Lecture 1 - Intro To Dermatology Flashcards
What are the key parts to a dermatological Hx?
Presenting complaint
Hx of complaint
PMHx
FHx
Social Hx
Travel Hx
Dx
Allergies
ICE
What do we need to consider with the presenting complaint for a dermatological Hx?
Nature
Site
Duration
What do we need to consider when learning about the Hx of presenting complaint?
Initial appearance
Location
Associated symptoms
Aggravating and relieving
Previous episodes
Treatments
Contact Hx
What do we need to consider with past medical Hx in dermatological history taking?
Systemic disease (SLE)
History of Atopy
History of skin cancer
History of sun burn (uses sun beds?)
What is Atopy?
Triad of eczema, hay fever and asthma
What do we need to consider with FHx in dermatological history taking?
Family Hx of:
Skin disease
Atopy
Autoimmune disease
What do we need to consider when asking about Social Hx with dermatological Hx taking?
Home situation (pets)
Smoking (worsens skin health)
Drugs and alcohol (IV drug use)
Occupation
Diet (allergens)
Cleaning products
What do we need to ask about when taking a Drug Hx for a dermatological Hx?
Prescribed drugs they take
Over the counter meds they buy
What is the pneumonic to remember what to look for in dermatological exams?
SCAM
What does SCAM stand for ini dermatological exams?
S = site and distribution (rash) , size and shape of lesion
C = colour and configuration
A = associated changes
M = morphology
What are extensules?
When the rash or lesion is on the knees or elbows
What are flexules?
When rash is in cubital fossa or popliteal fossa
What areas are lesions/rashees commmon in for eczema?
Flexules
What are some words to describe the distribution / site of a rash/lesion?
Generalised (all over body)
Widespread
Localised
Symmetrical
Flexural
Extensor
Dermatome L
What is meant by follicular distribution?
Lesions in the distribution of the hair follicles
What is meant by a Dermatome distribution?
Area of skin supplied by a single dermatotme affected
What is a photosensitive site//distribution for a lesion?
Sun exposed areas such as face, neck and back of hands affected
What is referred to as a pressure area distribution?
Sacrum
Buttocks
Ankles
Heels
What is meant by a discrete configuration for a lesion/rash?
Individual separate lesions
What is meant by a confluent configuration for a rash/legion?
Individual lesions that blend/margin into each other
What is meant by a linear configuration for a rash/legion?
In a line
What is meant by a targetoid configuration for a rash/legion?
Have 3 distinct regions/concentric circles
What is meant by erythema in terms of colour for skin lesions/rashes?
Redness which blanches on pressure
What is meant by petechiae in terms of colour for skin lesions/rashes?
Red or purple colour (bleeding into skin or mucous membrane) which doesn’t blanch on pressure
(Between 1-2mm in diameter)
What is meant by purpura in terms of colour for skin lesions/rashes?
Red or purple colour (bleeding into skin or mucous membrane) which doesn’t blanch on pressure
(Between 2-10mm in diameter)
What is the bigger lesion/rash, petichae or purpura?
Petichae small
Purpura larger
What is meant by hyperpigmented in terms of colour for skin lesions/rashes?
Increase in skin colour (darker)
What is meant by hypopigmented in terms of colour for skin lesions/rashes?
Loss of skin colour
What is vitiligo?
Autoimmune attack on melanocytes usually localised, can be symmetrical areas
Usually associated with thyroid disease and T1DM
What is meant by morphology of a skin lesion?
The structure of a skin lesion
What is a primary lesion?
What is a secondary lesion?
A primary lesion develops as a direct result of a disease
A secondary lesion is a modification of the primary lesion
What is the meaning of a Macule when describing the morphology of a primary lesion?
Flat area of altered colour (<1cm diameter)
What is the meaning of a patch when describing the morphology of a primary lesion?
Flat area of altered colour or texture >1cm in diameter
What is larger a Macule or a patch?
Patch is larger
Macule is smaller
What is the meaning of a papule when describing the morphology of a primary lesion?
Small raised lesion <1cm in diameter
What is the meaning of a nodule when describing the morphology of a primary lesion?
Solid raised lesion >1cm in diameter
What is the meaning of a plaque when describing the morphology of a primary lesion?
Palpable raised lesions >1cm in diameter
What are the 2 terms used to describe the morphology of raised clear fluid filled lesions?
