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239 Cards in this Set

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Macule
circumscribed flat area of skin that is different in color and texture from its surrounding tissue, less than 1 cm in size.
Vesicle
A circumscribed elevation of the skin that contains serous fluid that is under 1 cm in diameter
Nodule
Solid mass of skin, observed as an elevation or can be palpated that is over 1 cm in diameter. It often extends into the dermis (deeper)
Papule
Small solid elevated lesion
under 1 cm in diameter
Wheal
Elevated white or pink compressible papule or plaque
red axon-mediated flare often surrounds it
Commonly associated with allergic reactions
small plaque?
Papule
Abcess
a localized collection of purulent fluid in a cavity formed by disintergration or necrosis of tissues that is over 1 cm in size
Tumor
mass over a few centimeters in diameter.
It can be firm or soft, benign or malignant
Small Patch?
Macule
Pustule
A visible accumulation of purulent fluid under the skin under 1 cm in diameter
Vesicle
A circumscribed elevation of the skin that contains serous fluid that is under 1 cm in diameter
Cyst
Raised, encapsulated, fluid filled lesion
can be found anywhere
Wheal
Elevated white or pink compressible papule or plaque
red axon-mediated flare often surrounds it
Commonly associated wtih allergic reactions
(circumscribed area of skin edema
Abcess
a localized collection of purulent fluid in a cavity formed by disintergration or necrosis of tissues that is over 1 cm in size
Purapura
flat, red-purple discoloration caused by RBCs lodged in the skin
DOES NOT BLANCH
Papule
Small solid elevated lesion
under 1 cm in diameter
small plaque?
Papule
Small Patch?
Macule
Bullae
Fluid filled lesion over 1 cm in diameter
ex blister (COMMON EXAM QUESTION)
necrotizing fascitis
An ant bite's an example of?
papule
An elevated nevus is an example of?
Papule
A verruca's an example of?
Papule
Acne's an example of?
Pustule
Impetigo's an example of?
Pustule
Herpes simplex is an example of?
Vesicle
Varicella's an example of?
Vesicle
Herpes Zoster's an example of?
Vesicle
Xanthoma is an example of?
Nodule
xanthoma
is a deposition of yellowish cholesterol-rich material in tendons or other body parts in various disease states.
They are cutaneous manifestations of lipidosis in which there is an accumulation of lipids in large foam cells within the skin.

They are associated with hyperlipidemias, both primary and secondary types.
Pneumonic for Malignant Melanoma
If 2/6 usually MM
ABCD
Asymmetry
Borders Irregularity
Color variation
Diameter>6 mm pencil eraser
Elevation and Enlargment
xanthoma
There are various type of xanthomas.
xanthelasma of the eyelids.
xanthoma
Ephelides
Other name?
An example of?
Freckles
Macule
Petechiae?
Morphology of Petechiae?
Small purapura- doesn't blanch
(1-2mm) red or purple spot on the body, caused by a minor hemorrhage (broken capillary blood vessels).
< 1 cm, usually caused by thrombocytopenia (a low platelet count)
Petechiae's an example of a Macule

