Skin Flashcards
_______ ______ = all coverings go the body which are directly exposed to the outside world
external medicine
The ____ is the most accessible of all body tissues
skin
What are the 3 layers of skin structure?
- epidermis
- dermis
- subcutaneous tissue
What is the top layer of skin called?
stratum corneum
_____ = small spot, not palpable, < 1cm
macule
_____ = large spot, not palpable >1cm
patch
_____ = small bump, superficial, elevated, < 1cm
papule
_____ = large bump, superficial, elevated, > 1cm
plaque
____ = small bubble, fluid filled usually superficial, <0.5cm
vesicle
____ = large bubble, fluid filled, can be superficial or deep, > 0.5cm
bulla
_____ = pus containing bubble, often categorized according to whether or not they are related to hair follicles
pustule
_____ = accumulation or excess shedding of keratin from the stratum corneum
scale
____ = dried exudate on the skin surface, synonymous with scab
crust
______ = loss of skin due to scratching or picking
excoriation
______ = superficial open wound, loss of epidermis or mucosa only
erosion
______ = deeper open wound with partial or complete loss of dermis or submucosa
ulcer
What are 2 types of flat lesions?
- macule
2. patch
What are 2 types of elevated lesions?
- papule
2. plaque
What are 3 types of fluid-filled lesions?
- vesicle
- bulla
- pustule
First degree burn
Extent of injury?
Appearance?
- superficial
- erythema
Second degree burn
Extent of injury?
Appearance?
- partial thickness
- blistering
Third degree burn
Extent of injury?
Appearance?
- full thickness
- necrosis
Rule of __’s = used to estimate body surface area of involvement in thermal burns
9
Rules of palms = palm of hand is ~ __% of body surface area
1
What are 3 types of physical trauma to skin?
- mechanical
- thermal
- chronic ulcers
What are the 4 types of chronic ulcers?
- pressure
- vascular
- neuropathic
- other
If an ulcer is BELOW the ankle, it is usually ______; if it is ABOVE the ankle, it is usually _____.
arterial; venous
In general scarring does not occur unless there is significant damage to the ______.
dermis
Superficial injury with _______ blistering and erosions only = heals without scarring
epidermal
3 phases of wound healing?
- Inflammatory
- Proliferation
- Remodelling
_______ phase = __hr -__ weeks; involves vascular effects and a cellular response that culminates in acute inflammation which is aimed at eliminating pathogens or debris and delivering the materials required for healing the wouldn’t.
inflammatory; 24-2
_______ phase = ____ to ____; production of materials to restore a functional skin barrier; both dermis and epidermis need to be repaired
proliferative; days to months
In the proliferative phase, there is ______ and ________ in the dermis
fibroplasial; neovascularization
In the proliferative phase, early angiogenesis and fibroplasia result in friable beefy-red tissue called _________ tissue.
Granulation
In the proliferative phase, at the surface the wound must re-epithelialize through _______ proliferation and migration.
keratinocyte
What cells cause neovascularization?
endothelial
______ = ____; during this phase, the wound contracts and acquires increased tensile strength; healed would culminates in a scar
remodelling; months
What are 3 ways to classify wounds?
- timing
- extent
- repair method
_______ thickness wounds involve epidermis and part of dermis
partial
_____ thickness wounds extend throughout the dermis and may also include subcutaneous layer or deeper
full
Wound closed by surgical excision = ______ intention healing
primary
Wound left to heal completely on it’s own = _______ intention healing
secondary
When a wound is healing, promote a _____ environment to facilitate cell proliferation (fibroblasts, vasculature , keratinocytes)
moist
In general wounds heal faster if ______.
occluded
______ scare = thick scare that is in excess of the amount of tissue required to replace the damaged dermis
hypertrophic
______ = thick scar that clear extends beyond the margins of the original wound
keloid
Bacterial infection are usually only deep (T/F).
FALSE; can be superficial or deep
Bacterial infections are most commonly caused by what 2 species?
- Streptococcus
2. Staphylococcus
Fungal infections of the skin can be superficial or deep (T/F).
FALSE; usually only superficial since causative organisms do not invade beyond the epidermis
What are the 2 major types of superficial fungal infections?
- dermatophytosis
2. candidiasis
How is diagnosis of fungal infections confirmed?
microscopic examination of skin scrapings
Dermatophytosis eats ______ so infection can occur anywhere on the skin.
keratin
Tinea capitis?
scalp
Tinea corporis?
body - “ring worm”
Tinea cruris
groin - “jock itch”
Tinea manum
hands
Tinea pedis
feet - “athletes foot”
Tinea unguium
nails
Advancing ridge that is red = good sign that the infection is (bacterial/fungal)
fungal
The most common herpes virus infections are due to _____ ____ and ____ ____.
herpes simplex; varicella zoster
Herpes virus infections are clinically characterized by ____ and ______ that evolve into crusts.
pain; vesicles
Herpes virus infections are pathologically characterized by _____ infection –> ____ infection within the sensory nerve ganglia –> viral _______.
primary; latent; reactivation
Genital cancers can be caused by oncogenic _____ subtypes.