Vesicle
Bulla
What is the meaning of a vesicle when describing the morphology of a primary lesion?
Small raised blister that is filled with clear fluid <1cm in diameter
What is the meaning of a bulla when describing the morphology of a primary lesion?
Large raised blister filled with clear fluid >1cm in diameter
What is the meaning of a pustule when describing the morphology of a primary lesion?
Pus containing lesion that’s small and circumscribed
What is an abscess?
Localised accumulation of pus on the dermis or subcutaneous tissueees
What is the meaning of a comedome when describing the morphology of a primary lesion?
Pores or hair follicles that have gotten blocked with bacteria, oil and dead skin cells forming bumps on your skin
What is the meaning of annula when describing the morphology of a primary lesion?
Circular ring whose edge differs to the middle
What is lost when erosion has happened in a secondary lesion?
Epidermis is lost
What is excoriation?
When the epidermis is lost following trauma
What is lichenification?
Well defined roughening and thickening of skin with clear skin markings
What are scales?
Flakes of the stratum Corneum
What is the meaning of crust when describing the morphology of a secondary lesion?
Rough surface consisting of dried blood, serum, bacteria and cellular debris that has exuded through eroded epidermis
What is lost when a lesion is described as an ulcer?
Epidermis and dermis
What are striae?
Linear areas which progress from pink to white that looks like a scar
What is a scar?
Nee fibrous tissue. Whihc occurs post wound healing
What is Alopecia?
Attack on hair follicles causing hair loss
What is the difference between patchy Alopecia and diffuse Alopecia?
Patchy is in patches
Diffuse is widespread
What is hirsutisum?
Hair growth in females in androgen dependant locations
What is hypertrichosis?
When excessive hair grows in non androgen dependant locations.
What are some nail changes associated with dermatological conditions?
Pitting
Oncholysis
Koilonychia
Clubbing
What is nail pitting?
What conditions is it often related to?
Depression in the nail plate
Psoriasis
Eczema
Alopecia areata
What is koilonychia?
Spoon shaped depression of nails
What condition is koilonychia commonloy seen in?
Iron deficiency anaemia
What is oncholysis?
Separation of the distal end of the nail plate from the nail bed
What usually causes oncholysis?
Trauma
Psoriasis
Fungal nail infections
Hyperthyroidism
Go to slide 39,
What distribution is the conditions on the left then the right?
Left = flexures
Right = widespread
Go to slide 40,
What distribution is the conditions on the left then the right?
Left = follicular
Right = Dermatome
Go to slide 41,
What distribution is the conditions on the right?
Photosensitive rash
Go to slide 42,
What distribution is the conditions on the left then the right?
Left = discreted
Right = confluent
Go to slide 43,
What distribution is the conditions on the left then the right?
Left = linear
Right = targetoid
Go to slide 44,
What colour is the conditions on the right image for circle 1 then 2?
1 = petechiae
2 = purpura
Go to slide 45,
What colour is the conditions on the left?
L = hyperpigmented
Go to slide 46,
What colour is the conditions on the left then the right?
Both hypopigmented
Go to slide 47,
What morphology of the primary lesions is the conditions on the left then the right?
L = macule
R = patch
Go to slide 48,
What morphology of the primary lesions is the conditions on the left then the right?
L = papule
R = nodule
Go to slide 49,
What morphology of the primary lesions is the conditions on the left then the right?
L = plaque
R = vesicle
Go to slide 50,
What morphology of the primary lesions is the conditions on the left then the right?
L = bulla
R = pustule
Go to slide 51,
What morphology of the primary lesions is the conditions on the left, middle then the right?
L = annula
M = comidome
R = hives
Go to slide 52,
What morphology of the secondary lesions is the conditions on the left then the right?
L = excoriation
R = lichenification
Go to slide 53,
What morphology of the secondary lesions is the conditions on the left then the right?
L = crust (rough surface of dried blood and infection
R = scales
Go to slide 54,
What hair changes are seen on the conditions on the left, middle and right?
L = Alopecia
M = hypertrichosis
R = hirsutism
Go to slide 55,
What nail changes are seen on the conditions on the left and middle?
L = pitting
M = oncholysis
Go to slide 55,
What nail changes are seen on the conditions on the right top and right bottom?
Right top = koilonychia
Right bottom = clubbing
