MIDTERM- Derm Flashcards
Define macule
Flat, circumscribed, area that is change in color of skin (i.e., freckles, flat moles (nevi)
Define papule
Raised/ elevated firm, circumscribed area less than 1 cm in diameter (wart, elevated moles, lichen planus, insect bite)
Define patch
Flat, non palpable, irregular area that is change in skin color more than 1 cm in diameter (i.e., vitiligo, port wine, Mongolian spots)
Define plaque
Raised/ elevated, firm, rough lesion with flat top greater than 1 cm diameter (psoriasis, seborrheic and acitinic keratoses)
Define wheal
Elevated, irregular shaped area of cutaneous edema; solid, transient, variable diameter (insect bites, uticaria, allergic reaction)
Define nodule
Elevated, firm, circumscribed lesion; deeper in dermis than papule, 1-2 cm in diameter (i.e., lipoma, erythema nodosum)
Define tumour
Elevated, solid lesion. May be clearly demarcated. Deeper in dermis. More than 2 cm diameter (neoplasm, benign tumor, lipoma, hemangioma)
Define vesicle
Elevated, circumscribed, superficial; does not extend into dermis. Filled with serous fluid; less than 1 cm diameter (varicella, shingles, hsv)
Define bulla
Vesicles more than 1 cm in diameter (blister, pemphigus vulgaris)
Define pustule
Elevated, superficial, similar to vesicle but filled with purulent fluid (impetigo, acne)
Define cyst
Elevated, circumscribed, encapsulated lesion in dermis or subcutaneous layer; filled with liquid or semisolid material (sebaceous cyst; cystic acne
Define telangiectasia
Fine (0.5-1mm) irregular red lines produced by capillary dilation; can be assoc with acne rosacea, venous HTN, sclerosis, or developmental abnormalities
Define crust
Dried exudate on surface (blood/ serum/ pus combo) i.e., scab
Define erosion
Loss of part of epidermis; superficial; depressed, moist, glistening, follows rupture of vesicle or bulla or chemical injury
Define ulcer
Deeper- loss of epidermis and dermis- concave, varies in size (pressure and stasis ulcer
Define comedone
Small, flesh colored white/ dark bumps that give skin a rough texture. Clogged hair follicle with keratin + oil. Typical of acne
Define milia
Tiny white bumps that are clogged eccrine sweat glands; keratin filled little cysts just under epidermis. Found in babies. In adults, usually around eyes, nose, groin. Harder texture than comedone.
Define scale
Heaped up, keratinized cells; flaky skin; irregular shape, thick or thin, dry or oily, variation in size (i.e., flaking of skin with seborrheic dermatitis; can follow medication reaction; dry skin)
Define lichenification
Roughened, thickened epidermis secondary to persistent rubbing, itching, or skin irritation. Often involves flexor surface of extremity. i.e., chronic dermatitis
Define keloid
Irregular shaped, elevated, progressively enlarging scar; grows beyond boundaries of wound, caused by excessive collagen formation during healing (i.e., keloid)
Define scar
Thin to thick fibrous tissue that replaces normal skin following injury/ laceration to dermis
Define excoriation
Loss of epidermis- linear, hollowed out, crusted area (i.e., abrasion, scabies)
Define fissure
Linear crack or break from epidermis to dermis. Moist or dy. i.e., athletes foot, anal fissure, dermatitis, cracks at corner of mouth
Define petechiae
Non blanchable punctuate foci of hemorrage (i.e., platelet abnoramlties, thrombocytopenia, vasculitis, infection (RMSV, meningococcemia)
Define prurpura
Larger area of hemorrage; may be palpable. Half mark of leukocystoclastic vasculitis. May indicate coagulopathy. Large areas of purpura can be called ecymosis (bruise)
Define burrow
Thread like linear or serpiginous (wavy/ serpent like) tunnel in epidermis. Typically caused by parasite (i.e., scabies)
Describe 7 skin functions
Protection, secretion, absorption, excretion, filtration, diffusion, sensory reception
What is a myocses
Disease caused by fungal infection
What is a dermatophyte
Fungi requiring keratin for growth, causing superficial infection of skin, hair, nails
ID with potassium hydroxide stain
How are bacteria classified