HPV
________ ________ = translucent papule with central keratotic core
molluscum contagiosum
Is molluscum contagiosum more common in children or adults?
children
If molluscum contagiosum occurs in young adults, it is commonly in _______ regions.
genital; considered an STD
______ = intensely pruritic infection; look for linear burrows on the skin
scabies
Psoriasis develops before pt is 20 (T/F).
FALSE; can develop any time during life
What are the 5 cardinal morphologic features of psoriasis vulgaris?
- plaque
- well-circumscribed margins
- bright salmon-red colour
- silvery micaceous scale
- symmetric distribution
What are sides of predilection in psoriasis?
- extensor surfaces over bony prominences
- scalp, retroauricular and ears
- palms and soles
- umbilicus, penis
- lumbar, shins
- nails
Psoriasis is a common _______ disease of the skin characterized by profound cutaneous inflammation and ______ hyperproliferation.
immunologic; epidermal
Severe psoriasis is associated with increased risk of ________ disease and shortened lifespan.
CV
__-__% of pt’s with psoriasis will have psoriatic arthritis
5-10
______ = ITCHY, red, scaly disorders
eczema
Eczema can be _____ (atopic dermatitis) or ______ (contact dermatitis)
endogenous; exogenous
________ ______ = intensely pruritic inflammatory skin disorder associated with atopy; asthma, hayfever, and allergic conjunctivitis
atopic dermatitis
______ is thickening of skin lines, common in atopic dermatitis
lichenification
Contact dermatitis can be split into what two types?
- Allergic
2. Irritant
Is seborrheic dermatitis more similar to eczema or psoriasis?
psoriasis!
Seborrheic dermatitis occurs in areas of higher _______ gland activity
sebaceous
Seborrheic dermatitis is probably due to an excessive immune reaction to a lipophilic yeast called ______ that normally occurs on the skin.
pityrosporum
Seborrheic dermatitis is seen frequently ______ disease and ____ infection.
parkinson’s; HIV
______ alone represents the most mild form of seborrheic dermatitis.
dandruff
Lupus erythematosus can be ______ or _____.
localized; systemic
Skin findings in ______: malar “butterfly rash”, localized erythema and edema, alopecia, photosensitivity, mucosal ulcers, Raynaud’s phenomeon
lupus
How is lupus diagnosed?
+ serum antinuclear antibodies
_______ = autoimmunity provokes a massive fibrotic tissue response
scleroderma
In scleroderma, cutaneous fibrosis can be localized or widespread, and may lead to ______ ______.
joint contractures
Raynaud’s phenomenon is common with scerloderma (T/F).
TRUE
What are 4 systemic manifestations of scleroderma ?
- HTN
- pulmonary fibrosis
- GI dysmotility
- renal
_______/______ = inflammatory myositis; leads to muscle weakness
dermatomyositis/polymyositis
______myositis = muscle involvement only; _____myositis = skin and muscles involve
poly; derma
If skin is involved in dermatomyositis, it will be _______ with an erythematous eruption over face (esp what 3 regions?)
purplish; upper eyelids, hands and forearms
What are 2 types of benign skin tumours?
- seborrheic keratosis (greasy, warty texture; usually raised and well marginated)
- melanocytic nevi (moles; benign moles are small and uniform)
Skin cancer has a __ in __ lifetime risk.
1 in 5
Skin cancer is easily treated if detected early (T/F).
TRUE
What are 3 types of skin cancer?
- Basal cell carcinoma
- Squamous cell carcinoma
- Malignant melanoma
What is the most common type of skin cancer?
BCC
_____ = translucent skin-coloured nodules
BCC
_____ may be eroded or ulcerated
BCC
BCC has a ___ risk of spreading to other organs, and can be locally invasive.
low
What are the 3 major types of BCC?
- nodular
- superfiical
- sclerosing
____ = solid skin tumours
SCC
____ = may often be volcano shaped
SCC
SCC has a thick overlying ____.
scale
Does BCC or SCC have a greater risk of spreading to other organs?
SCC
What is the precursor lesion to SCC?
actinic keratosis
What colour is actinic keratosis?
skin-coloured, pink or red
______ ______ = most dangerous form of skin cancer, highest potential for spreading to other organs
malignant melanoma
Prognosis of malignant melanoma depends on what?
Thickness in the skin
If melanoma cells are more than >___ thick then you have a poor prognosis.
1mm
If a growth is smaller than the size of a pencil eraser, then there is (smaller/greater) chance that is is melanoma.
smaller
What is the ABCDE rule for melanoma?
A = asymmetry B = border C = colour D = diameter E = evolving or eccentric
