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NUNP 547 - Older Adult > Skin - Final > Flashcards

Skin - Final Flashcards

1
Q

Red rash with central clearing that resembles a target, hot to touch and rough texture

A

Erythema migrans (early lyme disease)

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2
Q

Honey-colored crusts, fragie bullae, pruritic

A

Impetigo

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3
Q

Kopliks spots)( Small, white, round and red base spots on buccal mucosa by rear molars

A

Measles

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4
Q

Pruritic, especially at night, serpiginous rash on interdigital webs, waist, auxilla, penis

A

Scabies

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5
Q

Sandpaper rash with sore throat

A

Scarlet fever

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6
Q

Hypopigmented, round to oval macular rashes, commonly on shoulder and back. Non-pruritic

A

Tinea versicolor

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7
Q

Christmas tress pattern, with larger patch that appears initially

A

Pityriasis rosea

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8
Q

Smooth papules 1 mm size that are dome shaped with central umbilication with white “plug”

A

Molluscum contagiousum

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9
Q

Purple-colored to dark red painful skin lesions all over body, acute onset of high fever, headache, altered LOC

A

meningococcemia

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10
Q

Flat lesion, give examples for each
< 1cm
> 1 cm

A

< 1cm - macule, freckle

> 1 cm - patch, vitiligo

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11
Q

give examples for each
Raised superficial lesion
<1cm
>1cm

A

<1cm - papule/wart

>1cm - plaque/psoriasis

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12
Q

give examples for each
Deep palpable lesion (dermal or SC)
< 1cm
> 1cm

A

<1cm - nodule/dermatofibroma

>1cm - tumor/lipoma

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13
Q

give examples for each
Elevated fluid filled lesions
<1cm
>1cm

A

<1cm - vesicle/HSV

>1cm - bulla/bullous pemphigoid

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14
Q 
Name the following secondary lesions by description and give example:
Dried fluid (blood, purulent or serum) originating from lesion
A

Crust ie. impetigo

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15
Q

Name the following secondary lesions by description, give example:
Excess keratin

A

Scale ie. seborrheic dermatitis

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16
Q

Name the following secondary lesions by description, give example:
Thickening of skin and accentuation of normal skin markings

A

Lichenification, chronic atopic dermatitis

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17
Q

Name the following secondary lesions by description:

Linear slit-like cleavage of skin

A

Fissure

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18
Q

Name the following secondary lesions by description: scratch mark

A

Excoriation ie. scabies

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19
Q

Name the following secondary lesions by description:

Disruption of skin involving epidermis alone, heals without scarring

A

Erosion

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20
Q

Name the following secondary lesions by description:

Disruption of the skin that extends into dermis or deeper, may heal with scarring

A

Ulcer

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21
Q

Name the following secondary lesions by description, give example:
Pathologic dryness of skin, conjunctiva or mucous membranes

A

Xerosis

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22
Q

Name the following secondary lesions by description:

Histological decrease in size or # of cells or tissues, resulting in thinning or depression of the skin

A

Atrophy

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23
Q

An internally epithelial-lined structure containing semi-solid material or fluid

A

Cyst

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24
Q

Elevated lesion containing collection of neutrophils (infectious or inflammatory)

A

Pustule

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25
Q

Replacement fibrosis of dermis and SC tissue

A

Scar

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26
Q

form of papule or plaque that is transient < 24 hours and blanchable, often with a halo and central clearing

A

Urticaria

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27
Q

Superficial collection of sebum and keratin and most commonly seen in _____

A

Comodome, acne

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28
Q

Pinpoint extravasation of blood into dermis resulting in hemorrhagic lesions, non-blanchable < 3 mm in size

A

petechiae

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29
Q

Larger petechia > 3mm < 1cm

A

purpura

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30
Q

Larger than purpura > 1 cm

A

ecchymosis

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31
Q

Dilated superficial blood vessels, blanchable, reticulated and of small caliber

A

Telangiectasia

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32
Q

Koebner phenomenon, ex. what conditions

A

appearance of lesions at site of injury

ex. lichen planus, psoriasis, vitiligo

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33
Q

firm papule or nodule slightly pigmented with dimple sign/fitzpatricks sign

A

Dermatofibroma

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34
Q

Describe -

Management -

A

Describe - Waxy, stuck on appearance - seborrheic keratosis

Management - none required, cryotherapy for cosmetic purposes

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35
Q

Name this sign and what it is associated with:

explosive onset of multiple pruritic seborrheic keratoses, often with an inflammatory base < 3 month duration

A

Leser-Trelat sign, associated with malignancy (ie. gastric adenocarcinoma)

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36
Q

Where are SK not found

A

Palms or soles of feet

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37
Q

SK:
Patho -
Epi -

A

benign epithelial growth of keratinocytes and melanocytes

Unusual in < 30 years old, M>F

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38
Q

nevus that is pink in color. This lesion is symmetric with a regular outline and uniform pigmentation. Commonly seen on face and neck.

