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Ashly Benson: CPD > Week 4: Dermatology > Flashcards

Week 4: Dermatology Flashcards

1
Q

Macule

A

flat, non palpable color change, variable shape

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2
Q

Papule

A

elevated, palpable

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3
Q

Plaque

A

elevated plateau-like lesion greater than 10 mm; superficial

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4
Q

Nodule

A

firm papule, palpable, extends into dermis or subcutaneous tissue

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5
Q

Tumor

A

large nodule greater than 10 mm

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6
Q

Vesicle

A

fluid-filled blister less than 10 mm (clear fluid)

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7
Q

Bullae

A

vesicles larger than 10 mm

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8
Q

Pustule

A

elevated lesion containing pus

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9
Q

Urticaria (wheals or hives)

A

transient elevated lesion due to localized edema; feels kind of damp/fluidy

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10
Q

Scale

A

accumulation of epithelium; dry, whitish

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11
Q

Crust

A

dried pus, blood or serous exudate on the surface; usually due to broken pustules or vesicles

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12
Q

Erosion

A

loss of epidermis

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13
Q

Excoration

A

linear erosion usually caused by scratching

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14
Q

Ulcer

A

deeper erosions involving the dermis; (bleeding and scaring)

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15
Q

Petechiae

A

small non-blanchable punctuate foci of hemorrhage (vascular rash)

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16
Q

Purpura

A

larger area or hemorrhage, maybe palpable (bruises or ecchymosis: a coalesced petechia patch)

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17
Q

Atrophy

A

paper thin wrinkled and dry-appearing skin

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18
Q

Scar

A

fibrous tissue replacement after injury

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19
Q

Telangiectasia

A

dilated superficial blood vessels

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20
Q

What are the 6 categories used to describe and chart a lesion?

A 
Secondary morphology/configuration (shape of single lesion or cluster of lesions)
Texture
Location and distribution
Color
Other Clinical Signs
Diagnostic Tests
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21
Q

Annular

A

rings with central clearing

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22
Q

Nummular

A

circular

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23
Q

Target

A

rings with central duskiness

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24
Q

Serpiginous

A

fungal and parasitic infections

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25
Q

Reticulated

A

lacy pattern

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26
Q

Verrucous

A

irregular surface

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27
Q

Lichenification

A

epidermal thickening with accentuation of skin lines due to chronic irritation

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28
Q

Induration

A

dermal thickening; skin feels hard and rough

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29
Q

Umbilicated

A

with a central indentation

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30
Q

Red (Erythema), indicates……

A

increased blood flow to the skin

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31
Q

Orange indicates……

A

hypercarotenemia

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32
Q

Yellow indicates…….

A

jaundice, heavy metal poisoning, myxedema, uremia

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33
Q

Green indicates…….

A

in fingernails suggests pseudomonas

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34
Q

Violet indicates…..

A

darkening cutaneous hemorrhage, vasculitis

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35
Q

Gray/blue skin indicates……..

A

cyanosis; metal deposits

36
Q

Black indicates…….

A

melanocytic lesions, infection or arterial insufficiency

37
Q

White indicates……..

A

tinea, Pityriasis alba, vitiligo

38
Q

Dermatographism

A

urticaria after stroking the skin

39
Q

Diascopy

A

pressure to indicate blanching (hemorrhagic lesions don’t blanch, inflammatory lesions do)

40
Q

Darier’s sign

A

stroking lesions causes intense and sudden erythema and wheal formation

41
Q

Nikolsky’s sign

A

bullae formation and erosion following gentle traction pressure

42
Q

Auspitz’ sign

A

pinpoint bleeding after removal of plaques

43
Q

Koebner’s phenomenon

A

development of lesions with areas of trauma

44
Q

What two diagnostic tests are used regarding fungi?

A

Wood’s lamp and KOH test

45
Q

A pruritus diagnosis must include what in it’s history?

A

Drug and occupational/hobby exposures

46
Q

What is the most common cause of pruritus?

A

Dry skin

47
Q

What is pruritus?

A

Itching of the skin

48
Q

What testing can be done for a pt. with pruritus?

A

Biopsy, CBC, liver, kidney, thyroid function, evaluation for underlying malignancy, immunoglobulins

49
Q

What is Urticaria?

A

Migratory, erythematous pruritic plaques mostly involving release of histamine.

50
Q

What determines acute vs. chronic urticaria?

A

> 6 weeks duration

51
Q

Etiology of Urticaria?

A

Viral/bacterial infection, IgE allergy, medications (NSAIDs), rare autoimmune dz, malignancy

52
Q

What are important aspects of the history to gather with Urticaria?

A

Duration, triggers, frequency, concomitant symptoms (GI), always ask about respiratory system, use of drugs, travel and family history

53
Q

What testing should be done with Urticaria?

A

CBC, Immunoglobulins to foods, ANA or thyroid studies, biopsy if uncertain

54
Q

What PE should be done in a Urticaria case?

A

Complete examination of the skin; look for signs of infection and systemic disease

55
Q

What does acne vulgaris present (s/sx) with?

A

Comedones, papules, pustules, inflamed nodules, superficial pus filled cysts and sometimes deep purulent sacs.

