Skin Flashcards
Macule
cirucumscribed, flat, nonpalpable change in skin color
up to 1cm
ex. freckles, flat nevi, hypopigmentation, petechiae, measles, scarlet fever
Patch
macule larger than 1 cm
ex. Mongolian spot, vitiligo, cafe au lait spot, choloasma, measles rash
Papule
palpable, elevated, circumscribed, solid mass
caused by superficial thickening in the epidermis
up to 0.5 cm
ex. Elevated nevus, lichen planus, molluscum, wart
Plaque
flat, elevated surface larger than 0.5 cm
often formed by coalescence of papules
larger than 0.5cm
ex. Psoriasis, lichen planus, xanthoma
Nodule
solid, elevated, firm or soft mass larger than 0.5cm
may be firmer and extend deeper into the dermis than a papule
0.5 to 1 or 2cm
ex. Xanthoma, fibroma, intradermal nevi
Tumor
solid, elevated, firm or soft mass larger than 1-2cm extending even deeper into dermis may be benign or malignant larger than 1-2cm ex. Lipoma, hemangioma
Wheal
superficial, raised, erythmatous, transient lesion with somewhat irregular borders due to localized edema
size varies
ex. mosquito bite, allergic reaction, dermographism
Urticaria
Wheals coalescing to form an extensive reaction
intensely pruritic
size varies
ex. Hives
Vesicle
circumscribed, superficial, elevated cavity containing free fluid
clear fluid flows if wall is ruptured
up to 1cm
ex. Herpes simplex, early varicella, herpes zoster (shingles), contact dermatitis
Bulla
larger vesicle usually single chambered (unilocular) superficial in epidermis thin-walled (ruptures easily) Larger than 1cm ex. friction blister, pemphigus, burns, contact dermatitis
Pustule
circumscribed, superficial, elevated cavity containing turbid fluid (pus)
up to 1cm
ex. impetigo, acne
Cyst
encapsulated, fluid- or pus-filled cavity in dermis or subcutaneous layer
tensely elevating the skin
larger than 1cm
ex. sebaceous cyst, wen
secondary skin lesion
usually occur after a primary lesion
Crust
thickened, dried residue or burst vesicles, pustules, or blood
can be red-brown, honey-colored, or yellow depending on fluid’s origin
ex. eczema, impetigo, scab following an abrasion
Scale
compact, desiccated flakes of skin dry or greasy silvery or white, from shedding excess dead keratin cells visible exfoliation of the dermis ex. post scarlet fever or drug reaction psoriasis (silvery) seborrheic dermatitis (yellow, greasy) dandruff, dry skin
excoriation
scratch
superficial
ex. scratch from a foreign body, insect bites, scabies, dermatitis, varicella
Fissure
linear crack with abrupt edges
extends into dermis
can be dry or moist
ex. Cheilosis (at corners of mouth), athlete’s foot, anal fissure
Erosion
superficial, circumscribed loss of epidermis
leaves a scooped-out, but shallow depression
moist, but no bleeding
heals without a scar because does not extend into dermis
ex. stage 2 decubitus ulcer, burn (most likely a scalding)
Ulcer
circumscribed depression extending into the dermis
irregular shape
may bleed
leaves a scar
ex. stasis ulcer, pressure sore, chancre, malignant growth
scar
replacement of destroyed normal skin tissue by fibrous connective tissue
a permanent change
keloid
hypertrophic scar
resulted skin level is elevated by excess scar tissue
ex. keloid
Lichenification
thickening and roughening of skin, usually a result of intense scratching
results from a set of tightly packed set of papules
causes increased visibility of the superficial skin markings
ex. long-standing eczema, atopic dermatitis
Jaundice
rise in bilirubin in blood
1st place noticeable–sclera of eye or roof of mouth
hepatitis, sickle cell, cirrhosis of liver
infants–physiological-first few days
Erythema
excess blood supply in areas closest to surface
blushing or infection
in darker skinned people–feel if warmth or skin more taut
most common–carbon monoxide poisoining
Cyanosis
