Signs and Symptoms and General Diagnosis in Dermatology Flashcards
Primary Lesions
macules Papules Vesicles Pustules Nodules Comedo Cyst Tumor Wheal Telangiectasia Purpura Sclerosis
Secondary lesions
Scales Crusts Erosions Ulcers Fissures Excoriations Scars Lichenification Atrophy Sclerosis
Caused by capillary dilatation. Usually diffuse involvement of the skin
Erythema
Violaceous eythema and swelling around periorbital area
Dermatomyositis
Caused by extravasated red blood cells
Purpura
Hypersensitivity Vasculitis; when you biopsy it you would see leukocytoplastic vasculitis
Henoch-Schonlein Purpura
increased melanin in the basal layer
Freckles
Increased melanin in the basal layer with increased number of melanocytes
Cafe-au-lait spots nd lentigo
Common among women who had been pregnant or are taking oral contraceptive pills
Melasma
Decreased melanin in epidermis, usually seen in atopic dermatitis
Hypopigmentation
Pityriasis alba
Substance secreted by M. furfur
Azelaic acid
Absence of melanocytes in epidermis
Depigmentation
Consistency of Neurofibroma
soft
Hyperpigmented lesion, usually seen in the legs and usually secondary to some form of trauma
Dermatofibroma (firm consistency)
Benign follicular tumor, histologically will show ghost cells
Pilomatricoma
consistency (HARD)
localized scleroderma-whitish indurated patch (palpate it to appreciate induration or firmness/boardlike quality)
Morphea
Tender nodules that involve subcutaneous tissue; histology would show septal pappiliditis. Clinically, this may also present with post-inflammatory hyperpigmentation
Erythema Nodosum
Shape of Lesion
ROund or oval Polygonal Annular Polycyclic wheals Iris Serpiginous Umbilicated
Target Lesions. Appears as concentric rings
Erythema Multiforme
Arrangement of Multiple Lesions
Grouped
Disseminated
Multiple eruptive seborrheic keratosis, most commonly associated with gastrointestinal adenocarcinoma
Lesser Trelait Sign
Most common cutaneous symptom
Pruritus
The sensation of pruritus is carried from the skin by ???
Unmyelinated C fibers
Mediator of Itch on the Skin
Histamine Serotonin Endopeptidases Neuropeptidas Eicosanoids
4P’s of Lichen Planus
Pruritic
Polygonal
Purplish
Papules
Dermatitis herpetiformis
show deposition of IgA at the tips of the dermal papilla; Histopath to confirm diagnosis; do not scratch because you will develop new lesions when it is traumatied (KOEBER PHENOMENON)
Pain, tingling sensation before skin lesions and post herpetic neuralgia (sensation of pain remains even when the lesions disappear)
herpes Zoster
Tender, reddish-brown tumors seen in the arms and may also involve the trunk; biopsy to confirm
Pilar Leiomyoma
Normal hair loss:
50 to 100 strands per day)
Patchy baldnes which can be solitary or several that typiccally begins with rapid hair loss on discrete areas of the scalp
Alopecia Areata
Characteristic diagnostic finding is short, broken hairs called exclamation point hairs. Associated with autoimmune diseases like thyroid disease or vitiligo
Alopecia areata
Total loss of scalp hair
Can Affect eyebrows and eyelashes
Alopecia Totalis
Total loss of both body and scalp hair
Alopecia Universalis
Also known as male-pattern baldness. Recession begins above temples. Hairline eventually form a characteristic “M” Shape
Androgenic Alopecia
Increased shedding of hair resulting from the early entry in the telogen phase
Telogen Effluvium
Resting phase of the hair follicle when hair strands are shed off
Telogen Phase
Causes of Telogen Effluvium
Pregnancy (Shedding of hair 4 months after but will grow again)
Discontinuing or changing type of oral contraceptives
Major surgical procedure
“Crash” dieting
Green/yellow- green fluorescence with Wood’s lamp
Tinea capitis
Green patch type
ectothrix
Starts out as a more typical presentation of tinea capitis but is endothrix (invasion of hair shaft)
Kerion (Tinea capitis)
- does not exhibit fluorescence with the Wood’s lamp
- can cause inflammation and deteriorate to a deep abscess
a rare inflmmatory condition that results in patchy progressive permanent hair loss mainly in the scalp
Lichen planopilaris
Causes of Nail splitting
Nail trauma Skin Irritations LAck of moisture Artificial nail coatings Repetitive exposure to water and harsh chemicals Deficiencies of IRON VIT. C or PROTEIN
Transverse splitting into layers at or near the free edge
Onychoschizia (lamellar dystrophy)
Longitudinal ridging and splitting of the free edge
Onychorrhexis (Brittle nails)
Small punctate depressions on the surface of the nail
Nail Pitting
Presence of misshapen, partially or completely destroyed nail plates
Dystrophic nails
caused by:
Psoriasis
Onychomycosis
Trauma
Orange brown or tan brown spot in nails
Can be yellowish - rule out of fungal infection
Oil spots of psoriasis
Melanocytic nevus in white persons, maybe normal in black/brown-skinned persons.. if it extends to periungual skin (HUTCHINSON SIGN), then rule out melanoma
Brown linear band or streak
Transverse depressions across the fingernail. Can occur after acute stress such as MI, hypotension, shock, injury to the nail, malnutrition, severe infection during chemotherapy for cancer
Beau’s lines
If the length of the Beau’s line is somewhere in middle
stressful event occured 1 1/2 - 3 months
Dilated capilalries around the nail. Might be indicative of connective tissue disorders such as Dermatomyositis, LE, RA
Periungual telangiectasia
Bulbous enlargement and broadening of the fingertips. Lovibond’s angle exceeds 180 degrees
Clubbing
-inherited: AD
Normal Lovibond’s angle
160 degrees
Severe form of erythema multiforme (EM). Involves 2 or more mucous membranes such as oral cavity/lips, eyes/cojunctiva, perianal, genital mucosa
Stevens-Johnson Syndrome (SJS)
SJS separation of epidermis from dermis
<10%: SJS
>30%: Toxic epidermal necrolysis (TEN)
10-30%: overlap between SJS and TEN
Autoimmune Disorder. Initial and can be the only manifestation: blisters and erosions in the inner lining of oral cavity
Pemphigus Vulgaris
Biopsy of Pemphigus Vulgaris
Biopsy will reveal a suprabasal blister
Dx can also be made by direct immunofluorescence IgG+ complement deposited in between keratinocytes in the epidermis
Large erosions due to tendency to extend peripherally after application of pressure (in Pemphigus Vulgaris)
Nikolsky sign
Erythematous scaly plaques Advancing borders Central clearing Very pruritic Named according to body part affected
Dermatophytoses
Burning, eythematous, moist,partially eroded patch after application of irritant
irritant Contact Dermatitis
Solitary or multiple wart like papules
Verruca
Plaques with silvery white scales
Psoriasis
common chronic skin disease involving blockage and/or inflammation of pilosebaceous units
Acne Vulgaris
Firm, tender nodule
Furuncle
Hypoesthetic (reduced sense of torch or sensation) plaque with erythematous border and hypopigmented center
Tuberculoid Leprosy
Circumscribed plaque from repetitive rubbing and scratching
Lichen SImplex/Chronicus
Hyperpigmented macules due to herpes zoster infection
Post-Inflammatory changes