56
Q

What are dietary causes for acne vulgaris?

A

Dairy, sugar and bromine

57
Q

What are the grading criteria for acne vulgarism?

A

Mild = 5 cysts or 125 lesions

58
Q

Name the chronic inflammatory disorder characterized by facial flushing, telangiectasias, erythema, papules, pustules and possible rhinopyma?

A

Rosacea

59
Q

Pts with Rosacea have higher infection rates of __________ and __________

A

Pts with Rosacea have higher infection rates of H. Pylori and SIBO

60
Q

What are some triggers for rosacea episodes?

A

hot or spicy foods
drinking alcohol
temperature extremes
emotional reactions

61
Q

What are the stages of Rosacea?

A

Pre-rosacea
Vascular phase
Inflammatory phase: papules, pustules, nodules and cycts present
Late stage/rhinophyma

62
Q

Rosacea must display one primary and one secondary feature. Name possibilities for each of those.

A

Primary: Flushing, non-transient erythema, papules and pustules, telangiectasia

Secondary: Burning or stinging, plaque, dry appearance, edema, ocular manifestation, peripheral location, phymatous changes

63
Q

Name this uncommon, chronic pruritic bullous disease.

A

Bullous pemphigoid

64
Q

What do all bullous diseases have in common?

A

Autoimmune causes

65
Q

What causes outside of autoimmunity does bullous pemphigoid have?

A

Drug induced from furosemide, captopril and NSAIDS

66
Q

Does bullous pemphigoid have a positive or negative Nikolsky’s sign?

A

Negative

67
Q

What does the prodromal phase of bullous pemphigoid look like?

A

Pruritic eczematous papular or uticaria-like skin lesions that become tense bullae

68
Q

What is the distribution pattern for bullous pemphigoid?

A

Trunk, lower legs, extremity flexures, axillary and inguinal folds

69
Q

What is bullous pemphigoid associated with and what is the age range affected?

A

Associated with dementia, parkinson’s disease and unipolar/bipolar
Age>60

70
Q

What diagnostic criteria are used for bullous pemphigoid?

A

Biopsy: shows sub epidermal bulla with infiltrate of eosinophils;

Direct immunofluorescence (GOLD STANDARD) of skin shows IgG and/or C# in a linear band in basement membrane.

71
Q

What disease presents in ages 20-50; male:female __(?)___; as chronic, recurring, intensely itchy with symmetrical groups of inflamed vesicles, papules and hives?

A

What disease presents in ages 20-50; male:female 2:1; as chronic, recurring, intensely itchy with symmetrical groups of inflamed vesicles, papules and hives?

Dermatitis herpetiformis

72
Q

Dermatitis herpetiformis is caused by autoimmune diseases, especially _________ and also associated with ________ disorders

A

Dermatitis herpetiformis is caused by autoimmune diseases, especially celiac disease (even asx) and associated with thyroid disorders.

73
Q

What is the distribution of dermatitis herpetiformis?

A

symmetrical extensor aspects, sacrum, base of head or generalized (rare)

74
Q

How is dermatitis herpetiformis diagnosed?

A

Skin biopsy of lesions and adjacent skin = sub epidermal clefting and papillary dermal tips w/neutrophils and eosinophils;

Direct immunoflorescence is a GOLD STANDARD: IgA deposition

75
Q

Pemphigus vulgaris is ________________ with the highest incidence occurring in ___________.

A

Pemphigus vulgaris is a rare potentially fatal (15%) blistering disease with the highest incidence occurring in Ashkenazi Jews.

76
Q

Pemphigus vulgaris’ distribution

A

Oral lesions precede skin lesions in 50-70%; then found on groin, scalp, abd, back, upper legs, axilla and umbilicus

77
Q

How is pemphigus vulgaris diagnosed?

A

Biopsy = intradermal bulla or separation of epidermal cells

Immunfluorescence from edge of fresh lesion

Nikolsky’s sign (+)

78
Q

Epidermal thickening that is usually asymptomatic with intact skin lines

A

Callus

79
Q

Epidermal thickening that maybe painful with pressure that has a yellowish core when pared and interrupts skin lines

A

Corn

80
Q

Scaling and flaking of skin is called……

A

Ichthyosis

81
Q

What are characteristics of inherited Ichthyosis?

A

Autosomal Dominant and X-linked; resembles cracked pavement; accentuated palmar creases

82
Q

What is the distribution of ichthyosis?

A

shins and outer arms

83
Q

What is required for diagnosis?

A

H and PE

No biopsy

84
Q

What happens during Keratosis pillaris?

A

Horny plugs fill the openings of hair follicles: follicular papules on lateral aspects of upper arms, thighs and buttocks. On the face of children (sandpaper skin)

85
Q

What are causes of keratosis pillaris?

A

Nutritional deficiency, or genetic

86
Q

Name and describe the causes of this immune-mediated skin inflammation with a genetic component?

A

Atopid Dermatitis

Causes: Genetics (atopy), food and environmental allergies, aggravated by dry skin, wool, sweating, allergens, tight clothing, emotional stress, nutritional

Ashly Benson: CPD (3 decks)

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