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DERM > SKIN EXAM & DERM THERAPY PDF > Flashcards

SKIN EXAM & DERM THERAPY PDF Flashcards

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Dermatology Board Prep flashcards
1
Q

when describing skin lesions = what to include

A
  • carefully describe ALL skin lesions
  • indicate the distribution of the lesions (where are they on the body?)
  • indicate the configuration of the lesions (shape & grouping)
  • indicate the color of lesions
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2
Q

lesions that represent the early stage of the lesion, how they look when they start, prior to evolving

A

PRIMARY LESIONS

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3
Q

lesions that represent a later stage; after the lesion has evolved or been altered

A

SECONDARY LESIONS

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4
Q

Identifying the lesion as primary or secondary may help you determine

A

where in the skin the process is occurring (epidermis, dermis, fat)

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5
Q

types of primary lesions

A 
Macule
Patch
Papule
Nodule
Plaque
Wheal
Cyst
Vesicle
Bullae
Pustule
Telangiectasia
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6
Q

types of secondary lesions

A 
Crust
Scale
Induration
Erosion
Ulcer / ulceration
Atrophy
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7
Q

flat, non-palpable lesion < 1cm

A

MACULE

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8
Q

flat, non-palpable circumscribed lesion > 1cm

A

PATCH

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9
Q

Vitiligo is what type of primary lesion

A

PATCH

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10
Q

Macules & Patches = only represent a change in

Red means
White means
Brown means

A

color

the color helps to locate the pathology
⦁ Red = from blood vessels in the dermis
⦁ White = from loss of melanin in the epidermis
⦁ Brown = from melanin in the epidermis or dermis

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11
Q

Palpable, elevated solid mass
Up to 1cm (< 0.5 cm)
Example: elevated nevus

A

PAPULE

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12
Q

palpable elevated solid mass > 0.5 cm

A

NODULE

Palpable
Elevated solid mass
0.5 cm to 1-2cm
Often deeper and firmer than a papule

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13
Q

Large nodules, >2cm are often referred to as

A

tumors

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14
Q

plateau like lesion > 0.5 cm

A

plaque

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15
Q

Palpable
Flat, elevated surface
Larger than 1 cm
Often formed by the coalescence of papules

A

plaque

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16
Q

Special plaque composed only of fluid (a hive)

A

wheal

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17
Q

primary lesion that is somewhat irregular
Relatively transient
Superficial area of localized skin edema

Example: mosquito bite, hives

A

wheal

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18
Q

Papule or nodule filled fluid or semisolid material

A

cyst

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19
Q

fluid filled blister (< 0.5cm)

A

vesicle

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20
Q

fluid filled blister (> 0.5cm)

A

bullae

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21
Q

Cloudy fluid filled lesion containing Cloudy fluid filled lesion containing many inflammatory cells (pus)

A

pustule

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22
Q

Dilated superficial vessels (not Dilated superficial vessels (not “broken blood vessels”)

A

telangiectasia

23
Q

dried fluid & keratinocytes arising from broken vesicles & bullae

A

crust

24
Q

thickened stratum corneum (scale occurs in the epidermis)

A

scale

25
Q

scale occurs in the

A

epidermis

26
Q

increased firmness & thickening of the dermis

A

induration

27
Q

loss of epidermis

A

erosion

28
Q

loss of epidermis & some or all of dermis and sometimes subcutaneous tissue

A

ulcer

29
Q

loss of dermis or fat (sunken in) or thinning of the epidermis (skin becomes finely wrinkled and translucent)

A

atrophy

30
Q

shapes & configurations of lesions

A
  • annular
  • grouped
  • linear
  • dermatomal
31
Q

making a circle, round or oval, clear in the center

A

annular

32
Q

lesions Going along the nerves

A

dermatomal

33
Q

efficacy of dermatologic topical therapy is related to

A
  1. the concentration of the medication
  2. the vehicle (mode in which med is in = ointment / cream / lotion / etc)
  3. the active ingredient (correlates with strength)
  4. anatomic location
34
Q

most effective vehicle for penetrating the skin

A

ointment = greasy & moisturizing, but messy

ex: vaseline

35
Q

vanish when rubbed in; are less greasy, can sting, and are more likely to cause an allergy (due to preservatives / fragrances)

