Lecture 1 - Intro To Dermatology Flashcards

1
Q

What are the key parts to a dermatological Hx?

A

Presenting complaint
Hx of complaint
PMHx
FHx
Social Hx
Travel Hx
Dx
Allergies
ICE

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2
Q

What do we need to consider with the presenting complaint for a dermatological Hx?

A

Nature
Site
Duration

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3
Q

What do we need to consider when learning about the Hx of presenting complaint?

A

Initial appearance
Location
Associated symptoms
Aggravating and relieving
Previous episodes
Treatments
Contact Hx

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4
Q

What do we need to consider with past medical Hx in dermatological history taking?

A

Systemic disease (SLE)
History of Atopy
History of skin cancer
History of sun burn (uses sun beds?)

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5
Q

What is Atopy?

A

Triad of eczema, hay fever and asthma

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6
Q

What do we need to consider with FHx in dermatological history taking?

A

Family Hx of:
Skin disease
Atopy
Autoimmune disease

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7
Q

What do we need to consider when asking about Social Hx with dermatological Hx taking?

A

Home situation (pets)
Smoking (worsens skin health)
Drugs and alcohol (IV drug use)
Occupation
Diet (allergens)
Cleaning products

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8
Q

What do we need to ask about when taking a Drug Hx for a dermatological Hx?

A

Prescribed drugs they take
Over the counter meds they buy

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9
Q

What is the pneumonic to remember what to look for in dermatological exams?

A

SCAM

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10
Q

What does SCAM stand for ini dermatological exams?

A

S = site and distribution (rash) , size and shape of lesion

C = colour and configuration

A = associated changes

M = morphology

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11
Q

What are extensules?

A

When the rash or lesion is on the knees or elbows

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12
Q

What are flexules?

A

When rash is in cubital fossa or popliteal fossa

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13
Q

What areas are lesions/rashees commmon in for eczema?

A

Flexules

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14
Q

What are some words to describe the distribution / site of a rash/lesion?

A

Generalised (all over body)
Widespread
Localised
Symmetrical
Flexural
Extensor
Dermatome L

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15
Q

What is meant by follicular distribution?

A

Lesions in the distribution of the hair follicles

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16
Q

What is meant by a Dermatome distribution?

A

Area of skin supplied by a single dermatotme affected

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17
Q

What is a photosensitive site//distribution for a lesion?

A

Sun exposed areas such as face, neck and back of hands affected

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18
Q

What is referred to as a pressure area distribution?

A

Sacrum
Buttocks
Ankles
Heels

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19
Q

What is meant by a discrete configuration for a lesion/rash?

A

Individual separate lesions

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20
Q

What is meant by a confluent configuration for a rash/legion?

A

Individual lesions that blend/margin into each other

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21
Q

What is meant by a linear configuration for a rash/legion?

A

In a line

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22
Q

What is meant by a targetoid configuration for a rash/legion?

A

Have 3 distinct regions/concentric circles

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23
Q

What is meant by erythema in terms of colour for skin lesions/rashes?

A

Redness which blanches on pressure

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24
Q

What is meant by petechiae in terms of colour for skin lesions/rashes?

A

Red or purple colour (bleeding into skin or mucous membrane) which doesn’t blanch on pressure

(Between 1-2mm in diameter)

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25
Q

What is meant by purpura in terms of colour for skin lesions/rashes?

A

Red or purple colour (bleeding into skin or mucous membrane) which doesn’t blanch on pressure

(Between 2-10mm in diameter)

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26
Q

What is the bigger lesion/rash, petichae or purpura?

A

Petichae small
Purpura larger

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27
Q

What is meant by hyperpigmented in terms of colour for skin lesions/rashes?

A

Increase in skin colour (darker)

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28
Q

What is meant by hypopigmented in terms of colour for skin lesions/rashes?

A

Loss of skin colour

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29
Q

What is vitiligo?

A

Autoimmune attack on melanocytes usually localised, can be symmetrical areas

Usually associated with thyroid disease and T1DM

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30
Q

What is meant by morphology of a skin lesion?

A

The structure of a skin lesion

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31
Q

What is a primary lesion?

What is a secondary lesion?

A

A primary lesion develops as a direct result of a disease

A secondary lesion is a modification of the primary lesion

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32
Q

What is the meaning of a Macule when describing the morphology of a primary lesion?

A

Flat area of altered colour (<1cm diameter)

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33
Q

What is the meaning of a patch when describing the morphology of a primary lesion?

A

Flat area of altered colour or texture >1cm in diameter

34
Q

What is larger a Macule or a patch?

A

Patch is larger
Macule is smaller

35
Q

What is the meaning of a papule when describing the morphology of a primary lesion?

A

Small raised lesion <1cm in diameter

36
Q

What is the meaning of a nodule when describing the morphology of a primary lesion?

A

Solid raised lesion >1cm in diameter

37
Q

What is the meaning of a plaque when describing the morphology of a primary lesion?

A

Palpable raised lesions >1cm in diameter

38
Q

What are the 2 terms used to describe the morphology of raised clear fluid filled lesions?

