The Limster 1-2 Flashcards
When you see vesicles or bullae in a linear pattern what should you be thinking?
contact dermatitis
What is a dermal vesicle?
Okay, brace yourselves. It is a vesicle (i.e. free collection of fluid less than 0.5 cm in diameter) in? …THE DERMIS.
What is it called when macules coalesce? What about when papules coalesce?
macules = patch, papules = plaque
What is a cyst?
A circumscribed lesion with a wall and a lumen that may contain fluid or solid matter
What should you think if you see a burrow in the skin?
Scabies
What is a very common cause of cutaneous atrophy?
overuse of topical steroids or injection of SubQ steroid when it was supposed to be IM
What is a fissure?
a linear loss of epidermis AND dermis with sharply defined, near vertical walls
Damage to what layer is implied by the presence of a scar?
Dermis (at least) because the basal layer of epidermis is lost
This is a circumscribed deposit of blood less than 0.5 cm in diameter
petechiae
What is the most common cause of erythema multiforme?
HSV-1 also Mycoplasma pneumoniae
What is an erosion that is specifically caused by scratching?
Excoriation
What are scales?
Excess dead epidermal cells produced by abnromal keratinization and shedding
Telangiectasias are very characteristic of what CA?
Basal cell carcinoma
If you see lichenification, was the initial lesion most likely painful, itchy, or not noticed by the patient?
itchy, lichenification results from repeated scratching of the skin
Give an example of a chemical that can cause vitiligo
phenols
What is the difference between a keloid and a hypertrophic scar?
A keloid is a tumor of scar tissue that grows beyond the bounds of the initial lesion whereas a hypertrophic scar is just an excessively thickened scar
What are the two biochromes of the dermis?
Oxyhemoglobin (bright red), Reduced hemoglobin (bluish red)
Where does a pilar cyst come from? Where does an epidermal cyst come from?
Pilar cyst is from hair shaft, Epidermal cyst is from sebaceous gland and has a central punctum
What kind of conditions are associated with acne excoriate?
neuroses, because they scratch like crazy (pun intended) at their acne leading to excoriations
What is a vesicle?
Circiumscribed collection of free fluid up to 0.5 cm in diameter
What is a circumscribed collection of blood greater than 0.5 cm
purpura
What’s the difference between a vesicle and a bulla?
A bulla is circumscribed collection of free fluid greater than 0.5 cm whereas a vesicle is less than 0.5 cm
What is a firm (i.e. indurated) edematous plaque resulting from infiltration of the dermis with fluid?
Wheal
Why is the center of the erythema multiforme lesion white while the surrounding areas are red?
At the center there is necrosis and surrounding it is erythema
What is the name of the feces of Scabies?
scybala
What are purpura?
circumscribed deposits of blood greater than 0.5 cm
These well circumscribed lesions contain a wall and a lumen and may contain solid or fluid matter?
Cyst
The necrotic, crusty (black) secondary lesions of herpes in the perianal area is called __________
herpes gangrenosum
How is a pustule different from a vesicle?
Pustule is a circumscribed collection of LEUKOCYTES and free fluid and vesicle is just free fluid
What are the primary lesions of acne called?
Comedones
This is a circumscribed and flat bump in the skin that may be brown, blue, red
MACULE
What may be assoc. with hard and indurated skin?
scleroderma, myxedema, and amyloidosis
How does an ulcer heal? Why?
with scarring because the basal layer (stem cell layer) of epidermis is lost
This is a tumor of scar tissue that grows beyond the bounds of the initial cut
keloid
Name 5 secondary lesions
crusts, fissures, erosions, ulcer, scar
What are petechiae?
circumscribed deposit of blood less than 0.5 cm
What are milia? How do you differentiate from a whitehead?
small superficial keratin cysts without a visible opening
Why do UV and radiated skin often have telangiectasias?
UV and other forms of radiation cause cutaneous atrophy and expose the dilated blood vessels
If one felt inclined to differentiate between a depigmented macule and a hypopigmented macule, how would one embark on this endeavor?
One could use a Wood’s lamp. By doing so, one would note that a depigmented macule would have a “brilliant” purple color change. Conversely, with a hypopigmented macule, one would note a less “brilliant” color change
What happens to the amount of hair in Cushing’s dz and anemia?
more in Cushing’s Dz, less in anemia
What may be assoc. with soft skin?
hypopituitarism or hypothyroidism
Hallmark of MCV infections
umbilicated lesions ZOMG
What does anasarca indicate?
could indicate severe liver or kidney disease with or without CHF
What is a good way to Tx a keloid?
inject with steroids, re-excising would be dumb because they are known to be prone to keloid formation
What are the two biochromes of the epidermis?
melanin = brown and Carotenoids = yellow
What does poor turgor indicate?
dehydration
What does it mean to have a positive Nikolsky sign?
You can easly dissect your finger through the bulla
What are some of the most common causes of angular chelitis?
licking the lips and vitamin deficiencies
What eponym describes the ability to easily dissect through a bulla?
Nikolsky sign
What is a linear loss of epidermis and dermis with sharply defined, nearly vertical walls?
fissure
What is an excoriation?
An erosion caused specifically d/t scratching
What is a circumscribed collection of leukocytes and free fluid that varies in size?
pustule
What is the “knee-jerk” reaction as described by Dr. Lim when you see a polygonal plaque?
lichen planus, recall that a plaque is a confluence of papules
Why don?t erosions heal with scarring? Where else in the body does this occur?
Because the basal layer of epidermis remains intact. This also occurs in the GI tract? Think about Crohn’s Dz, you get stricture formation and creeping of the mesenteric fat because you have lost more than the basal layer of cells of the mucosa. Therefore, there will be scar formation = stricture. Same deal in skin.
4 places keloids tend to form?
neck, chest, shoulders, and upper back
What is a macule?
a circumscribed FLAT discoloration
This is a depression in the skin resulting from thinning of epidermis or dermis
atrophy
Tissue at the base of an ulcer that is soft and friable is sometimes called ________ flesh
proud flesh
What is a nodule? What is a large nodule referred to as?
circumscribed elevated, and solid lesion greater than 0.5 cm? Large nodule = tumor
What is a patch?
A patch is a macule more than 3-4 cm in diameter
This is a dilated superficial blood vessel
telangiectasia
What is lichenification?
An area of thickening epidermis induced by scratching
Layterm for crusts
scab? Yes that’s right, only the modern medical intellects employ the fancy word “crust”
What are other names for A) open comedone and B) closed comedone
A) blackhead B) whitehead
What are excess dead epidermal cells produced by abnormal keratinization and shedding?
Scales
What is (cutaneous) atrophy?
Depression in the skin from thinning of epidermis or dermis
What is a lesion that involves a focal loss of epidermis ONLY? What is the next stage?
erosion, ulcer
What is an area of thickening of the epidermis induced by scratching?
lichenification
What was the point of the introductory lecture?
No one knows. Don’t question it. Don’t talk about it. Just go with it.