A

Intradermal nevus

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39
Q

Three stages of evolution of acquired nevomelanocytic nevi

A

junctional –> compound –> dermal

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40
Q

nevus with darker pigmentation in the center than at the periphery. This lesion is symmetric with a regular outline.

A

Flat junctional nevus

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41
Q

nevus with central elevation. This lesion is symmetric with a regular outline and uniform pigmentation. NOT found on palms or soles.

A

Compound nevus

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42
Q

outgrowth of normal skin. They appear as pedunculated lesions on narrow stalks. Skin tags occur in approximately 50 percent of adults; the risk increases with age

A

Acrochordon (skin tag)

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43
Q

firm, often hyperpigmented nodules 0.3 to 1 cm in diameter, but giant lesions larger than 3 cm in diameter have been described. They occur most often in adults and are most commonly located on the lower extremities. Lesions are usually asymptomatic but may be pruritic

A

Dermatofibroma

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44
Q

They can occur anywhere on the body and typically present as asymptomatic, skin-colored dermal nodules often with a clinically visible central punctum. The size ranges from a few millimeters to several centimeters in diameter.

A

epidermoid cyst

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45
Q

They typically present as asymptomatic, soft, skin-colored or hyperpigmented papules or nodules that are <2 cm in diameter. Applying direct pressure to some may make them seem to retract into the skin, a finding that has been described as the “button-hole” sign.

A

Cutaneous neurofibromas

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46
Q

dome shaped, typically 0.1 to 0.4 cm in diameter, and do not usually blanch with pressure

A

cherry angioma

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47
Q

small, well-circumscribed, brown macules on sun-exposed areas.

A

Solar lentigines

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48
Q

A compressible blue papule is present on the central lower lip.

A

Venous lake

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49
Q

diffuse thickening of the outermost layer of the skin, the stratum corneum, in response to repeated friction or pressure

A

Callus

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50
Q

A hyperkeratotic papule with a central “core”

A

Corn

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51
Q

How to differentiate corn/callus from wart?

A

After paring down, warts will have several dark specks that represent punctate capillary thromboses. Warts also disrupt normal skin markings so that the skin lines are no longer evident. Skin lines are MORE prominent in callosities.

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52
Q

Treatment of corns/callus

A

Salicylic acid plaster
Urea 40% cream
Paring down skin

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53
Q

Raised yellow colored soft plaques that are located under brown or upper/lower lids of eyes on nasal side. Can indicate what in people < 40 years?

A

Xanthelasma

Hyperlipidemia

54
Q

Pathognomic for familial hypercholesterolemia

A

Xanthomas located on fingers

55
Q

Generalized eruption of lesions that initially had a target-like appearance but then became confluent, brightly erythematous, and bullous affecting < 10 % of TBSA and mucosal involvement. Prodrome with fever/flu-like for 1-3 days before.

A

SJS

56
Q

Nikolsky sign

A

elicitation of skin blistering as a result of gentle mechanical pressure on the skin
Seen in SJS and TEN

57
Q

Timeline for Acute generalized exanthematous pustulosis (AGEP), Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), or Drug reaction with eosinophilia and systemic symptoms (DRESS), also termed drug-induced hypersensitivity syndrome (DIHS).

A

AGEP (<3 days)
SJS/TEN (4-10 days)
DRESS/DIHS (often 6 weeks).

58
Q

Common medications that cause this rash?

A

Allopurinol
Anticonvulsants - lamotrigine, carbemazepine, phenobarb
Sulfonamides - Trimethoprim/Sulfamethoxazole
“oxicam” NSAIDS - ie. meloxicam

59
Q

ABCDE for melanoma

A 
Asymmetry
Border irregular
Color variation
Diameter > 6 mm
Enlargement/evolution

OR ugly duckling

60
Q

What is the most common type of skin cancer?

A

BCC

61
Q

Painless pundunculated outgrowths that commonly occur in DM and obese patients

A

Acrochordon

62
Q

Diffuse velvety thickening of skin located behind neck and on auxilla. Associated with DM, metabolic syndrome, obesity and cancer of the GI tract.

