Skin Exam Flashcards
Fitzpatrick’s “TAD” system
For describing skin lesions.
- Type
- Arrangement
- Distribution
Telangiectasia
A linear, punctate or sometimes arborizing thin blood vessel
Wheal
Transient, pink elevation of the skin; caused by edema in the dermis or occasionally in the dermis and fat. Often surrounded by a red flare. The skin surface reflects the presence of edema fluid by showing pores that look stretched like the surface of an orange, hence the term peau d’orange to describe these wheals.
Comedo
A plugged, dilated pore, often called blackhead (“open” comedo) or whitehead (“closed” comedo).
Cyst
Semisolid or fluid-filled mass surrounded by a capsule; usually located deeply. In same cases, this lesion is like a water-filled balloon beneath the skin.
Abscess
Localized collection of pus in a cavity formed by disintegration or necrosis of tissue.
serpiginous
snake-like in shape
Furfuraceous/Branny scale
Scales that are fine & loose
Ichthyotic
Scales that are large & polygonal
Silvery/Micaceous
Scales characteristic of parakeratosis, especially psoriasis
parakeratosis refers to nuclei retention in stratum corneum
Greasy scales
Scales that are yellowish and moist
Collarette scales
A fine peripherally-attached & centrally-detached scale at the edge of an inflammatory lesion
Desquamation scale
Superficial shedding or peeling of the epidermis
skin atrophy
Thinning of the skin; appreciated best by palpation. Characterized by loss of normal skin markings. May affect epidermis, dermis OR subcutaneous fat. May be fine wrinkles & increased translucency unless sclerosis is associated
Skin burrow
A small tunnel in the skin that houses a parasite such as scabies mite.
Skin Fissure
A crack in the epidermis
Erosion
Superficial loss of epidermis; not associated with scarring; often accompanies vesicles, bullae or pustules.
Ulcer
A deep erosion resulting from loss of epidermis and part of dermis; often heals with a scar
Excoriation
A linear erosion caused by scratching; may be superficial or deep
Fibrosis
Formation of excessive fibrous tissue
Oozing
Accumulation of moist sebum, serum, cellular & bacterial debris over a damaged epidermis; often overlies erosion and is seen in vesicles, bullae, and pustules.
Crust
Accumulation of dried sebum, serum, cellular & bacterial debris over a damaged epidermis; often overlies erosion and is seen in vesicles, bullae, and pustules
Lichenification
Thickened skin with accentuated surface markings caused by chronic rubbing, and scratching. This term derives from the fact that a lichenified surface can resemble the bark of a tree
Types of scar
- hypertrophic: elevated with excess growth of fibrous tissue
- atrophic: thin & wrinkled
- cribriform: scar is perforated with multiple small pits
Poikiloderma
The association of hyperpigmentation, hypopigmentation, atrophy, and telangiectasia all in one skin lesion. This finding can be seen, for example, in some cutaneous lymphomas
Sinus
A tract leading from a suppurative cavity to the skin surface or between cystic or abscess cavities
Koebnerization
Linear streak distribution due to physical contact or rub against a noxious source, like poison ivy
Annular distribution
Extending from a central point. Often circular
Photodistributed
affecting sites that routinely receive solar radiation
Intertriginous
affecting warm, moist opposed sites
Flexor distribution
affecting antecubital & popliteal fossae, skin folds
Extensor distribution
affecting extensor aspects on limbs, including elbows and knees
Wood’s Lamp
- Assess level of melanin (especially for diagnosing vitiligo)
- Check for certain skin infections which fluoresce under Wood’s Lamp
- Detect porphyrin within urine sample