Pict of vasculitis, has some purapura also
Flat nevi are an example of?
Macule
Mongolian spots are an example of?
Patch
Cafe' au lait spots are an example of?
Patch
Name the configuration: circular, begins in the center and spreads to the periphery?
Example?
Annular
Tinea
Name the configuration: Lesions run together?
Confluent/ Coalesce
Name the configuration: Clustered Lesions?
Grouped
Name the configuration: Twisted, coiled, spiral, snake-like?
Example?
Gyrate
eg. Scabies
Name the configuration: Scratch, strek, line, stripe?
Linear
Name the configuration: merged annular lesions?
Polycyclic
Name the configuration: individual and distinct lesions that remain separate?
Solitary or discrete
Name the configuration:Resembles the iris of an eye?
Example?
Target
Lyme dx
Name the configuration: linear arrangement along a nerve route?
Example?
Zosteriform
herpes zoster
Name the configuration: Lesions with concentric rings of color
Target
Fibroma is an example of?
Nodule
Ephelides is an example of?
macule
Freckles
Fibroma
are benign tumors that are composed of fibrous or connective tissue. They can grow in all organs, arising from mesenchyme tissue. The term "fibroblastic" or "fibromatous" is used to describe tumors of the fibrous connective tissue. When the term fibroma is used without modifier, it is usually considered benign, with the term fibrosarcoma reserved for malignant tumors.
fibroma
fibroma of tongue
Burns are an example of?
Bulla
Superficial blisters are an example of?
Bulla
Morphology of contact dermatitis?
Bulla
A blister is an example of?
Bulla
PPD is an example of?
Wheal
Mosquito bite are an example of?
Wheal
Sebacous cyst is an example of?
cyst
comedone
lump or plug in the skin
open comedone
blackhead
opening capped with a blackened skin debris
closed comedone
whitehead
obstruced openings
Morphology of a Pimple?
Papule/ Pustule
Types of acne?
Pustules and Papules
Comedones (black and white)
Cysts
Nodules
Scarring
When do you refer acne?
Cysts, Nodules or a lot of scarring
Comedolytic agents are effective after how long?
usually 90 days
Comedolytic agents
are creams or gels less irritating?
creams
Name some comedolytic agents?
Benzoyl peroxide
Salicylic acid (Neutrogena2% wash)
Azelaic acid (Azelex)
Tretinoin (Retin-A)
Adapalene (Differin)
Tazarotene (Tazorac)
Name combination agents?
Benzoyl peroxide+ Erythromycin (Benzamycin)
Benzoyl peroxide+ Clindamycin (BenzaClin
Benzoyl peroxide + Drying agents Sulfacetamide sulfur (Novacet or Sulfacet)
Which combination agent requires refrigeration?
Benzoyl peroxide+ Erythromycin (Benzamycin)
Is benzoyl peroxide bacteriocidal or bacteriostatic?
bacteriocidal
(keratolytic)
acne, cradle cap, dandruff and seborrheic dermatitis, warts and other lesions.

therapy is treatment to remove warts and other lesions (in which the epidermis produces excess skin. In this therapy, acid medicine, such as salicylic acid is put on the lesion. Keratolytic therapy thins the skin on and around the lesion.) It causes the outer layer of the skin to loosen and shed.

Keratolytics can also be used to soften keratin, a major component of the skin. This serves to improve the skin's moisture binding capacity, which is beneficial in the treatment of dry skin. Such agents (keratolytics) include urea, lactic acid, and allantoin.

While cytostatic agents such as zinc pyrithione are first line, keratolytics (salicylic acid and sulfur) can also be used in the treatment of dandruff and seborrheic dermatitis.

Sulfur and salicylic acid can also be used to effectively treat acne and cradle cap in some patients.
Keratolytic agents in reference to acne?
reduces comedone formation
Azelex