A

Acanthosis Nigricans

63
Q

HPA axis suppression may occur with excessive or prolonged use of topical steroids > ______

A

> 2 weeks

64
Q

SE of high potency or long term use of topical steroids

A

Striae, skin atrophy, telangiectasia, acne, hypo-pigmentation

65
Q

Red rash with central clearing that resembles a target, hot to touch and rough texture

A

Erythema migrans (early lyme disease)

66
Q

Honey-colored crusts, fragie bullae, pruritic

A

Impetigo

67
Q

Kopliks spots)( Small, white, round and red base spots on buccal mucosa by rear molars

A

Measles

68
Q

Pruritic, especially at night, serpiginous rash on interdigital webs, waist, auxilla, penis

A

Scabies

69
Q

Sandpaper rash with sore throat

A

Scarlet fever

70
Q

Hypopigmented, round to oval macular rashes, commonly on shoulder and back. Non-pruritic

A

Tinea versicolor

71
Q

Christmas tress pattern, with larger patch that appears initially

A

Pityriasis rosea

72
Q

Smooth papules 1 mm size that are dome shaped with central umbilication with white “plug”

A

Molluscum contagiousum

73
Q

Purple-colored to dark red painful skin lesions all over body, acute onset of high fever, headache, altered LOC

A

meningococcemia

74
Q

Flat lesion, give examples for each
< 1cm
> 1 cm

A

< 1cm - macule, freckle

> 1 cm - patch, vitiligo

75
Q

give examples for each
Raised superficial lesion
<1cm
>1cm

A

<1cm - papule/wart

>1cm - plaque/psoriasis

76
Q

give examples for each
Deep palpable lesion (dermal or SC)
< 1cm
> 1cm

A

<1cm - nodule/dermatofibroma

>1cm - tumor/lipoma

77
Q

give examples for each
Elevated fluid filled lesions
<1cm
>1cm

A

<1cm - vesicle/HSV

>1cm - bulla/bullous pemphigoid

78
Q 
Name the following secondary lesions by description and give example:
Dried fluid (blood, purulent or serum) originating from lesion
A

Crust ie. impetigo

79
Q

Name the following secondary lesions by description, give example:
Excess keratin

A

Scale ie. seborrheic dermatitis

80
Q

Name the following secondary lesions by description, give example:
Thickening of skin and accentuation of normal skin markings

A

Lichenification, chronic atopic dermatitis

81
Q

Name the following secondary lesions by description:

Linear slit-like cleavage of skin

A

Fissure

82
Q

Name the following secondary lesions by description: scratch mark

A

Excoriation ie. scabies

83
Q

Name the following secondary lesions by description:

Disruption of skin involving epidermis alone, heals without scarring

A

Erosion

84
Q

Name the following secondary lesions by description:

Disruption of the skin that extends into dermis or deeper, may heal with scarring

A

Ulcer

85
Q

Name the following secondary lesions by description, give example:
Pathologic dryness of skin, conjunctiva or mucous membranes

A

Xerosis

86
Q

Name the following secondary lesions by description:

Histological decrease in size or # of cells or tissues, resulting in thinning or depression of the skin

A

Atrophy

87
Q

An internally epithelial-lined structure containing semi-solid material or fluid

A

Cyst

88
Q

Elevated lesion containing collection of neutrophils (infectious or inflammatory)

A

Pustule

89
Q

Replacement fibrosis of dermis and SC tissue

A

Scar

90
Q

form of papule or plaque that is transient < 24 hours and blanchable, often with a halo and central clearing

A

Urticaria

91
Q

Superficial collection of sebum and keratin and most commonly seen in _____

A

Comodome, acne

92
Q

Pinpoint extravasation of blood into dermis resulting in hemorrhagic lesions, non-blanchable < 3 mm in size

A

petechiae

93
Q

Larger petechia > 3mm < 1cm

A

purpura

94
Q

Larger than purpura > 1 cm

A

ecchymosis

95
Q

Dilated superficial blood vessels, blanchable, reticulated and of small caliber

A

Telangiectasia

96
Q

Koebner phenomenon, ex. what conditions

A

appearance of lesions at site of injury

ex. lichen planus, psoriasis, vitiligo

97
Q

firm papule or nodule slightly pigmented with dimple sign/fitzpatricks sign

A

Dermatofibroma

98
Q

Describe -

Management -

A

Describe - Waxy, stuck on appearance - seborrheic keratosis

Management - none required, cryotherapy for cosmetic purposes

99
Q

Name this sign and what it is associated with:

explosive onset of multiple pruritic seborrheic keratoses, often with an inflammatory base < 3 month duration

A

Leser-Trelat sign, associated with malignancy (ie. gastric adenocarcinoma)

100
Q

Where are SK not found

A

Palms or soles of feet

101
Q

SK:
Patho -
Epi -

A

benign epithelial growth of keratinocytes and melanocytes

Unusual in < 30 years old, M>F

102
Q

nevus that is pink in color. This lesion is symmetric with a regular outline and uniform pigmentation. Commonly seen on face and neck.

A

Intradermal nevus

103
Q

Three stages of evolution of acquired nevomelanocytic nevi

A

junctional –> compound –> dermal

104
Q

nevus with darker pigmentation in the center than at the periphery. This lesion is symmetric with a regular outline.

A

Flat junctional nevus

105
Q

nevus with central elevation. This lesion is symmetric with a regular outline and uniform pigmentation. NOT found on palms or soles.

