Skin conditions Flashcards
Poor digital skin infarctions
Heliotrope rash
Rash on knuckles
Dermatomyositis
Is dermatomyositis indicative of an underlying cancer?
YES
What components are necessary for the skin exam?
Inspection and Palpation
Should patients be inspected from head to toe?
YES
Is adequate lighting necessary?
YES
Exam equipment?
Centimeter ruler, flashlight, Wood’s lamp, handheld magnifying lens
Inspection?
Lesion type, distribution, secondary characteristics, shape of individual lesions, arrangement of multiple lesions, color, consistency
Palpation?
Feel. Moisture, temperature, texture, turgor, mobility
Normal moisture
Minimal perspiration or oiliness present
Temperature
Check using dorsum of hands or fingers
Texture
Smooth, soft or even, verrucuous
Turgor
Depends on if patient is considerably dehydrated or if edema is present
Mobility
Skin should move easily when pinched and return to pace immediately when released
Macule
Freckle-like, flat, non-palpable
Papule
Elevated nevus, Palpable, circumscribed
Nodule
Wart, well-circumscribed
Vesicle
Blister, serous-filled
Pustule
Acne, vesicle with pus in it
Wheal
Mosquito bite, irregular borders
Primary lesions
How it came about
Secondary lesion
After scratching
Plaque
Psoriasis, large (>5 mm), formed by confluence of papules
Cysts
Ex: Sebaceous cyst. Enclosed cavity with lining containing liquid or semisolid material
Teleangiectasia
Dilated superficial vessel. Indicative of liver disease. Blanches when pressed on and fills back when pressure is released
Bullae
Ex: Pemphigus. Large
Secondary lesions
Excoriation Lichenification Edema Scale Crust
Excoriation
Superficial skin erosion casued by scratching
Lichenification
Increased skin markings and thickening secondary to chronic inflammation by scratching or other inflammation
Edema
Swelling due to accumulation of water
Scale
Superficial dead cells
Fissure
Deep split in skin extending into dermis
Erosion
Superficial focal loss of part of the epidermis
Ulceration
Focal loss of epidermis extending into the dermis
Atrophy
the elderly, decreased skin thickness due to skin thinning
Scar
Abnormal fibrous tissue replacing normal tissue after skin injury
Hypo-, hyper or de-pigmentation
Hypo- Patient’s skin is the base but has white spots
Hyper- Patient’s skin is the base but has darker spots. Ex: sun exposure
De- vitiligo. Common on extremities and around eyes
ABCDE of staging a nevus
A-ASSYMETRY. One 1/2 doesn’t match the other
B-BORDERS. Irreg, ragged, notched, blurred
C- COLOR. Heterogeneous
D-DIAMETER. Greater than 6 mm
E-EVOLUTION.
Why automatic referral by PCP to derm or surgery for possible melanoma?
Biopsying the specimen may help metastasis if melanoma
Basal cell carcinoma
Usually doesn’t metastasize
Hallmark: Pearly border with shallow “ulcer” at center
Squamous cell carcinoma
Typical in sun-exposed areas of skin, metastasize, bleed, irreg borders
Rx: excision
malignant melanoma
Lethal, common in NON sun-exposed areas, metastasizes early and widely, evolves over time
Kaposi sarcoma
Cancer of the epithelium due to HHV8
Assoc’d with HIV patients
Eczematous dermatitis
Irritant contact, allergic contact, atopic dermatitis
Rosacea
Chronic inflammatory skin disorder
Rx: sun protection, removal of casue
Follicultis
Inflammation of hair follicle, infected with bacteria, usually Staph
Rx: warm compresses
Cellulitis
Infection
Can be severe
Rx: Elevation, treat underlying condition and empiric antibx Rx
Psoriasis
Heriditary
Thick-red silvery plaques on extensor surfaces. Ex: Elbows and knees
Rx: PhotoRx
Acanthosis nigricans
Nonspecific rxn
Assoc’d with DM, insulin resistance and obesity. Also PCOS
Herpes Simplex type I
Lip
Type II
Shaft
Herpes Zoster
Grouped vesicles on erythematous base following a dermatome
Usually unilateral
Risk: Elderly, immunosuppressed
Alopecia areata
Sudden, rapid loss of hair usually from scalp or face
Cherry hemangiomas/angiomata
Mature capillary proliferation.
Does not blanch when pressed
Seborrheic keratoses
Waxy, benign, slowly-growing tumor
Chronic venous stasis
das
Plantar’s wart
Black dots seen around tissue
Rx: salcyclic acid or liquid nitrogen
Paronychia (Witlow)
Inflammation under the nail due to biting naills
Fro exam
- Melanoma send to derm
- Know bad things in ABCDE
- Pattern recognition and picture recognition