Bacteriocidal or bacteriostatic?
Action?
bacteriocidal and reduces comedone formation
Retin A (Tretinoin) Risks?
increases risk of sun burn
Pregnancy category C
1 Adapalene's other name?
2 Is less irritating than?
3 Pregnancy Risk?
1 (Differin)
2 Less skin irritation then Retin A
3 Pregnancy cetegory C
Tazarotene (Tazorac) Pregnancy Risk?
Expensive
Pregnancy Category X
Topical A/B for acne?
Clindamycin
Erythromycin
Tetracycline
Metronidazole
Most frequently used topical a/b for acne?
Clindamycin
Second a/b most frequently topical a/b for acne?
Erythromycin
Which topical a/b is not commonly used because of adverse effects?
Tetracycline
Frequently used topical for rosacea?
Metronidazole
Oral a/b for acne?
Tetracycline
Erythromycin
Minocycline
Doxycycline
Clindamycin
Most widely prescribed oral a/b for skin infections?
tetracycline
tetracycline is contraindicated in which patients?
In pregnancy and children under 9 yrs b/c of staining of the teeth
Melasma
hyperpigmentation
What can be used for severe unrespnonsive acne?
Isotretinion (Accutane)
Oral contraceptives used for acne?
Combination therapy is most effective
Ortho Tri Cyclen and Estro- Step
May cause brownish blotches or Melasma on the skin
What MUST be done when using Isotretinion (Accutane)?
Always obtain informed consent
It's contraindicated in pregnancy, 2 forms of birth control are needed
Melasma
Melasma
Another name for a Boil
Furuncle
Topical A/B for acne?
Clindamycin
Erythromycin
Tetracycline
Metronidazole
Furuncles are caused by what organism?
Staphylococcus aureus
Tazorac's other name?
Pregnancy Risk and con?
1 Tazarotene
2 Pregnancy Category X
3 Expensive
Most skin infections are caused by?
Staph, but cellulitis is usually by strep
Adapalene
Adapalene (Differin)
Out patient skin infections are usually caused by?
1.Strep pyogenes (Group A Strep
2.Staph Aureus-less common
3. Other Strep (Gp B,C,G)
Out patient skin infections are usually caused by?
1.Strep pyogenes (Group A Strep
2.Staph Aureus-less common
3. Other Strep (Gp B,C,G)
Inpt skin infections are usually caused by?
1 Gm neg organisms like e coli, Klebsiella, Pseudomonas, Enterobacter)
2. S aureus (MRSA? CA-MRSA?)
3 Strep
Furuncles are usually caused by what organism?
S aureus
How do you tx CA MRSA
1 Bactrim (95-100%)
2 Doxy/ Minocycline (90-95%)
3 Clindamycin (85-95%)
Cellulitis are usually caused by what organism?
S pyogenes
Folliculitis
Inflammation of the hair follicle
Other name for Tazarotene?
used for?
Preg Category?
Tazarotene (Tazorac)
Used as a comedolytic agent
Preg category x
Furuncle
Boil, localized infection originating in the hair follicle caused by staphylococcus aureus
Oral a/b for acne?
Tetracycline
Erythromycin
Minocycline
Doxycycline
Carbuncles are usually caused by what organism?
S aureus
Name combination agents?
Benzoyl peroxide+ Erythromycin (Benzamycin)
Benzoyl peroxide+ Clindamycin (BenzaClin
Benzoyl peroxide + Drying agents Sulfacetamide sulfur (Novacet or Sulfacet)
Cellulitis are usually caused by what organism?
S pyogenes
Carbuncles are usually caused by what organism?
S aureus
How do you tx CA MRSA
1 Bactrim (95-100%)
2 Doxycycline
3 Minocycline (90-95%)
4 Clindamycin (85-95%)
Furuncles are usually caused by what organism?
S aureus
Cellulitis are usually caused by what organism?
Strep pyogenes
Name some comedolytic agents?
Benzoyl peroxide
Salicylic acid (Neutrogena2% wash)
Azelaic acid (Azelex)
Tretinoin (Retin-A)
Adapalene (Differin)
Tazarotene (Tazorac)
Inpt skin infections are usually caused by?
1 Gm neg organisms like e coli, Klebsiella, Pseudomonas, Enterobacter)
2. Staph aureus (MRSA? CA-MRSA?)
3 Strep
What a/b should be used for Group a Strep?
You need additional coverage
Bactrim, Doxycycline/ Minocycline or clindamycin with a
beta lactam or 1st generation cephalosporin
(PCN, Amoxicillin), 1 st generation cephalosporin (Keflex)
A beta-lactamase inhibitor ?
A beta-lactamase inhibitor is a drug given in conjunction with a beta-lactam antibiotic. Although the inhibitor does not usually have significant antibiotic activity on its own, it inhibits activity of beta-lactamase, a protein that confers resistance of beta-lactam antibiotics to bacteria.