A

Compound nevus

106
Q

outgrowth of normal skin. They appear as pedunculated lesions on narrow stalks. Skin tags occur in approximately 50 percent of adults; the risk increases with age

A

Acrochordon (skin tag)

107
Q

firm, often hyperpigmented nodules 0.3 to 1 cm in diameter, but giant lesions larger than 3 cm in diameter have been described. They occur most often in adults and are most commonly located on the lower extremities. Lesions are usually asymptomatic but may be pruritic

A

Dermatofibroma

108
Q

They can occur anywhere on the body and typically present as asymptomatic, skin-colored dermal nodules often with a clinically visible central punctum. The size ranges from a few millimeters to several centimeters in diameter.

A

epidermoid cyst

109
Q

They typically present as asymptomatic, soft, skin-colored or hyperpigmented papules or nodules that are <2 cm in diameter. Applying direct pressure to some may make them seem to retract into the skin, a finding that has been described as the “button-hole” sign.

A

Cutaneous neurofibromas

110
Q

dome shaped, typically 0.1 to 0.4 cm in diameter, and do not usually blanch with pressure

A

cherry angioma

111
Q

small, well-circumscribed, brown macules on sun-exposed areas.

A

Solar lentigines

112
Q

A compressible blue papule is present on the central lower lip.

A

Venous lake

113
Q

diffuse thickening of the outermost layer of the skin, the stratum corneum, in response to repeated friction or pressure

A

Callus

114
Q

A hyperkeratotic papule with a central “core”

A

Corn

115
Q

How to differentiate corn/callus from wart?

A

After paring down, warts will have several dark specks that represent punctate capillary thromboses. Warts also disrupt normal skin markings so that the skin lines are no longer evident. Skin lines are MORE prominent in callosities.

116
Q

Treatment of corns/callus

A

Salicylic acid plaster
Urea 40% cream
Paring down skin

117
Q

Raised yellow colored soft plaques that are located under brown or upper/lower lids of eyes on nasal side. Can indicate what in people < 40 years?

A

Xanthelasma

Hyperlipidemia

118
Q

Pathognomic for familial hypercholesterolemia

A

Xanthomas located on fingers

119
Q

Generalized eruption of lesions that initially had a target-like appearance but then became confluent, brightly erythematous, and bullous affecting < 10 % of TBSA and mucosal involvement. Prodrome with fever/flu-like for 1-3 days before.

A

SJS

120
Q

Nikolsky sign

A

elicitation of skin blistering as a result of gentle mechanical pressure on the skin
Seen in SJS and TEN

121
Q

Timeline for Acute generalized exanthematous pustulosis (AGEP), Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), or Drug reaction with eosinophilia and systemic symptoms (DRESS), also termed drug-induced hypersensitivity syndrome (DIHS).

A

AGEP (<3 days)
SJS/TEN (4-10 days)
DRESS/DIHS (often 6 weeks).

122
Q

Common medications that cause this rash?

A

Allopurinol
Anticonvulsants - lamotrigine, carbemazepine, phenobarb
Sulfonamides - Trimethoprim/Sulfamethoxazole
“oxicam” NSAIDS - ie. meloxicam

123
Q

ABCDE for melanoma

A 
Asymmetry
Border irregular
Color variation
Diameter > 6 mm
Enlargement/evolution

OR ugly duckling

124
Q

What is the most common type of skin cancer?

A

BCC

125
Q

Painless pundunculated outgrowths that commonly occur in DM and obese patients

A

Acrochordon

126
Q

Diffuse velvety thickening of skin located behind neck and on auxilla. Associated with DM, metabolic syndrome, obesity and cancer of the GI tract.

A

Acanthosis Nigricans

127
Q

HPA axis suppression may occur with excessive or prolonged use of topical steroids > ______

A

> 2 weeks

128
Q

SE of high potency or long term use of topical steroids

A

Striae, skin atrophy, telangiectasia, acne, hypo-pigmentation

129
Q

A 66-year-old man reports a nodule that has markedly changed in size. It grew rapidly by over two weeks until it was a large dome, and now is beginning to involute. Which one of the following is the MOST likely diagnosis?

Prurigo Nodularis

Malignant Melanoma

Squamous Cell Carcinoma

Keratoacanthoma

A

Keratoacanthoma grow rapidly. They have a bud or dome shape with a slightly reddish colour. It occurs most often on sun-exposed hair-bearing skin in persons ≥60 years of age. The morphology & growth patterns of keratoacanthomas are usually diagnostic. Biopsy & treatment are recommended, however, because clinically and histologically these lesions resemble a carcinoma.

130
Q

T/F?

People with GCA are at increased risk for AA, MI, stroke, PVD

A

True

NUNP 547 - Older Adult (19 decks)

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