Tutorial 4 - Dermatology (A) - terminology Flashcards

1
Q

How would you structure a dermatological history?
1. Explore history of presenting complaint.
2. Explore PMH
3. Explore FH
4. Explore social history
5. Current medication.
6. Explore how it affects their quality of life.

A
  1. History - Duration of lesion, associated symptoms (i.e. itching, bleeding, blistering, systemic symptoms), evoloution of rash / lesion, fluctuate or persistent lesion, relieving / exacerbating factors, past treatments tried.
  2. PMH - History of skin conditions, conditions which can present with skin changes.
  3. FH - Some skin conditions can run in the family i.e., psoriasis.
  4. Social history - Work / hobbies, exposure to sun, sun bed use, smoking / alcohol, sexual history, travel.
  5. Current medications - Prescribed, OTC and herbal current treatments.
  6. How is the dermatological concern affecting the patient’s life and mental health.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How would you examine a dermatological lesion ?

A
  • INSPECT
  • DESCRIBE
  • PALPATE
  • SYSTEMIC CHECK
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is involved in the INSPECTION ?

A
  • General observation
  • Comment if rash or lesion
  • Establish pattern of distribution.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is involved in the DESCRIPTION ?

A
  • ABCD:
  • Asymmetry (is it a mirror image?)
  • Boarders (has it got regular boarders?)
  • Colours (Is it one colour / mixture of colours)
  • Diameter (size)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is involved in the PALPATION?

A
  • TEMPERATURE
  • TENDERNESS
  • MOBILITY
  • CONSISTENCY
  • SURFACE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is involved in the SYSTEMIC CHECK?

A

Examine nailbeds, scalp, hair and mucous membranes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is meant by PRURITUS?

A

Itching

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is meant by LESION?

A
  • Single area of altered skin.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is meant by RASH?

A
  • Multiple lesions
  • Widespread eruptions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is meant by NAVEUS?

A
  • Another term for a mole.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is meant by COMEDONE?

A
  • Blockage of a sebaceous follicle by sebum, can present as whiteheads or blackheads.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is meant by GENERALISED?

A
  • All over the body.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is meant by LOCALIZED?

A
  • Restricted to one area of skin only.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is meant by FLEXURAL?

A
  • In body folds, i.e. groin, behind ears.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is meant by EXTENSOR ?

A
  • Knees, elbows, shins.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is meant by DISCRETE?

A
  • Individual lesions separated from each other.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is meant by CONFLUENT

A
  • Individual lesions merging together.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is meant by LINEAR?

A
  • In a line.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is meant by TARGET?

A
  • Concentric rings - like that of a target.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is meant by ANULAR?

A
  • Like a circle or ring.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is meant by ERYTHEMA?

A
  • Redness which is often due to inflammation / vasodilation - when pressure applied seems to disappear (blanching).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is meant by PURPURA, PETECHIAE, ECCHYMOSES?

A
  • PETECHIAE - small, pinpoint bleeding (red/purple/brown non blanching lesions)
  • PURPURA and ECCHYMOSES are progressively larger red/purple/brown non blanching lesions.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is meant by HYPOPIGMENTATION?

A
  • Areas of paler skin.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is meant by HYPERPIGMENTATION?

A
  • Areas of darker skin.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is meant by DE-PIGMENTATION?
- White skin due to absence of melanin.
26
What is meant by MACULE?
- Flat area of altered colour < 1 cm
27
What is meant by PATCH?
- Flat area of altered skin > 1 cm
28
What is meant by PAPULE?
- Solid raised lesion <0.5 cm
29
What is meant by NODULE?
- Solid raised lesion > 1 cm
30
What is meant by PLAQUE?
- Scaling, raised lesion >0.5 cm
31
What is meant by VESICE?
- Raise clear fluid lesion < 0.5 cm
32
What is meant by BULLA?
- Raised clear fluid lesion > 0.5cm
33
What is meant by PUSTULE?
- Raised, pus containing lesion < 0.5 cm
34
What is meant by ABSCESS?
- Localized accumulation of pus deep in dermis or hypodermis.
35
What is meant by EXCORIATION?
- Loss of epidermis following trauma.
36
What is meant by LICHENIFICATION?
- Thickening / leathery feel of skin.
37
What is meant by SCALE?
- Visable flakes of the stratum corneum.
38
What is meant by CRUST?
- Dried exudates (blood)
39
What is meant by SCAR?
- New fibrous tissue which occurs post wound healing.
40
What is meant by ULCER?
- Loss of epidermis and dermis.
41
What is meant by FISSURE?
- An epidermal crack often due to excessive dryness.
42
What is meant by STRIAE?
- Stretch marks which progress from purple to pink to white.
43
What is meant by ALOPECIA ?
- Loss of hair
44
What is meant by HIRSUTISM ?
- Growth of short, course hairs o face, neck, stomach, thighs of a women.
45
What is meant by CLUBBING ?
- Convex, like an upside-down spoon.
46
What is meant by KOILONYCHIA ?
- Concave, like a spoon.
47
What is meant by PITTING ?
- Shallow / deep depression in nail plate.
48
What are the functions of skin?
- Protection - Temperature regulation - Sensation - Vitamin D synthesis - First line defence - immunosurveillance.
49
What are the 3 layers of the skin?
- Epidermis - Dermis - Subcutaneous tissue / hypodermis.
50
What layers make up the epidermis?
- Stratum lucidum (only present on some parts of skin i.e., sole of fee). - Stratum corneum - Stratum Granulosum - Stratum spinosum - Stratum Basale (actively dividing cells)
51
What pathology might affect the epidermis?
1. Changes in the epidermal turnover rate leading to psoriasis. 2. Changes in the surface of the skin - scales / crusting / ulcer. 3. Hyper / hypo pigmentation.
52
What does the dermis contain?
- The dermis is made up of collagen and elastin which give it its strength and elasticity. It also contains immune cells, blood cells, nerve cell, hair shaft / follicle, sebaceous glands, sweat glands.
53
What pathology might affect the dermis?
- Changes in the contour of the skin - atrophic scarring. - Papules / nodules - Changes related to the blood vessels i.e., erythema (vasodilation), urticaria (increased permeability of the blood vessels), purpura (capillary leakage).
54
What are the 3 types of hair?
- Lanugo hairs (fine long hairs in a foetus) - Vellus hair (fine short hair found on all body surfaces) - Terminal hair (coarse long hair on the scalp, eyebrows, eyelashes and pubic hair).
55
What is the structure of hair?
- Hair shaft - Hair root - Hair follicle
56
What are the 4 hair follicle stages?
- Anagen (growing phase) - Catagen (transition phase) - Telogen (resting phase) - Exogen (shedding phase)
57
What pathology might affect the hair?
- Reduced / absent melanin production leading to grey / white hair. - Changes in the duration of the growth cycles.
58
Briefily describe the structure of the nails.
- Nail plate - outer keratin cover - Nail matrix - Where the nail plate starts to grow from - Nail bed - Contains blood capillaries which give nails them their pink colour.
59
What pathology can affect the nails?
- Abnormalities of the nail bed i.e., splinter haemorrhage. - Abnormalities of the nail plate i.e., discolouration - Abnormalities of the nail matrix i.e., pits
60
What are sebaceous glands and what pathology can they cause?
- Produce sebum, which travels to skin via hair follicle (pilosebaceous unit). The sebum lubricates and waterproofs the skin. - Sebaceous glands are stimulated by the conversion of androgens to DHT. - When you have excess sebum production it can block up the hair follicles leading to acne.