Beta-lactamase inhibitors in clinical use include clavulanic acid and its potassium salt (usually combined with amoxicillin or ticarcillin), sulbactam and tazobactam
Clavulanate+ Ticarcillin =Timentin
Clavulanate+ amoxicillin= Augmentin
Tazobactam+Pipercillin=Zosyn
Sulbactam+ ampicillin=Unasyn
β-lactam antibiotics?
The β-lactam ring is part of the core structure of several antibiotic families, the principal ones being the
1-penicillins
2-cephalosporins,
3-carbapenems,
4-monobactams,
5-Cephamycins
6-Beta-lactamase inhibitors
How do the β-lactam antibiotics work?
Bacteriocidal

Nearly all of these antibiotics work by inhibiting bacterial cell wall biosynthesis. This has a lethal effect on bacteria. Bacteria can, however, become resistant against β-lactam antibiotics by expressing a β-lactamase.
Gram neg organisms that usually cause inpt bacterial skin infections?
E coli, klebsiella, pseudomonas, enterobacter
In areas of very low CA MRSA prevelance, which a/b can be used for group a strep?
Dicloxacillin or Cephalexin (Keflex)
purple patches
purpura (purple patches).
Erysipelas
Erysipelas
Erysipelas
Erysipelas s/s
a rapid progression of an erythematous, warm, indurated area
hiradenitis suppurativa?
skin disease that most commonly affects areas bearing apocrine sweat glands or sebaceous glands, such as the underarms, breasts, inner thighs, groin and buttocks
hiradenitis suppurativa is usually caused by?
staph aureus infection
hidradenitis suppurativa
Impetigo is usually caused by which organism?
Staph aureus
Impetigo
infection of the skin (vesicle to pustules)
Primary lesion is a thin walled vesicle that breaks easily, it's honey colored crust at the edge, commonly satelite lesions can appear and spread to remote areas of the skin,
can have pustules
Paronychia is usually caused by what org?
Staph aureus
Paronychia
Staph around the nail fold
s/s of bacterial skin infections
1 regional lymphadenopathy
2 pain
3 swelling
4 warmth
5 erythema
6 vesicles
7 pustules
8 purulent drainage
s/s of bacterial skin infections in systemic infections
1 fever
2 malaise
3 chills
4 anorexia
Management for bacterial skin infections
Culture if needed
I&D as needed
Systemic tx should be directed at the offending organism
May need antipyretic, analgesic
For minor skin infections, consider which topical antimicrobials?
Bacitracin, Bactroban (Mupirocin)
For minor skin infections, consider which oral antimicrobials?
1 st generation cephalosporin (Cephalexin- Keflex)
or Penicillinase resistant PCN (Dicloxacillin)
Clincamycin or amoxicillin clavulanate may be used if it's a human bite, but not so great for polymicrobial infect.
Herpes Zoster S/S?
Pain along a dermatomal distribution, usually on the trunk
Grouped vesicle eruption along the dermatomal pathway
Diagnosis for Herpes Zoster ?
May scrape the blisters for analysis
Management for Herpes Zoster?
Treatment options include Acyclovir, Famiciclovir, Valaciclovir
If suspected ocular involvement for Herpes Zoster?
Refer
Meds for herpetic Neuralgia?
Gabapentin (neurontin)
Pregabalin (Lyrica)
Vaccine for Herpes Zoster?
What age should it be given at?
Zostavax prophylaxis indicated at age 60 yrs
Which skin lesions have the potential to turn into cancer?
What type of cancer?
Actinic Keratoses and Keratoacanthoma lesions can progress into Squamous cell
Most common skin cancer?
Basal Cell carcinoma
Skin cancer with the highest mortality?
Malignant Melanoma
The M's with malignant melanoma?
Malignant Melanoma
Mortality Highest
May metastasize from a mole to any organ
Another name for shingles
Herpes zoster
herpes zoster def?
a condition with vesicular eruptions due to varicella zoster virus; may be life threatening in immunocompromised adults
herpes zoster s/s?
grouped vesicle eruption along the dermatomal pathway with pain usually on the trunk
Pityriasis Rosea
A harmless rash, pityriasis rosea usually begins with a single, scaly pink patch with a raised border. Days to weeks later, a scaly rash appears on the arms, legs, back, chest, and abdomen, and sometimes the neck. The rash may appear like a "Christmas tree". The rash, whose cause is unknown, isn't believed to be contagious and can be itchy. It often goes away in 6-8 weeks without treatment. Pityriasis rosea is most often seen between the ages of 10 and 35.
Basal Cell Carcinoma
the most common skin cancer
waxy pearly appearance, may be shiny red
central depression or rolled edge may have telangiectatic vessels
How fast does Basal Cell Carcinoma grow
slowly 1-2 cm after years
Tx for Basal Cell Carcinoma
shave/ punch biopsy and surgical excision
Tx for malignant melanoma?
biopsy and surgical excision
Median age for Malignant melanoma
40 yrs
4 M's of Malignant melanoma
-Malignant
-May metastasize from a mole
-Mortality is highest of all cancers
-May metastasize to any organ
Herald
One that gives a sign or indication of something to come
Skin disorder that presents with a Herald patch
Pityriasis Rosea
Another name for Atopic Dermatitis
Eczema
Eczema
Chronic skin condition characterized by intense pruritis,
acute flare ups
red, shiny or thickend patches
inflamed/ scabbed lesions with erythema/ scaling
dry, leathery lichenification
Other name for Eczema
Atopic Dermatitis
Tx for Allergic Contact Dermatitis?
What should one avoid?
Topical Steroids
Prednisone taper if severe

