MSCT Week 4: Skin Morphology and Exam Flashcards by Jay Sandoval

How is morphology used by dermatologists?

used to describe the shape, form, and structure of skin lesions
morphologic characteristics are key elements in establishing the diagnosis and communicating skin findings

How well did you know this?

Not at all

Perfectly

Critical steps describing morphology

Careful visual and tactile inspection
Correct use of terminology

How well did you know this?

Not at all

Perfectly

A good description includes

6 Listed

Palpability
Color
Shape
Texture
Size
Location

How well did you know this?

Not at all

Perfectly

Skin Biopsies: Shave/Snip Properties

3 Listed

Dermablade, 15 blade, scissors, etc.
Obtains epidermis to dermis
Does not require suture

How well did you know this?

Not at all

Perfectly

Skin Biopsies: Punch

3 Listed

Various sizes 2-8 mm
Obtains epidermis, dermis to fat
> 3 mm usually requires a suture

How well did you know this?

Not at all

Perfectly

Skin Biopsies: Excisional

How well did you know this?

Not at all

Perfectly

Dermatologic Exam & Description

4 Steps

Step 1: What is the primary lesion?

Color/Size

Step 2: What are the secondary changes?

Step 3: Configuration/Shape

Step 4: Body Distribution

How well did you know this?

Not at all

Perfectly

Identify

Macule

Flat < 1 cm

How well did you know this?

Not at all

Perfectly

Identify

Papule

Raised < 1 cm

How well did you know this?

Not at all

Perfectly

Identify

Vesicle

Clear Fluid Filled < 1 cm

Pustule

White fluid-filled

How well did you know this?

Not at all

Perfectly

Identify

Patch

Flat > 1 cm

How well did you know this?

Not at all

Perfectly

Identify

Plaque

Raised > 1 cm

How well did you know this?

Not at all

Perfectly

Identify

Nodule

Raised + Deep > 1 cm

How well did you know this?

Not at all

Perfectly

Identify

Tumor/Mass

Raised + Deep > 2 cm

How well did you know this?

Not at all

Perfectly

Identify

Bulla

Clear Fluid-filled > 1 cm

How well did you know this?

Not at all

Perfectly

Primary Lesion: Macule

a Macule is flat and small < 1 cm

If you can feel it, it is not a macule

How well did you know this?

Not at all

Perfectly

What are these?

Macules

How well did you know this?

Not at all

Perfectly

Primary Lesion: Patch

Patches are flat but larger than macules (> 1 cm)
If you can feel it at all, it is NOT a patch

How well did you know this?

Not at all

Perfectly

What are these?

Patches

How well did you know this?

Not at all

Perfectly

Primary Lesion: Papule

Papules are small, raised lesions (< 1 cm)
Caused by a proliferation of cells in epidermis or superficial dermis

How well did you know this?

Not at all

Perfectly

What are these?

Papules

How well did you know this?

Not at all

Perfectly

Primary Lesion: Plaque

Plaques are > 1 cm
You can feel them
Cast a shadow with side lighting
Caused by a proliferation of cell in epidermis or superficial dermis

How well did you know this?

Not at all

Perfectly

What are these?

Plaques

How well did you know this?

Not at all

Perfectly

Primary Lesion: Nodule

Nodulus = small knot in Latin
usually > 1 cm, deep, palpable
Caused by a proliferation of cells into the mid-deep dermis or fat

How well did you know this?

Not at all

Perfectly

What are these?

Nodules

Primary Lesion: Vesicle & Bulla

* Fluid-filled palpable lesion * Vesicles = small (\< 1 cm) * Bullae = large (\> 1 cm)

What are these?

Vesicles & Bullae

Primary Lesion: Pustule

Palpable bump filled with white fluid (pus)

Erythematous means?

Red from inflammation

Size description

* Measure * minute, small, large 5 mm, 5 cm

Texture description

smooth, soft, rock-hard

Additional Descriptors 9 Listed

* Scale * Crust * Excoriation * Erosion * Ulcer * Fissure * Lichenification * Atrophy * Scar

Secondary Change: Scale

Accumulated skin (stratum corneum) secondary change

Secondary Change: Crust

Dried exudate: blood, serum, pus

Secondary Change: Excoriation

Traumatized due to scratching

Secondary Change: Erosion

* Depression with loss of epidermis (superficial) * Loss of superficial epidermal layer

Secondary Change: Ulcer

Depression with loss of epidermis and dermis (deeper)

Secondary Change: Fissure

Linear Cleavage

Secondary Change: Lichenification

Thickening, accentuated skin lines

Secondary Change: Atrophy

Depression, thinning & wrinkling

Secondary Change: Scar

Permanent fibrotic change

Secondary descriptors: Vascular/Vasculitic

* Will not blanche with pressure * Diascopy

Secondary Change: Erosion vs Ulcer

What is the secondary change?

Scale

What is the secondary change?

Erosion

What is the secondary change?

Ulceration

What is the secondary change?

Erosion and Crust

What is the secondary change?

No secondary change seen

Distribution

Location(s) on the body

Configuration

How the lesions are arranged or relate to each other

Configuration examples 7 Listed

* Solitary * Discrete * Annular (ring-like) * Confluent * Clustered or Grouped * Linear * Reticulated (net-like)

Distribution Terms examples

Generalized Symmetric Unilateral Dermatomal Lines of Blaschko

Distribution Patterns Examples

* Acral * Truncal * Extensor * Flexor * Follicular * Koebnerized * Photodistributed * Pressure/dependency

Complete description

Complete Description

What is the primary Lesion?

What is the secondary change?

What is the configuration?

What is the distribution?

What is the best description?

Purpura Description

* Acute to subacute leakage of capillaries or small-larger vessels within the skin * usually larger * may be palpable

Ecchymotic Description

* subacute to chronic hemorrhage within skin * Usually larger