Rash Flashcards
Bulla
circumscribed, elevated lesion > 1 cm containing serous or hemorrhagic fluid
Macule
circumscribed, nonpalpable discoloration of skin
Nodule
palpable, solid, round or ellipsoidal lesion > 1 cm, more vertical than wide
Papule
elevated, solid lesion
Patch
circumscribed, nonpalpable discoloration of skin > 1 cm
Petechiae
nonblanching reddish macules
Plaque
palpable, solid lesion > 1 cm
Purpura
nonblanching reddish macules > 0.3 cm
Pustule
lesion containing pus, may be follicular or nonfollicular
Vesicle
circumscribed, elevated lesion
Wheal
round or annular (ring-like), edematous papule or plaque, evanescent, disappearing within hours
Atrophy
depression in the skin resulting from thinning of epidermis, dermis, and/or subQ fat
Crust
collection of dried blood, serum, and/or cellular debris
Erosion
focal loss of epidermis, does not penetrate below dermal-epidermal junction, can heal w/o scarring
Lichenification
thickening of epidermis d/t repeated rubbing, appearing as accentuation of skin markings
Scale
excess dead epidermal cells, mb fine, silvery, greasy, desquamative, or adherent
Scar
abnormal formation of CT, implying dermal damage
Ulcer
focal loss of full-thickness epidermis and partial to full-thickness dermis, often heals w/ scarring
Nikolsky sign
further shearing of skin when lateral pressure applied to normal-appearing epidermis in area adjacent to bulla
Morphologic Patterns (9)
Exanthematous eruptions Papulosquamous dermatoses Eczematous dermatoses Vesiculobullous disorders Pustular dermatoses Purpuras Erythemas Urticaria Subcutaneous nodules
Morphologic Pattern: Do you have a rash consisting of many small red spots and/or bumps?
Exanthematous eruptions
Morphologic Pattern: Do you have scaly spots and/or bumps on your skin?
Papulosquamous dermatoses
Morphologic Pattern: Do you have red, itchy, oozy, crusty, and scaly skin?
Eczematous dermatoses
Morphologic Pattern: Have blisters developed on your skin?
Vesiculobullous disorders
Morphologic Pattern: Do you ever have bumps on your skin that are filled with fluid?
Vesiculobullous disorders
Morphologic Pattern: Do you have “pus bumps” or pimples on your skin?
Pustular dermatoses
Morphologic Pattern: Do you have red or purple spots or bumps that do not fade when you press on them? (i.e. lesions are nonblanching)?
Purpuras
Morphologic Pattern: Do you have areas of red, hot skin?
Erythemas
Morphologic Pattern: Do you have spots on your skin that look like targets?
Erythemas
Morphologic Pattern: Do you have hives?
Urticaria
Morphologic Pattern: Do you have bumps deep in your skin?
Subcutaneous nodules
Exanthematous eruptions (5)
Morbilliform drug eruption Drug rash w/ eosinophilia and systemic symptoms (DRESS) Acute graft-versus-host disease (GVHD) Scarlet fever Viral exanthems
Viral exanthems (4)
Measles
Rubella
Roseola
Erythema infectiosum
Papulosquamous dermatoses (8)
Lichen planus Pityriasis rosea Psoriasis Seborrheic dermatitis Lupus erythematosus Dermatomyositis Tinea Secondary syphilis
Eczematous dermatoses (6)
Atopic dermatitis Allergic contact dermatitis Irritant contact dermatitis Venous stasis dermatitis Autosensitization dermatitis (id rxn) Systemic contact dermatitis
Vesiculobullous disorders (11)
Stevens-Johnson syndrome/toxic epidermal necrolysis Bullous pemphigoid Pemphigus vulgaris Porphyria cutanea tarda Dermatitis herpetiformis Phytophotodermatitis HSV infection Varicella Zoster Staphylococcal scalded skin syndrome (SSSS) Bullous impetigo
Pustular dermatoses (9)
Acute generalized exanthematous pustulosis Generalized pustular psoriasis Acne vulgaris Steroid acne Acne rosacea Periorificial dermatitis Folliculitis Cutaneous candidiasis Disseminated gonococcal infection
Purpuras (13)
Thrombocytopenic purpura Schamberg pigmented purpuric dermatosis Actinic purpura Scurvy Leukocytoclastic vasculitis Polyarteritis nodosa Cryoglobulinemia, type I Cholesterol emboli Calciphylaxis Purpura fulminans Rocky mountain spotted fever Acute bacterial endocarditis Ecthyma gangrenosum
Erythemas and urticaria (9)
Phototoxic reactions Urticaria Erythema multiforme Sweet syndrome Erysipelas Cellulitis Necrotizing fasciitis Lyme disease Toxic shock syndrome
Subcutaneous nodules (6)
Erythema nodosum Nodular vasculitis Lipodermatosclerosis Pancreatic panniculitis a1-antitrypsin deficiency panniculitis Lupus panniculitis
Serious Dx: Exanthematous eruptions (2)
DRESS
GVHD
Serious Dx: Papulosquamous dermatoses (3)
Erythrodermic psoriasis
Systemic lupus erythematosus
Dermatomyositis
Serious Dx: Eczematous dermatoses (1)
Erythrodermic dermatitis
Serious Dx: Vesiculobullous disorders (4)
SJS/TEN
Pemphigus vulgaris
Disseminated HSV infection
Disseminated zoster
Serious Dx: Pustular dermatoses (3)
Generalized pustular psoriasis
Disseminated gonococcal infection
Serious Dx: Purpuras (7)