Do not Scrub with soap and H2O
Tx for Psoriasis
Topicals for scalp (tar/Salicyllic acid shampoo)
Topical steroids (betamethasone)
UVB light exposure
Allergic contact Dermatitis
Acute or chronic condition characterized by inflammation at the site of contact with chemical allergens
Redness, Pruritits, Scabbing etc.
Sharp, defined borders
Psoriasis

Definition?
May be a sign of?
S/S?
Benign hyperproliferative inflammation of the skin that can be acute or chronic

HIV may be present as a first sign of HIV infection (explosive onset)

S/S
1 Itching,
2 red
3 precisely defined plaques with silvery scales
4 Fine pitting of the nails
5 Auspitz sign
Auspitz sign
droplets of blood when scales removed
Pityriasis Rosea
Mild, acute inflammatory disorder
Pityriasis Rosea's more common in which gender?
female during the Spring and Fall
Pityriasis Rosea's usually found where on the body?
Pruritic rash found on the trunk and proximal extremities
How does Pityriasis Rosea typically present initally?
Initial lesion 2-10 cm herald patch with a general rash within 1-2 weeks.
Lesions follow a christmas tree pattern (follows cleavage lines on the trunk) and resolve within 2-10 weeks
Pityriasis Rosea typically lasts for?
the eruptions lasts for 4-8 weeks
If a skin condition looks like pityriasis rosea,
but it doesn't itch,
presents of the palmer or plantar surface or the lesions are few and perfect, test for
syphyllis
Only 50% of the cases in lyme dx present with?
distinctive bull's eye macular/papular rash and/ or flu like symptoms

Erythema chronicum migrans
Expanding red lesion with central clearing associated with lyme dx
Erythema migrans
How long does it take a tick to feed and transmit the infecting organism Borrelia burgdorferi to the host?
24-48 hrs
Initial test for lyme dx?
ELISA
Confirmatory test for lyme dx?
Western Blot
Tx for Lyme dx
Amoxicillin
Cefuroxime (Ceftin), Azythromycin, others
Doxycycline (not in children or pregnancy)
xanthoma
Pneumonic for Malignant Melanoma?
If 2/6 usually MM
ABCD
Asymmetry
Borders Irregularity
Color variation
Diameter>6 mm pencil eraser
Elevation and Enlargment
Actinic Keratoses
premalignant small patches occuring on sun exposed parts of the body, that may be tender, rough, flesh colored, pink or hyperpigmented
Treatment for Actinic Keratoses
Pharm options
1 5FU
2 Imiquimod
3 Diclofenac gel
4 PDT with topical delta aminolevulinic acid