A

Vesicle
Bulla

39
Q

What is the meaning of a vesicle when describing the morphology of a primary lesion?

A

Small raised blister that is filled with clear fluid <1cm in diameter

40
Q

What is the meaning of a bulla when describing the morphology of a primary lesion?

A

Large raised blister filled with clear fluid >1cm in diameter

41
Q

What is the meaning of a pustule when describing the morphology of a primary lesion?

A

Pus containing lesion that’s small and circumscribed

42
Q

What is an abscess?

A

Localised accumulation of pus on the dermis or subcutaneous tissueees

43
Q

What is the meaning of a comedome when describing the morphology of a primary lesion?

A

Pores or hair follicles that have gotten blocked with bacteria, oil and dead skin cells forming bumps on your skin

44
Q

What is the meaning of annula when describing the morphology of a primary lesion?

A

Circular ring whose edge differs to the middle

45
Q

What is lost when erosion has happened in a secondary lesion?

A

Epidermis is lost

46
Q

What is excoriation?

A

When the epidermis is lost following trauma

47
Q

What is lichenification?

A

Well defined roughening and thickening of skin with clear skin markings

48
Q

What are scales?

A

Flakes of the stratum Corneum

49
Q

What is the meaning of crust when describing the morphology of a secondary lesion?

A

Rough surface consisting of dried blood, serum, bacteria and cellular debris that has exuded through eroded epidermis

50
Q

What is lost when a lesion is described as an ulcer?

A

Epidermis and dermis

51
Q

What are striae?

A

Linear areas which progress from pink to white that looks like a scar

52
Q

What is a scar?

A

Nee fibrous tissue. Whihc occurs post wound healing

53
Q

What is Alopecia?

A

Attack on hair follicles causing hair loss

54
Q

What is the difference between patchy Alopecia and diffuse Alopecia?

A

Patchy is in patches

Diffuse is widespread

55
Q

What is hirsutisum?

A

Hair growth in females in androgen dependant locations

56
Q

What is hypertrichosis?

A

When excessive hair grows in non androgen dependant locations.

57
Q

What are some nail changes associated with dermatological conditions?

A

Pitting
Oncholysis
Koilonychia
Clubbing

58
Q

What is nail pitting?

What conditions is it often related to?

A

Depression in the nail plate

Psoriasis
Eczema
Alopecia areata

59
Q

What is koilonychia?

A

Spoon shaped depression of nails

60
Q

What condition is koilonychia commonloy seen in?

A

Iron deficiency anaemia

61
Q

What is oncholysis?

A

Separation of the distal end of the nail plate from the nail bed

62
Q

What usually causes oncholysis?

A

Trauma
Psoriasis
Fungal nail infections
Hyperthyroidism

63
Q

Go to slide 39,

What distribution is the conditions on the left then the right?

A

Left = flexures

Right = widespread

64
Q

Go to slide 40,

What distribution is the conditions on the left then the right?

A

Left = follicular

Right = Dermatome

65
Q

Go to slide 41,

What distribution is the conditions on the right?

A

Photosensitive rash

66
Q

Go to slide 42,

What distribution is the conditions on the left then the right?

A

Left = discreted

Right = confluent

67
Q

Go to slide 43,

What distribution is the conditions on the left then the right?

A

Left = linear

Right = targetoid

68
Q

Go to slide 44,

What colour is the conditions on the right image for circle 1 then 2?

A

1 = petechiae
2 = purpura

69
Q

Go to slide 45,

What colour is the conditions on the left?

A

L = hyperpigmented

70
Q

Go to slide 46,

What colour is the conditions on the left then the right?

A

Both hypopigmented

71
Q

Go to slide 47,

What morphology of the primary lesions is the conditions on the left then the right?

A

L = macule
R = patch

72
Q

Go to slide 48,

What morphology of the primary lesions is the conditions on the left then the right?

A

L = papule
R = nodule

73
Q

Go to slide 49,

What morphology of the primary lesions is the conditions on the left then the right?

A

L = plaque
R = vesicle

74
Q

Go to slide 50,

What morphology of the primary lesions is the conditions on the left then the right?

A

L = bulla
R = pustule

75
Q

Go to slide 51,

What morphology of the primary lesions is the conditions on the left, middle then the right?

A

L = annula
M = comidome
R = hives

76
Q

Go to slide 52,

What morphology of the secondary lesions is the conditions on the left then the right?

A

L = excoriation
R = lichenification

77
Q

Go to slide 53,

What morphology of the secondary lesions is the conditions on the left then the right?

A

L = crust (rough surface of dried blood and infection
R = scales

78
Q

Go to slide 54,

What hair changes are seen on the conditions on the left, middle and right?

A

L = Alopecia
M = hypertrichosis
R = hirsutism

79
Q

Go to slide 55,

What nail changes are seen on the conditions on the left and middle?

A

L = pitting
M = oncholysis

80
Q

Go to slide 55,

What nail changes are seen on the conditions on the right top and right bottom?

A

Right top = koilonychia
Right bottom = clubbing