bluish, modeled color decreased perfusion of oxygenated blood most often will show signs of low oxygen level--general generalized--heart failure, sepsis hypoxemia
Vitiligo
acquired condition
absence of melanin
usually on the face, neck
Acanthosis Nigricans
adolescents
increased pigmentation around the neck
precursor to diabetes
can be a sign of a tumor or other condition
Mongolian spots
due to deeper melanocytes sacrum and buttocks does not blanche will go away infants
Cafe au lait spot
generally benign
light brown pigmentation
if 6 or more, send for consult
Acrocyanosis
common in newborn the first day
does blanche
Cutis marmorata
response to cold
can be critical
for baby–oxygen needs double with a two-degree change in temperature
Acne
comedonal–whitehead (closed), blackhead (open)
pustular–infection, larger
Senile lentigines
liver spots
Lymphedema
does not pit, but obvious to see
orthostatic edema
result of standing in place for a long time
edema
signs of fluid in interstitial tissues
to test, push with thumb over bony prominence for 4-5 sec
eschar
black
serous
yellow
purulent
puss filled
serosanguinous
yellow with a tinge of blood
annular
circular lesion
confluent
legions running together
discrete
single lesion
grouped
cluster of lesions
gyrate
twisted, coiled lesions
target
lesion with target in center (Lyme)
polycyclic
circular lesions growing together
zosteriform
follows the nerve root, when comes back follows the same root
petechiae
vascular lesion
red
pin sized macules of blood in skin
less than 3mm
purpura
vascular lesion
larger macule or papule of blood in the skin
0.3-1cm
do not blanch
ecchymosis
vascular lesion
from a bruise
small hemorrhagic spot in the skin or mucous membrane
larger than a petechia
non-elevated, rounded, or irregular blue or purplish patch
escape of blood into tissue from ruptured blood vessels
1cm
Cherry angioma
vascular lesion start around age 30 also called Campbell de Morgan spots small bright red papules benign common on trunks of middle-aged and elderly
spider angioma
vascular lesion–will blanch
if a lot on trunk–liver disease
children and pregnant women can have (esp. on face)
Telangiectasia
inside basal cell carcinomas
permanently dilated and visible vessels in skin
can appear as linear, punctuate, or stellate crimson-purple markings
can be caused by nifedipine
Nevus Flammeus–Port Wine Stain
type of erythematous "stork bite" on babies present at birth caused by dilated dermal capillaries pale pink to purple macules
Herpes Simplex I
viral infection
cold sore
Herpes Simplex II
viral infection
can be found in mouth or on genitals
Varicella (chicken pox)
viral infection
another form of herpes
Herpes Zoster (Shingles)
viral infection
zoster–only on one side
if on facial nerve, can paralyze
if in ear, can go deaf
Skin Cancer Warning Signs
A–Asymmetry in shape
B–Border irregularity
C–Color is mottled-shades of brown, black, grey, red, white
D–Diameter is unusually large (greater than pencil tip)
E–Elevation is almost always present
E–Enlargement–history of increase in size (malignant melanoma)
Basal Cell Carcinoma
most common malignancy locally invasive and destructive slow growing rarely metastasized almost translucent, dome-shaped papule with overlying telangeictasias (permanently dilated blood vessels)
Acetinic keratosis on scalp
keratonic lesions with malignant potential
can turn into squamous cell carcinoma
Squamous cell carcinoma
de novo–show up by itself
invasive malignancy
commonly found on head, neck or hands
may arise from acetinic keratosis
melanoma
superficial spreading–flat and irregular
nodular–dark color
Hirsutism
excessive hairiness on women in those parts of body where terminal hair does not normally occur or is minimal
depends on genetic background
on face and back
check for polycystic ovarian syndrome
Clubbing
when end of nail flattens and becomes greater than 180 degrees