Tissue destruction options
1 Liquid Nitrogen (cyrotherapy)
2 Laser Resurfacing
3 Chemical Peel
Squamous Cell Carcinoma can arise out of?
Actinic Keratoses
Keratoacanthoma
Squamous Cell Carcinoma?
Firm irregular papule/ nodule that develops over a few months from prolonged sun exposed areas in fair skin people
3-7% metastisize
Tx for Squamous Cell Carcinoma?
Biopsy and surgical excision (Mohs)
Mohs surgery
also known as chemosurgery, is microscopically controlled surgery used to treat common types of skin cancer.
Are Seborrheic Keratoses premalignant?
Benign
Are Seborrheic Keratoses painful?
no
Seborrheic Keratoses
beige, brown or black plaques with a stuck on appearance that are usually 3-20 mm in diameter
Tx for Seborrheic Keratoses
none or liquid nitrogen
Name this pattern?
Concentric
Concentric objects share the same center, axis or origin with one inside the other.
Presentation of Pityriasis Rosea
The rash usually first appears as a large, pink patch (which may be scaly in texture) on the chest or back. This first patch is called the herald patch or the mother patch. One to 2 weeks after the appearance of the mother patch, more pink patches will appear. Christmas tree like pattern. Like the mother patch, they are pink, often scaly, and oval. After a period of 2 to 10 weeks, the rash disappears on its own (spontaneously). Rarely, pityriasis rosea may be localized to a specific region of the skin.
Is Pityriasis Rosea casued by a virus/ bacteria?
What med seems to help it?
May be viral in origin
Erythromycin seems to help it
S/S that a skin infection is bacterial?
1 Any signs of inflammation
2 Regional lymphadenopathy
3 Pain
4 Swelling
5 Erythema
6 Warmth
7 Vesicles
8 Pustules
9 Purulent drainage
Strep usually causes what skin conditions?
Cellulitis
Erysipelas
Lichen simplex chronicus
This skin disorder leads to a scratch-itch cycle:
It may begin with something that rubs, irritates, or scratches the skin, such as clothing.
This causes the person to rub or scratch the affected area. Constant scratching causes the skin to thicken.
The thickened skin itches, causing more scratching, which causes more thickening.
The skin may become leathery and brownish in the affected area.
Staph usually causes what skin conditions?
Most skin conditions such as
Impetigo
Hidradenitis suppurativa
Paronychia
Folliculitis
Furuncle
Carbuncle
Seroconversion?
.
Seroconversion is a term that refers to the development in the blood of antibodies to an infectious organism or agent.
The phenomenon of seroconversion can be important in diagnosing infections that are caused by latent viruses
Can seroconversion occur with vaccination?
Typically, seroconversion is associated with infections caused by bacteria, viruses, and protozoans. But seroconversion also occurs after the deliberate inoculation with an antigen in the process of vaccination
Why is it that serocoversion happens weeks after an infection?
When these viruses first infect people, the viral nucleic acid can become incorporated into the genome of the host. As a result, there will not be an immune response mounted against the virus. However, once viral replication has commenced antibodies to viral proteins can accumulate to detectable levels in the serum.
secondary skin lesion
lesions altered by outside manipulation, tx, natural course of dx
ex crust
raised lesion caused by dried serum and blood remnants, develops when a vesicle ruptures.
crust
excoriation
lichenification
scales
erosion
ulcer
fissure
skin lesions under 1 cm
1 macule (patch)
2 papule (plaque)
3 pustule (abcess)
4 petechiae (purapura)
5 vesicle (bulla)
1 Skin lesions over 1 cm?
2 Skin lesions that can be any size?
1 plaque
2 bullae
3 abcess (big pustule)
4 Nodule
5 Tumor

