Skin Lesions High Yield Handout & Application

Question 1

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

Answer 1

Macule

Patch

Question 2

______ = lesion is raised, <1cm, and not fluid filled

Answer 2

Papule

Question 3

_______ = lesion is raised, >1cm, but not fluid filled

Answer 3

Plaque

Question 4

______ = lesion is raised, <1cm, and fluid filled

Answer 4

Vesicle

Question 5

______ = lesion is raised, >1cm, and fluid filled

Answer 5

Bulla

Question 6

8 characteristics you should state when describing a skin lesion

Answer 6

Primary lesion (flat or raised)

Number

Size

Shape

Color

Texture

Location

Configuration

Question 7

Fibroepithelial polyps; benign cutaneous growths. Commonly found in areas of frequent friction. Small, skin-colored or brown, soft papules

Answer 7

Acrochordons (skin tags)

Question 8

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

Answer 8

Atopic dermatitis (eczema)

Question 9

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

Answer 9

Allergic contact dermatitis

Question 10

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

Answer 10

Urticaria (hives)

Question 11

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

Answer 11

Erythema nodosum

Question 12

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

Answer 12

Folliculitis

Question 13

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

Answer 13

Lipodermatosclerosis

Question 14

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

Answer 14

Pityriasis Rosea

Question 15

Acquired leukoderma characterized by well-circumscribed chalk-white depigmented macules or patches. Hypothesized to either by autoimmune or an intrinsic melanocyte defect

Answer 15

Vitiligo

Question 16

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

Answer 16

HSV 1 and 2

Question 17

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

Answer 17

Herpes Zoster (shingles)

Question 18

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

Answer 18

Impetigo

Question 19

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

Answer 19

B. It indicates that there is inflammation