PHYSICAL EXAMINATION OF THE SKIN, HAIR AND NAILS Flashcards

You may prefer our related Brainscape-certified flashcards:
1
Q

Derm Specific History what to ask

Onset:

A

Abrupt or gradual onset?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Derm Specific History what to ask

Location:

A

Where lesions first noted and where they are now.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Derm Specific History what to ask

Location:

A

Where lesions first noted and where they are now.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Derm Specific History what to ask

Duration:

A

Recurrences, remissions, exacerbations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Derm Specific History what to ask

Evolution:

A

Has it spread? Gotten itchier? More painful?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Derm Specific History what to ask

Character:

A

Pruritus/pain, bleeding, non-healing, wounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Derm Specific History what to ask

Aggravating/Alleviating:

A

UV exposure, heat/cold, exposures (chemicals,medications, cosmetics, perfumes, plants, metals)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Derm Specific History what to ask

Temporal:

A

Constant, intermittent, worst at night, climate change.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Derm Specific History what to ask

Severity:

A

Severity of pain or pruritus (0/10 works for both).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Derm Specific History what to ask

Pertinent Derm Questions:

A

Previous occurrence(s), any close contacts with similar symptoms, new/change in hygiene products

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Overall Skin Inspection algorithm

CUTSHP

A

Color (rule out potentially actue issues)
Uniform Appearance
Thickness
Symmetry (unilateral vs. bilateral presentation)
Hygiene (some conditions have predisposing hygienic concerns)
Presence of any lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Definition of what?

(a) Rated as I-VI on the scale
(b) Quasi-objective metric of amount of melanin pigment in the skin

A

Fitzpatrick Scale

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

_____ resistance is largely determined by melanocyte activity and melanocytic pigmentation of the skin.

A

UVR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the umbrella term used in dermatology for any observed skin change or finding

A

Lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Size of lesion is measured on what dimensions and in what measurement scale?

A

1)Length
2)Width
3)Depth is covered by noting elevation or depression
Always in mm or cm!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Lesion Shapes:

Ring shape with central clearing

A

Annular (Ring shaped)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Lesion Shapes:

a) Coin-shaped; solid circle or oval
b) Uniform appearance from the edges to the center

A

Round (nummular)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Lesion Shapes:

Often a result of incomplete formation of an annular lesion

A

Arcuate (arc-shaped)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Lesion Shapes:

Multiple different shapes located closely together (grab-bag)

A

Multiform:

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Lesion Shapes:

Formed from coalescing circles, rings, or incomplete rings

A

Polycyclic:

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Lesion Shapes:

Target-like, with a center darker than the periphery

A

Targetoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Lesion Shapes:

Dot-like, typically around 1 mm

A

Punctate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Lesion Shapes:

a) With a central depression of the surface.
b) Also known as “delled”.

A

Umbilicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Lesion Shapes:

a) Resembling a straight line
b) Ex: Poison Ivy or scratch marks

A

Linear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Lesion Shapes:

a) Serpentine or snake-like
b) Ex: Lymphadenitis

A

Serpiginous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the most important additional feature of a lesion other than primary morphology(Shape)

A

Lesion Color

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

The most common types of color on the skin are:

A

1) Variations in brown
2) Hyperpigmentation
3) Hypopigmentation
4) Variations in red (erythema)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What part of the lesion inspection can be referred to as either ‘borders’ or ‘margins’?

A

Demarcation (Borders)

29
Q

What level of demarcation?

1) Borders are clearly defined and have a definitive ‘stop’ point
2) AKA ‘Discrete’ or well defined’

A

Well demarcated

30
Q

What level of demarcation?

1) Tight borders on a round lesion
2) Clear “beginning & end”

A

Circumscribed

31
Q

What level of demarcation?

1) Borders are indistinct and lack a definitive start/stop point
2) AKA ‘indistinct’ or ‘confluent’

A

Not well-demarcated

32
Q

Border/Margins definition

1) Expanding at margins
2) Ex: Cellulitis, erysipelas, necrotizing fasciitis, etc.

A

Advancing

33
Q

Border/Margins definition

1) AKA ‘central clearing
2) Similar to annular or arcuate except the border is being considered vice the shape.

A

Border raised above center

34
Q

This defines what?

Protein-rich fluid containing cellular elements extruded from blood vessels secondary to inflammation or injury

A

Exudate

35
Q

This defines what?

Thick, yellow to green discharge typically associated with infection.

A

Purulent

36
Q

This defines what?