Leukocytoclastic vasculitis w/ systemic involvement Polyarteritis nodosa Calciphylaxis Purpura fulminans Rocky mountain spotted fever Actue bacterial endocarditis Ecthyma gangernosum
Serious Dx: Erythemas (4)
Urticaria/angioedema associated w/ anaphylaxis
Erysipelas
Necrotizing fasciitis
TSS
Serious Dx: Subcutaneous nodules (1)
Pancreatic panniculitis
Alarm SSx: Painful skin -serious (5)
SJS/TEN Pemphigus vulgaris Pustular psoriasis Calciphylaxis Necrotizing fasciitis
Alarm SSx: Painful skin - benign (2)
SSSS
Phototoxic reaction
Alarm SSx: Confluent erythema serious (4)
DRESS
Acute GVHD
TEN
TSS
Alarm SSx: Confluent erythema - benign (4)
Severe morbilliform drug eruption
SSSS
AGEP
Scarlet fever
Alarm SSx: Erythroderma - serious (7)
Drug eruption Severe psoriasis Cutaneous T-cell lymphoma Atopic dermatitis Contact dermatitis Autosensitization dermatitis Seborrheic dermatitis
Erythroderma
Redness and scaling involving > 90% of the skin
Alarm SSx: Dusky or grayish-purple skin - serious (6)
SJS/TEN Caliphylaxis Purpura fulminans Polyarteritis nodosa Ecthyma gangernosum Necrotizing fasciitis
Alarm SSx: Widespread blistering or sloughing skin - serious (2)
SJS/TEN
Severe pemphigous vulgaris
Alarm SSx: Widespread blistering or sloughing skin - benign (2)
SSSS
Alarm SSx: Painful erosions of the mucous - serious (2)
SJS/TEN
Pemphigus vulgaris
Alarm SSx: Painful erosions of the mucous - benign (2)
Erythema multiforme
HSV infection w/ primary gingivostomatitis
Alarm SSx: Palpable purpura - serious (2)
Leukocytoclastic vasculitis w/ systemic involvement
Rocky mountain spotted fever
Alarm SSx: Palpable purpura - benign (2)
Leukocytoclastic vasculitis limited to skin
Alarm SSx: Facial swelling - serious (4)
DRESS
Acute cutaneous lupus erythematosus
Dermatomyositis
Angioedema
Alarm SSx: Facial swelling - benign (1)
AGEP
Alarm SSx: Swollen mouth/tongue, difficulty swallowing, tingling on top of mouth, and/or itching of palms/sides - serious (1)
Anaphylaxis
Alarm SSx: High fever (> 104˚ F) - serious (6)
DRESS SJS/TEN Purpura fulminans Rocky mountain spotted fever Acute bacterial endocarditis TSS
Alarm SSx: High fever (> 104˚ F) - benign (3)
Scarlet fever
Roseola
AGEP
Alarm SSx: Arthritis - serious (4)
Systemic lupus erythematosus
Disseminated gonococcal infection
Leukocytoclastic vasculitis w/ systemic involvement
Pancreatic panniculitis
Alarm SSx: Arthritis - benign (4)
Rubella
Erythema infectiosum psoriasis
Leukocytoclastic vasculitis w/ involvement limited to skin
Erythema nodosum
Alarm SSx: Shortness of breath or difficulty breathing - serious (1)
Anaphylaxis
Alarm SSx: Hypotension - serious (4)
Purpura fulminans
Ecthyma gangrenosum
Anaphylaxis
TSS
Have you started any new medications in the past 2 weeks?
Morbilliform drug eruption
Have you had a bone marrow or peripheral blood stem-cell transplantation within the past 3 months or recently stopped post-transplantation immunosuppressive medications?
GVHD
Have you recently had a sore throat, high fever, and headache?
Scarlet fever
Did you have a cough, runny nose, and red eyes just before developing this rash?
Measles
Has your child just had a high fever for several days, during which he or she otherwise looked well?
Roseola
Did your child have bright red cheeks, followed by lacy redness on the arms that is most noticeable when he/she is hot
Erythema infectiosum
Are your immunizations up to date?
If not, measles or rubella
Do you have itchy, purple, flat-topped bumps on your wrists or shins that you rub frequently?
Lichen planus
Do you have an itchy rash in areas exposed to the sun?
Lichen planus
Have you started a new medication within the past year?
Lichenoid drug eruption
Did you develop a single scaly pink spot on your trunk, followed by an eruption of multiple but smaller spots?
Pityriasis rosea
Do you have well-defined areas of thick, red skin covered with silvery scales on your elbows, knees, or scalp?
Psoriasis
Are the joints of your hands swollen and painful?
Psoriasis +/- psoriatic arthritis
Do you have a family history of psoriasis?
Psoriasis
Have you had redness and greasy scaling of your eyebrows, around your nose, and in/around your ears for many years?
Seborrheic dermatitis
Do you have dandruff?
Seborrheic dermatitis
Are you particularly sensitive to the sun?
Systemic lupus erythematosus
Have you noticed redness of your cheeks and the top of your nose in a “butterfly” shape?
Systemic lupus erythematosus
Do you have difficulty combing your hair or climbing stairs?
Dermatomyositis
Have you ever been diagnosed with any kind of cancer?
Dermatomyositis
Do you have pets, particularly a kitten?
Tinea corporis
Do you have a history of a genital ulcer in the past 6 months?
Secondary syphilis
Is your rash extremely itchy?
Atopic dermatitis
Have you had itchy rashes since childhood?
Atopic dermatitis
Do you or does anyone in your family have eczema, hay fever, or asthma?
Atopic dermatitis