastic vasculitis
• Often indicates coagulopathy
• Large purpura = bruise/ecchymoses

Question 18

What drug use can induce skin atrophy?

Answer 18

Long-term use of topical corticosteroids

Question 19

What is a keloid?

Answer 19

Hypetrophic scar extending beyond border

Question 20

Describe telangiectases

Answer 20

• Foci of small, permanently dilated blood vessels
• Sun damage, rosacea, systemic sclerosis, long-term use of fluorinated corticosteroids

Question 21

Describe a cyst.

Answer 21

• Cavity with liquid/solid
• Dome shaped, superficial appearing
• Skin colored, yellow, red, or blue

Question 22

What falls under atopic history?

Answer 22

• Asthma
• Hay fever/allergic rhinitis
• Eczema

Question 23

Image of Fitzpatrick skin types

Answer 23

The darker you are, the less the risk of developing skin cancer

Question 24

What fitzpatrick skin types are most susceptible to skin cancer?

Answer 24

• Type 1: Pale, gingers/blondes
• Type 2: Fair, light-colored, blue/brown eyes

Question 25

What are dermoscopy and diascopy?

Answer 25

• 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)