morphology and therapeutic basics Flashcards
morphology
use of descriptors to accurately characterize and document skin lesions
primary lesion
initial lesion that occurs
secondary lesions
changes that occur due to time or manipulation
small, flat lesions < 1 cm are called
macules
cause of macule
color changes in epidermis or upper dermis
macule
macule
macule is confined to
epidermis
do macules contain fluid
no
secondary changes to macules
scale or crust
flat lesion >1 cm
patch
patch
location of psoriasis
likes to be on extensor surfaces (knees, elbows) back, gluteal cleft
skin colored lesion
refers to a lesion of the same color as the patients skin tone
plaque
raised lesions larger than 1 cm
you can feel them
cast a shadow with side lighting
a plaque is a proliferation of cells in ____ or superficial _____
epidermis
dermis
plaque
plaque
papule
raised lesions < 1 cm
a proliferation of cells in epidermis or superficial dermis
a larger deep papule is called a
nodule
papule
papule
a proliferation of cells down to the mid-dermis
nodule
raised area in skin where the overlying epidermis looks and feels normal, but there is a proliferation of cells in deeper tissues
nodule
nodule latin
small knot
distribution
location on the body
configuration
how the lesions are arranged or relate to each other
linear dermatomal configuration
shingles
vesicle
small fluid filled sac or cyst <1 cm
a vesicle filled with pus
pustule
pustule
vesicle
pus is made up of
leukocytes and a thin fluid called liquor puris “pus liquid”
furuncle
pustule associated with a hair follicle
abscess
pustule that is deep
a superficial loss of the epidermis
erosion
an erosion involving the dermis
ulcer
deeper wound and may see a scar
_____ often heal with scarring, ____ usually do not
ulcers
erosions
how do secondary lesions form
external forces - scratching, trauma, infection, healing process
ex of raised lesions
papule
plaque
nodule
tumor
wheal
burrow
scar
ex of flat lesions
macule
patch
ex of depressed lesions
erosion
ulcer
atrophy
sinus
stria
fluid filled lesion ex
vesicle
bulla
pustule
furuncle
abscess
vascular lesions
telangiectasia
petechiae
ecchymosis
bullae
larger version of a vescle
> 1 cm
the efficacy of any topical medication is related to
the active ingredient (strength)
anatomic location
the vehicle (mode of transportation)
the concentration (of the medication)
vehicle
how the treatment is transported
ointments
greasy, some patients don’t like the mest
best on non hairy skin, away from erosion so it doesn’t sting
inherently stronger than creams or lotions
creams
less greasy, can sting on open skin
use for cream
intertriginous areas, minimal scale, patients who dislike thick ointment
lotion
less greasy than creams,
consider use of face and hair areas
use of oils/solutions
scalp
gel
non-greasy, dry quickly, may sting
use for gel
acne, scalp/hairy areas without matting
foams
spread readily, may sting open areas
use of foams
hairy areas, inflammation
sprays
aersols are rarely used, good for scalps but may sting
topical corticosteroids
reduce skin inflammation in many conditions
whats more important - type of steroid or concentration?
steroid type
intertriginous areas
skin areas that fold together like armpit or elbow
main therapies used
creams and ointments
class 1
super high potency - clobetasol
class II
high potency - fluocinonide
Class III - V
medium potency - triamcinolone
class VI - VII
low potency - desonide and hydrocortisone
look at the ___ of steroid not the ____
class
percentage
when to use super high potency (class I)
severe dermatoses over nonfacial and nonintertriginous areas
scalp, palms, soles, thick plaques on extensor surfaces
when to use medium to high potency (classes II - V)
milder conditions on trunk/extremeties or short periods for face and intertriginous sites
when to use low potency steroids (classes VI, VII)
face, eyelid, genital, intertriginous areas
side effects of topical steroids
skin atrophy
telangiectasias
striae
acne
steroid rosacea
hypopigmentation
the higher the ____ the more likely side effects will occur
potency
striae
strech mark