environment (aerobic vs anerobic), shape (cocci- round; bacilli- rod; spirrila- spiral), gram stain (positive- retains dye due to cell wall peptidoglycans- purple blue; negative- thin wall- pink or red)
What are 2 pathogens commonly causing skin infection
Staphyllococcal aureus (cellulitis, folliculitis, impetigo)
Streptococci (group A- impetigo; group B- cellulitis; pyogenes- impetigo)
What is a common virus causing skin infection
HPV (DS DNA) (condylmata accuminat, cold sores, verruca vulgaris)
Varicella (shingles)
Poxvirus (molluscum contagiosum)
What are common parasites causing skin infection
lice (pediculosis), scabies (mite), bed bugs
Name 3 skin conditions that can progress to cancer
Bowens disease (SCC in situ- epidermis only)
Keratocanthoma (often progresses to SCC)
Acitinic keratosis (early lesion of SCC and BCC- epidermal lesions of atypical keratinocytes at basal layer of skin)
Name 3 types of skin cancer and where they originate
SCC (basal layer of keratinocytes of epidermis)
BCC (dermis)
Melanoma (melanocytes)
Name 3 skin conditions with autoimmune causes
Possible answers include acnea rosacea, dermatitis, lichen planus, pemphigus, psoriasis, uticaria, vitiligo, alopecia (androgenica or areata)
What is pediculosis?
Lice
S&S of pediculosis?
Pruritus, often see ova/ nits attached to hair shaft 1 inch from head. May be located in hair, eyelashes, pubic region. May see red macule, papule, or wheal with hemorragic puncture site
Tx pediculosis?
Topical pediculicides (repeat in 1 week, as does not kill eggs)
What are the distinguishing signs of lichen planus?
flat, shiny, pruritic purple papules and patches; wickmans striae (white reticulated lacy pattern)
Who gets lichen planus?
30-60 year olds, rarely children. Risk factors- family history, thiazides, beta blockers, ACEis, sulfonylureas
What is the time course for lichen planus
Lesions are self limiting and average duration is 6-18 months
What is the cause of lichen planus
Acute, idiopathic skin eruption; thought to be benign autoimmune inflammatory disorder of skin. May involve T cell response to damaged keratinocytes
Tx for lichen planus?
Corticosteroids, antihistamines, retinoids, derm referall if refractory or mucosal involvement
What is steven johnsons syndrome
separation of basement membrane of skin; toxic epidermal necrolysis; skin peels off >10% of body
What is Nikolosky’s sign
skin peels off in sheets (stick arm on thumb, drag, and skin peels off) (SJS)
How does SJS progress
Abrupt red/ tender/ painful rash on trunk extends over hours to days onto face, limbs (rarely affecting scalp, palms, soles); max extent reaches by 4 days. Macules or purpuric spots and flaccid blisters.
What does a typical shingles lesion look like
Localized to dermatome; red swollen plaques with vesicles that rupture then form crusts
What virus causes shingles
Reactivated varicella zoster
Name the distinguishing feature/ characteristic for: acne vulgaris
comedones
Name the distinguishing feature/ characteristic for: allergic contact dermatitis
type 4 hypersensitivity, environmental allergen, intense itching, vesicles, distribution of exposure
Name the distinguishing feature/ characteristic for: irritant dermatitis
erythematous scales
Name the distinguishing feature/ characteristic for: atopic dermatitis (eczema)
dry skin and severe pruritus
Name the distinguishing feature/ characteristic for: Bowens disease
red scaly patch on skin in sun exposed area
Name the distinguishing feature/ characteristic for: Candidiasis
white scale
Name the distinguishing feature/ characteristic for: Cellulitis
dermis and subcutaneous tissue, redness, warmth, pain; indistinct border
Name the distinguishing feature/ characteristic for: condylmata accuminata
cauliflower warts on genitals
Name the distinguishing feature/ characteristic for: dematophytes
papules, plaques with round edge, white scale. may be pruritic
Name the distinguishing feature/ characteristic for: erythema multiform
many morphologies, iris center, appear suddenly in symmetric or crop pattern on palms, soles, forearm, legs.
