Skin Exam

Question 1

Fitzpatrick’s “TAD” system

Answer 1

For describing skin lesions.

• Type
• Arrangement
• Distribution

Question 2

Telangiectasia

Answer 2

A linear, punctate or sometimes arborizing thin blood vessel

Question 3

Wheal

Answer 3

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.

Question 4

Comedo

Answer 4

A plugged, dilated pore, often called blackhead (“open” comedo) or whitehead (“closed” comedo).

Question 5

Cyst

Answer 5

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.

Question 6

Abscess

Answer 6

Localized collection of pus in a cavity formed by disintegration or necrosis of tissue.

Question 7

serpiginous

Answer 7

snake-like in shape

Question 8

Furfuraceous/Branny scale

Answer 8

Scales that are fine & loose

Question 9

Ichthyotic

Answer 9

Scales that are large & polygonal

Question 10

Silvery/Micaceous

Answer 10

Scales characteristic of parakeratosis, especially psoriasis

parakeratosis refers to nuclei retention in stratum corneum

Question 11

Greasy scales

Answer 11

Scales that are yellowish and moist

Question 12

Collarette scales

Answer 12

A fine peripherally-attached & centrally-detached scale at the edge of an inflammatory lesion

Question 13

Desquamation scale

Answer 13

Superficial shedding or peeling of the epidermis

Question 14

skin atrophy

Answer 14

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

Question 15

Skin burrow

Answer 15

A small tunnel in the skin that houses a parasite such as scabies mite.

Question 16

Skin Fissure

Answer 16

A crack in the epidermis

Question 17

Erosion

Answer 17

Superficial loss of epidermis; not associated with scarring; often accompanies vesicles, bullae or pustules.

Question 18

Ulcer

Answer 18

A deep erosion resulting from loss of epidermis and part of dermis; often heals with a scar

Question 19

Excoriation

Answer 19

A linear erosion caused by scratching; may be superficial or deep

Question 20

Fibrosis

Answer 20

Formation of excessive fibrous tissue

Question 21

Oozing

Answer 21

Accumulation of moist sebum, serum, cellular & bacterial debris over a damaged epidermis; often overlies erosion and is seen in vesicles, bullae, and pustules.

Question 22

Crust

Answer 22

Accumulation of dried sebum, serum, cellular & bacterial debris over a damaged epidermis; often overlies erosion and is seen in vesicles, bullae, and pustules

Question 23

Lichenification

Answer 23

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

Question 24

Types of scar

Answer 24

• hypertrophic: elevated with excess growth of fibrous tissue
• atrophic: thin & wrinkled
• cribriform: scar is perforated with multiple small pits

Question 25

Poikiloderma

Answer 25

The association of hyperpigmentation, hypopigmentation, atrophy, and telangiectasia all in one skin lesion. This finding can be seen, for example, in some cutaneous lymphomas

Question 26

Sinus

Answer 26

A tract leading from a suppurative cavity to the skin surface or between cystic or abscess cavities

Question 27

Koebnerization

Answer 27

Linear streak distribution due to physical contact or rub against a noxious source, like poison ivy

Question 28

Annular distribution

Answer 28

Extending from a central point. Often circular

Question 29

Photodistributed

Answer 29

affecting sites that routinely receive solar radiation

Question 30

Intertriginous

Answer 30

affecting warm, moist opposed sites

Question 31

Flexor distribution

Answer 31

affecting antecubital & popliteal fossae, skin folds

Question 32

Extensor distribution

Answer 32

affecting extensor aspects on limbs, including elbows and knees

Question 33

Wood’s Lamp

Answer 33

• Assess level of melanin (especially for diagnosing vitiligo)
• Check for certain skin infections which fluoresce under Wood’s Lamp
• Detect porphyrin within urine sample