A

CREAMS

36
Q

liquid & has a cooling effect

good for use in hairy areas

A

lotion

37
Q

liquids that are greasy or alcoholic; can sting, good for hairy areas

A

SOLUTIONS

38
Q

semi solid alcohol-based; can sting; good for hairy areas or wet lesions

A

GELS

39
Q

cosmetically elegant; good for hairy areas

A

FOAM

40
Q

how many grams of topical medication covers the whole body

A

30g

41
Q

each whole leg is ____% of body surface area (BSA)

A

18%

42
Q

formula for calculating how many grams needed per application

A

grams for whole body x % of BSA needing medication

ex: for 1 whole leg = 30g x 18% = 30 x 0.18 = 5.4g per application

ex: ex: rash on left calf; must apply topical BID. How much does she need for 1 month?
30g x about 4% = 30 x 0.04 = 1.2 x 2 (BID) = 2.4 x 30 = 72g = give 80g…

43
Q

the sole of the foot = _____% of BSA

A

1%

44
Q

BSA OF THE BODY

A
  • head = 9% (anterior = 4.5, posterior = 4.5)
  • front torso = 18%
  • back = 18%
  • each arm = 9% (anterior arm = 4.5%, posterior arm = 4.5%)
  • each leg = 18% (anterior = 9%, posterior = 9%)
  • genitalia = 1%
45
Q

ex: How much would you prescribe for 1 month if someone needed to medicate both soles of their feet qd?

A
  • if each sole = 1%, then both soles = 2%

- 30g x 0.02 x 30 days = 18g (0.5 oz)

46
Q

steroid potency is inherent to the _________, not the concentration

A

class / molecule

47
Q

STEROIDS

super high potency
high potency
medium potency
mid-low potency
low potency
A

⦁ Super High Potency = Clobetasol (Temovate)
⦁ High Potency = Fluocinonide (Lidex)
⦁ Medium Potency = TAC
⦁ Mid - Low Potency = Aclometasone (Aclovate), Desonide
⦁ Lowest potency = Hydrocortisone

48
Q

applying corticosteroids

A
  • can be applied in general areas or as spot treatment
  • SOAK & SMEAR = patient soaks in tub x 15 minutes to open pores, then smear topical steroid on the skin
    ⦁ sometimes occlusion with saran wrap or vinyl suit over the area is done to increase penetration of steroid into skin
  • Typically mid-low / lowest potency steroids (aclometasone / desonide / hydrocortisone) are used on the face, and stronger steroids are used on the body. Using stronger steroids on the face may cause atrophy (thins the skin)
49
Q

SE of topical steroids

A

⦁ Acne (perioral dermatitis / rosacea) can result when a higher potency steroid is used on the face
⦁ Atrophy & Striae (stretch marks) can result when steroid used in groin or armpits
⦁ Petechiae & Telangiectasias are possible from skin atrophy
⦁ Increased fungal infections (ex: steroids suppress the immune response from killing the fungus on its own)

50
Q

fungistatic vs fungicidal

A 
fungistatic = stop fungus from growing
fungicidal = kill the fungus
51
Q

topical antifungals

A
  • Fungistatic = stop fungi from growing
  • Fungicidal = kill the fungi
  • not all conditions are treatable with topical antifungals (ex: hair & nail infections do NOT respond to topical treatment and require systemic treatment)
52
Q

imidazoles are ____________

examples of imidazole drugs

A

o IMIDAZOLES = fungistatic

⦁	Ketoconazole
⦁	Clotrimazole (OTC) = Lotrimin
⦁	Econazole
⦁	Oxiconazole
⦁	Sulconazole
⦁	Miconazole (OTC)
53
Q

allylamines are ____________

examples of allylamine drugs

A

o ALLYLAMINES (fungicidal)

⦁ Terbinafine (Lamisil)
⦁ Naftifine (Naftin)
⦁ Butenifine
⦁ Ciclopirox = may have both fungistatic & fungicidal properties)

DERM (12 decks)

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