Skin Lesions High Yield Handout & Application Flashcards
A primary skin lesion is categorized as FLAT (cannot palpate with the eyes closed) or RAISED (can palpate with the eyes closed).
2 types of flat primary lesions include:
_______ = lesion is flat and <1 cm
_______ = lesion is flat and >1 cm
Macule
Patch
______ = lesion is raised, <1cm, and not fluid filled
Papule
_______ = lesion is raised, >1cm, but not fluid filled
Plaque
______ = lesion is raised, <1cm, and fluid filled
Vesicle
______ = lesion is raised, >1cm, and fluid filled
Bulla
8 characteristics you should state when describing a skin lesion
Primary lesion (flat or raised)
Number
Size
Shape
Color
Texture
Location
Configuration
Fibroepithelial polyps; benign cutaneous growths. Commonly found in areas of frequent friction. Small, skin-colored or brown, soft papules
Acrochordons (skin tags)
Chronic, relapsing pruritic conditions often associated with allergic rhinitis and/or asthma. More common in children. Usually involves the flexural aspects of the extremities, but can be widespread. Intense pruritis is a hallmark. Scratching leads to lichenification. Secondary infections are common
Atopic dermatitis (eczema)
Type IV allergic reaction after exposure to an offending agent. In the case of Rhus dermatitis (poison ivy) the oil may cause linear vesicles or bulla on an erythematous base accompanied by intense itching
Allergic contact dermatitis
Wheals are areas of localized dermal edema that evanesces (comes and goes) within a period of 1-2 days. They appear as well circumscribed, erythematous, edematous papules or plaques, often with a pale center. Lesions vary from a few mm to over 30 cm. Can be associated with allergic response, but also numerous disease processes
Urticaria (hives)
Ill-defined, erythematous, tender nodules and plaques, usually 2-5 cm in diameter, bright red, slightly elevated. Most commonly pretibial. Associated with sarcoidosis, Crohns, Sjogrens, reactive arthritis, associated with numerous infections like Streptococcus, Shigella, Yersinia, Histoplasma, Coccidioides, HIV, Giardia, and TB, rarely associated with malignancy such as lymphoma
Erythema nodosum
Inflammation of the superficial hair follicles resulting in papules and pustules. May be sterile as a result of chronic irritation such as shaving. Commonly associated with skin flora, but can be fungal. Contaminated water may lead to infection by P.aeruginosa
Folliculitis
Inflammation of adipose below skin secondary to chronic venous insufficiency. Generally appears on LE. Initially is tender with erythema and hyperpigmentation. Progresses to sclerosis and hyperpigmentation
Lipodermatosclerosis
Scaly pink or flesh-colored ‘herald lesion’ followed by eruption of discrete oval, erythematous and scaly plaques and patches oriented along skin cleavage lines, commonly on the trunk. Spares the face, palms, and soles
Pityriasis Rosea
Acquired leukoderma characterized by well-circumscribed chalk-white depigmented macules or patches. Hypothesized to either by autoimmune or an intrinsic melanocyte defect
Vitiligo
Primary disease is more severe than recurrent episodes. Typically presents with pain described as burning and tingling with a viral syndrome (fever, malaise, etc). 2-4mm vesicles appear at inoculation site, coalesce and rupture leaving erosions or ulcerations. LAD is more common with primary eruption
HSV 1 and 2
1-3 day prodrome of burning pain or paresthesia in the affected dermatome, followed by eruption of erythematous papules and vesicles in the same distribution. Appears as grouped or confluent vesicles on erythematous base, confined to a distinct dermatome and not crossing the midline. Vesicles become umbilicated, pustular, or hemorrhagic. Typically crust over and resolve w/i 7-14 days
Herpes Zoster (shingles)
Highly contagious superficial skin infection caused by Staphylococcus aureus. However, Streptococcus pyogenes can also be a cause in developing countries. Presents as erythematous vesicles and/or pustules that quickly transition to superficial erosions with a characteristic ‘honey-colored’ crust. Face is most common area affected
Impetigo
When doing a skin exam, why is ‘blanching’ an important finding?
A. It’s part of the circulation assessment
B. It indicates that there is inflammation
C. It indicates a bacterial infection
D. Blanching lesions are more chronic
B. It indicates that there is inflammation
