Skin Flashcards
Macule vs patch?
Both flat lesions
Macule < 2 cm
Patch > 2 cm
Papule vs nodule vs Tumor?
Slightly elevated… (vs flat)
Papule (small skin induration) < 1 cm
Nodule 1-5 cm
Tumor > 5cm (e.g., SCC)
Vesicle vs bullae vs pustule
Fluid filled
Vesicle < 1 cm
Bullae > 1cm (think burns)
Pustule = vesicle filled w/ pus
Ulcer vs crust vs excoriation?
Ulcer = epidermal defect (e.g., syphilitic chancre)
Crust = skin defect covered w/ dried blood/plasma (healing wounds)
Excoriation = superficial skin defect from scratching
Fissure vs wheal vs scales?
Fissure - sharp edged defect into deeper layers (e.g., athelte’s foot)
Wheal = elevated itchy, transient lesion w/ erythema (insect bite)
Scales = skin flakes easily removed by scraping (e.g, seborrheic dermatitis)
Most common congenital skin anomaly
normal skin elements arranged abnormally
Nevus
- Melanotic nevus?
- Nevus flammeus
- Cherry/strawberry hemangiomas
- common birthmark
- “Port wine stain” = clustered capillaries
- vascular malformations of ENTIRE capillary; intense red color
Generalized hypopigmentation, lacking enzymes for melanin synthesis
White hair, red eyes
(should avoid sun, incrased risk for skin cancer)`
Albinism
Skin covered in large thick scales
Higher risk for infxn (treat w/ exfoliants/moisturizers)
autosomal dominant trait
Ichthyosis (fish skin)
jagged tear throgh skin into deeper tissue
rapid stretching of skin/impact
laceration
Epidermis only
MIld erythema/some edema
Heals quickly (1 week)
1st degree
Dermis is mostly spared
Bulla/blisters
Slower healing/new skin is thinner
2nd degree (partial thickness)
Epidermis/dermis completely burnt
Muscle deeper tissues often involved
Heals slowly w/ SIGNIFICANT SCARRING
May require grafting/special care
3rd degree
full thickness
Prolonged exposure to NONfreezing cold/wet environment
trench foot
Subfreezing temps
Upon rewarming, blotchy red, swollen, painful
frostbite
Damage involves deep tissue/internal organs
deep thrombi, compartment syndorme, arrhythmias, rhabo
Burns at entry and exit
electrical injuries
Sunlight (most common)
Ionizing (med procedures/occupational)
radiation injury
- HSV
- Shingles
- HPV
- cold sores
- Herp Zoster re-eruption of chickenpox
- verruca vulgaris (common wart)
post viral rashes?
exanthems
Occur on apparently normal skin
Typically caused by pus-forming “pyogenic” bacteria (staph a, strep pyogenes)
Primary bacterial skin infxn
Complicate and impede healing of existing skin wounds (eczema)
may be nosocomial infxn w/ abx resistant bacteria
Secondary skin infxn
Honey crusted lesions most often on face of children
Highly contagious but responds well to abx
Impetigo
staph, strep
Infxn limited to hair follicles (typically staph)
furuncle vs carbuncle?
Folliculitis
Furuncle = boil, single hair, POINTED appearance
Carbuncle = enlarged furuncle; multiple hair shafts
Thrush in children?
Secondary agent from intertrigo (dermatitis occuring at skin folds, esp obese people)
Candida albicans
Live in dead skin
Little inflammation but itching and scratching (could lead to secondary infxn)
Classic ringworm
Tinea (dermatophyte)
Redness, flaking, scaling, itching of skin (chronic)
Tx - steroids/sulfur-based shampoos
Seborrheic dermatitis
Elevated patches/plaques covered by silvery scales
Mostly on EXTENSOR surfaces (ELBOWS, KNEES) and scalp/nails
Psoriasis
t-lymphocyte mediated autoimmune d/o involving keratinocytes
Warning signs of skin cancer?
Pesistent non healing ulcer
Friable (bleeds easily)
Irregular shape/unclear margins
Surrounded by atrophic/keratotic skin
A B C D E
asymmetry borders (irregular/notching = bad) color (variations = bad) diameter (>6 cm = bad) evolving (lesion changing = bad)
Common benign epidermal tumor
Brownish, flat, wart w/ stuck-on appearance
Tx = cryotherapy
Seborrheic keratosis (epithelial tumor)
Seb Ks
Pre cancerous lesions (may precede SCC)
arise from sun exposure
Atrophic, redden macules, w/ rough keratotic/scaly surface
actinic keratosis
AKs
Tx = cryotherapy or Antineoplastic solution for desquamation
Malignant
Elevated nodule often w/ central depression
“rolled up” w/ pearl-like color
Rarely metastasizes
BCC
tx = excision/cautery/curettage
Invasive malignant tumor
Varible forms.. small flat plaque or persistent ulcer or slightly elevated papule
OFTEN W/ RECURRENT BLEEDING/CRUSTING
SCC
tx = full depth excision
BCC, SCC can appear similar so when in doubt cut it out
Macule/patch of melanocytes
Hyperreactive to UV light
freckle (benign)
Sharoly demarcated macule, unresponsive to UV light
Lentigo (benign)
overabundance of melanocytes
melanotic nevus (benign)
flat macule originating from freckle/nevus
Localized for 10-15 years then invasive
Lentigo maligna (type of malignant melanoma)
Most common melanoma
Maculae w/ irregular shape/border
typically on legs of women, backs of men
Superficial spreading melanoma (type of malignant melanoma)
Rapidly grwoing/infiltrating variant that has poor prognisis once invasiion into subQ
Nodular melanoma