Name the distinguishing feature/ characteristic for: folliculitis
dome shaped pustules; inflammation of hair follicle
Name the distinguishing feature/ characteristic for: furuncles
deep, red, painful, fluctuant, walled off collection of pus
Name the distinguishing feature/ characteristic for: carbuncles
deep, red, painful, nodules that are interconnected aggregates of infected abscessed follicles
Name the distinguishing feature/ characteristic for: HSV
papules then vesicles (on lips)
Name the distinguishing feature/ characteristic for: herpes zoster
vesicles, dermatomes, crust
Name the distinguishing feature/ characteristic for: impetigo
skin infection, bullous or non bullous, firmly adherent honey yellow crust, satellite lesions
Name the distinguishing feature/ characteristic for: lichen planus
flat, shiny, purple, pruritic papule or plaque; wickmans striae (white lacy reticulated pattern)
Name the distinguishing feature/ characteristic for: molluscum contagiosum
umbilicated
Name the distinguishing feature/ characteristic for: onychomycosis
yellow/ white nail plate, elevated, brittle, thick
Name the distinguishing feature/ characteristic for: pediculosis
eggs 1 cm from hair shaft, pinpoint macule or wheal, pruritus in hair
Name the distinguishing feature/ characteristic for: pemphigus
bullae 1-3 cm rupture easily, IgG destruction of cell to cell adhesion in dermal layer
Name the distinguishing feature/ characteristic for: pityriasis rosea
herald patch (salmon pink lesion 3-10 cm), secondary lesion (collarette/ pine tree)`
Name the distinguishing feature/ characteristic for: pityriasis versicolor
colors vary spot to spot
Name the distinguishing feature/ characteristic for: psoriasis
pruritic, well demarcated, erythematous plaques with silver scale
Name the distinguishing feature/ characteristic for: scabies
burrows
Name the distinguishing feature/ characteristic for: seborrheic dermatitis
red greasy scaling rash that is patches and plaques; stuck on
Name the distinguishing feature/ characteristic for: seborrheic keratosis
stick on, smashed, keratin cysts or horns
What are we suspicious of in the event of sudden appearance of many seborrheic keratoses?
internal malignancy
Name the distinguishing feature/ characteristic for: uticaria
acute- type 1- histamine release
Edema, erythema, 2-3 cm
Name the distinguishing feature/ characteristic for: verruca vulgairs
dome shape, hyperkeratotic, black dot (thrombosed capillaries)
Name the distinguishing feature/ characteristic for: vitiligo
white macules coalesce into patches
Name the distinguishing feature/ characteristic for: keratoacanthoma
dull red crateriform nodules, volcano like shape with central keratotic plug or depression
Name the distinguishing feature/ characteristic for: SCC
pink, pearly white, smooth, teleangiectasia, raised border
Name the distinguishing feature/ characteristic for: BCC
dull red, scale over central cavity, lower lip
Name the distinguishing feature/ characteristic for: acitinic keratosis
sun exposed skin, rough feeling usually detected by pt
Name the distinguishing feature/ characteristic for: melanoms
asymmetry, border, color, diameter, evolving
Small mole increases in size, changes in color, becomes ulcerated, bleeds easily. do not biopsy urgent derm referal
Name the distinguishing feature/ characteristic for: alopecia androgenica
male pattern baldness (temples to top)
Name the distinguishing feature/ characteristic for: alopecia areata
patchy hair loss 1-4 cm
Name the distinguishing feature/ characteristic for: lyme
bulls eye red and white alternating rings
Name the distinguishing feature/ characteristic for: rocky mountain spotted fever
petechial rash involving palms and soles, fever, malaise
Name the distinguishing feature/ characteristic for: erythema nodosum
tender nodules look like bruises
Name the distinguishing feature/ characteristic for: SJS/ TENs
nikolskys sign, separation of basement membrane
You see a rash on your patients palms and recall the acronym MRS TECK that helps you think of causative conditions
Meningiococcal/ measles, RMSF, syphilis, tens, sjs, endocarditis, coxsackie, kawasacki