Skin Flashcards
Give examples of skin function
- Protect against microbe and foreign substance invasion
- Retard body fluid loss
- Regulate body temp
- Provide sensory perception
- Make Vit D from precursors
- Help reg blood pressure
- Repair surface wounds
- Sebaceous glands (sebum)
- Hair
- Nails
In someone’s PMH who has a rash or integument issue, what would be notable?
- Chronic med conditions
- Meds
- Allergies
- SH (occupation, hobbies, travel, stress, chem exposure)
- FH
On skin exam, what are the first two important parts? What tools are essential?
Inspection and palpation;
NEED adequate lighting and perhaps a magnifying glass or dermatoscope!!
On general physical exam, what should you have with you?
Centimeter ruler, Wood’s lamp (for fungal infections mostly) and a flashlight/transilluminator;
optional magnifying lens
On inspection of the patient, what are you looking for?
- Lesion type and DISTRIBUTION
- Secondary characteristics
- Shape of the lesions
- How are lesions arranged?
- Color
- Consistency and feel
Things to look for on palpation?
- Moisture (should be minimal perspiration, oiliness)
- Temp
- Texture (smooth, soft and even? or rough, patchy, scaly)
- Turgor (could be due to dehydration or edema)
- Mobility (can it move or is it fixed and immobile?)
Associate the following with appropriate examples:
Macule, Papule, Nodule, Vesicle, Pustule, Wheal
- Macule: non-palpable, skin color change, < 1 cm; e.g. blister
- Pustule: pus-filled, e.g. acne
- Wheal: palpable, irregular borders e.g. mosquito bite
What are four primary lesions? Give examples of that
- Plaques (confluence of papules that are large; psoriasis)
- Cysts (enclosed cavities with liquid or semisolid material; sebaceous cyst)
- Telangiectasia (superficial blood vessel; N/A)
- Bullae (large vesicles; pemphigus)
For suspicious changes for skin cancer, what mnemonic do you use?
Asymmetry Border Color Diameter (greater than 6 mm) Evolution (how is skin changing over time?)
What is the most common form of skin cancer? What would you see on presentation?
Most common form of skin cancer; usually won’t metastasize, usually is sun damaged skin, smooth pearly borders with central pallor
What is characteristic of SCC?
Think sun exposure; ulceration, scabs; gets deeper and ulcerated over time
Where would you see malignant melanoma?
Non-sun exposed areas
What is Kaposi’s sarcoma?
These purply lesions due to neoplasm of the endo and epithelial layer of the skin caused by HHV8
What is a hallmark of chronically dry skin? What could be causes?
Eczematous dermatitis (maybe caused by dish soap, chemicals, other environmental cause)
What microorganism typically causes folliculitis?
Staph aureus
What could cause cellulitis? What features do you see on the skin? What can be used for treatment?
S aureus; bullae; large-spectrum antibiotics
Psoriasis tends to run in _______; what is thought to cause it? What else can trigger this? How can you improve this condition? What other things can you see on presentation?
families; immune system function errors;
emotional stress, skin injury, infection, meds;
SUN EXPOSURE!!;
Some lichenification, nail pitting, onycholysis
How is SLE different from rosacea?
It tends to be more ulcerated; classic butterly rash and could be triggered by UV light, stress, meds, antibiotics, hormonal changes, seen in women 15-45
What causes acanthosis nigricans? What is the presentation?
Could be obesity, diabetes or glucose intolerance, PCOD;
velvet, leathery thickening of the skin
What is herpes zoster/shingles? What’s the virus? What is a potential sequelae? What is characteristic of the patients who end up with herpes zoster?
Grouped vesicles on an erythematous base, following a sensory dermatome pattern;
varicella;
postherpetic neuralgia;
had chicken pox as a child
What is vitiligo?
Autoimmune disorder; attacks pigmented cells (depigmentation)
What do you want to not confuse cherry hemangioma with? What is the difference?
Telangiectasia; don’t see blanching if you press the cherry angiomata/hemangioma
Seborrheic keratoses?
Get more as you get older; DON’T PULL THEM OFF!!
What is seen with chronic venous stasis?
Brown stasis edema with pigment leaking out from veins and there are small ulcers due to poor venous return
What are you looking for if someone’s bitten their nails? Treatment?
Paronychia; antibiotics
What do you see with onychomycosis? Who is at risk of this?
Nails rough and ragged; seen in diabetics or immunosuppressed
What pathology would flouresce under a Wood’s lamp?
Tinea Cruris
Which path can be treated topically and appears hypopigmented?
Tinea Versicolor