Dried Crust discharge

A

Serum

37
Q

Location and Distribution Terms:

Unilateral & lying in the distribution of a single spinal afferent nerve root

A

Dermatomal/Zosteriform

38
Q

Location and Distribution Terms:

Lying along the distribution of a lymph vessel; implies infectious agent spreading from an acral (distal) site

A

Lymphangitic

39
Q

Location and Distribution Terms:

Occurring in distal locations, such as on the hands, feet, wrists, ankles, ears, or penis.

A

Distal (Acral)

40
Q

Location and Distribution Terms:

Occurring on the trunk or central body.

A

Truncal

41
Q

Location and Distribution Terms:

Occurring in areas usually not covered by clothing: face, dorsal hands

A

Sun Exposed (AKA Photo-distributed)

42
Q

Location and Distribution Terms:

Occurring in areas usually covered by one or more layers of clothing

A

Sun Protected

43
Q

Location and Distribution Terms:

Occurring over the dorsal extremities, (extensor muscles, knees, or elbows)

A

Extensor

44
Q

Location and Distribution Terms:

Overlying the flexor muscles of the extremities (antecubital & popliteal fossae)

A

Flexor

45
Q

Location and Distribution Terms:
Occurring in the skin folds, where 2 skin surfaces are in contact: (axillae,inguinal folds, inner thighs, inframammary skin)

A

Intertriginous (Latin inter, “between”’ trigo, “rubbing”)

46
Q

Location and Distribution Terms:

1) Favoring the hair-bearing locations of the skin
2) Scalp, eyebrows, beard, central chest, axillae, genitals, nasolabial and postauricular creases.

A

Seborrheic

47
Q

Location and Distribution Terms:

Confined to a single body location.

A

Localized

48
Q

Location and Distribution Terms:

Widespread

A

Generalized

49
Q

What type of lesion?

Flat, circumscribed area of color change less than 1 cm in diameter.

A

Macule

50
Q

What type of lesion?

A flat, non-palpable, irregularly shaped macule greater than 1 cm in diameter.

A

Patch

51
Q

What type of lesion?

An elevated, firm, circumscribed area less than 1 cm in diameter.

A

Papule

52
Q

What type of lesion?

An elevated firm, rough, lesion with flat top greater than 1 cm in diameter.

A

Plaque

53
Q

What type of lesion?

Elevated, circumscribed, superficial fluid-filled (clear/serous). Less than 1 cm.

A

Vesicle

54
Q

What type of lesion?

Elevated, superficial lesion. Similar to a vesicle but filled with purulent fluid

A

Pustule

55
Q

What type of lesion?

Vesicle greater than 1 cm

A

Bulla

56
Q

What type of lesion?

An elevated, irregularly-shaped area of cutaneous edema. Solid, transient and variable diameter.

A

Wheal (Hive)

57
Q

What type of lesion?

Elevated, firm, circumscribed lesion; deeper in the dermis than a papule. 1-2cm in diameter.

A

Nodule

58
Q

What type of lesion?

Elevated and solid lesion; may or may not be clearly demarcated; deep in dermis. Greater than 2 cm.

A

Tumor (Mass)

59
Q

What type of lesion?

Encapsulated lesion in the dermis or hypodermis; filled with liquid or semi-solid material.

A

Cyst

60
Q

What type of lesion?

Fine, irregular, red line produced by capillary dilation

A

Telangiectasia

61
Q

Secondary Skin Lesions

Typically categorized in what three ways:

A

1) Accumulation of material
2) Change in skin integrity or thickness
3) Loss of layers or skin breakdown

62
Q

What is this?

Irregularly shaped, elevated scar that grows beyond the boundaries of the initial injury or wound.

A

Keloid

63
Q

What is this?

Overgrowth of scar tissue that remains confined to the site of initial injury. May be raised or flat.

A

Hypertrophic Scar

64
Q

What is this?

Thinning of the skin and loss of skin markings. Skin can turn translucent and paper-like.

A

Atrophy

65
Q
What type of skin loss?
Loss of part of epidermis (not dermis)
a) Does not bleed
b) Heals without scarring
c) Follows rupture of a vesicle or bulla
d) Examples
-(1 Varicella
-(2 Variola after rupture
A

Erosion

66
Q
What type of skin loss?
Loss of epidermis and dermis
a) Concave
b) May bleed
c) Heals with scarring
A

Ulcer

67
Q

Loss of epidermis

a) Linear, hollowed-out crusted area
b) Due to mechanical trauma (scratching)

A

Excoriation

68
Q

Linear crack in skin continuity from epidermis to dermis

a) Can be moist or dry
b) Examples
- (1 Athlete’s foot
- (2 Intertrigo
- (3 Angular chelitis

A

Fissure

69
Q

True/False

Dermatoglyphics (fingerprint lines) are preserved over the surface in warts

A
FALSE
Dermatoglyphics (fingerprint lines) are preserved over the surface in Corns and callus