A cyst, wheal and purpura can be any size
lesions that can be any size
cyst
wheal
purpura
Distribution of an annular lesion?
Ex?
in an ring
Example: tinea
Erythema migrans (lyme dx) is concentric/ bull's eye/ target
Scattered Lesion?
Ex?
Generalized over body without a specific pattern or distribution
Maculopapular rash associated with rubella
Coalescent
Confluent lesions
Multiple lesions blending together
Clustered?
Ex?
Grouped lesions without a pattern
Some acnes
Linear?
Ex?
In streaks
Poison ivy/ oak
Reticular
ex?
Appearing in a net like cluster
erythema infectiosum = 5th dx slapped cheek appearance
dermatomal
Ex?
limited to boundaries of a single or multiple dermatones
Shingles

http://www.aafp.org/afp/2000/0815/p804.html
Examples of secondary lesions?
1 Excoriation
2 Crust
3 Lichenification
4 Scales
5 Erosion
6 Ulcer
7 Fissure
Excoriation?
Example?
Size?
usually linear, raised lesion often covered with a crust
ex. scratches over a nickle allergy (contact dermatitis)
can be any size
Crust
Example?
Size?
Raised lesions produced by dried serum and blood remnants
Ex. scab

can be any size
Lichenification
Example?
Size?
Skin thickening usually found over pruritic or friction areas
ex callous on the foot
eczema

can be any size
Scales
Example?
Size?
Raised superficial lesion that flake with ease
ex dandruff
psoriasis

can be any size
Erosion
Example?
Size?
loss of epidermis
area beneath a bullae or vesicle

> 1 cm
Ulcer
Example?
Size?
Loss of epidermis and dermis
syphilitic ulcer

> 1 cm
Fissure
Example?
Size?
narrow linear crack into the epidermis, exposing dermis

athletes foot
crack on dry lips

> 1 cm
Morphology
This includes aspects of the outward appearance (shape, structure, color, pattern)
Configuration
Examples?
Distribution

figure, determined by the arrangement of its parts or elements
Example Annular, Clustered, Linear, Reticular, Dermatormal, confluent
2 Precancerous Lesions that can progress into Squamous Cell Carcinoma?
Actinic Keratoses
Keratoacanthoma
2 Precancerous Lesions that can progress into Squamous Cell Carcinoma?
Actinic Keratoses
Keratoacanthoma
Describe AK?
also called "solar keratosis" and "senile keratosis"
Llight or dark, tan, pink, red, brown occasionally flesh colored, scaly, often tender on the sun exposed skin surfaces such as the face, neck, back of the hands and forearms.
Size ranges from microscopic to several cm

Can progress into squamous cell carcinoma, some go away on their own
Describe AK?
Red or brown scaly often tender . Occasionally flesh colored,on the sun exposed skin surfaces such as the face, neck, back of the hands and forearms.
Size ranges from microscopic to several cm
AK lesions can remain unchanged or progress to Squamous cell carc., what 2 options do you have?
Pharmacotherapy or tissue destruction options.
AK lesions can remain unchanged or progress to Squamous cell carc., what 2 options do you have?
Pharmacotherapy or tissue destruction options.
Options for AK tx?

http://www.youtube.com/watch?v=sZkC13icweA
Pharmacotherapy Options
1 5 FU topical 5 fluorouracil
2 5% Imiquimod Cream
3 Topical Diclofenac Gel
4 PDT Photodynamic therapy with topical delta aminolevulinic acid

Tissue destruction options
1 Cryosurgery
2 Laser Resurfacing
3 Chemical peel
Options for AK tx?
Pharmacotherapy Options
1 5 FU topical 5 fluorouracil
2 5% Imiquimod Cream
3 Topical Diclofenac Gel
4 PDT Photodynamic therapy with topical delta aminolevulinic acid

Tissue destruction options
1 Cryosurgery
2 Laser Resurfacing
3 Chemical peel
Description of Keratoacanthoma
typically skin colored or slightly reddish when they first develop, appearance usually changes from smooth, dome shaped and then within a few weeks, grow to 1-2 cm, craterlike with outer rim of tissue, with a crusted interior on sun exposed areas
Description of Keratoacanthoma
typically skin colored or slightly reddish when they first develop, appearance usually changes from smooth, dome shaped and then within a few weeks, grow to 1-2 cm, craterlike with outer rim of tissue, with a crusted interior on sun exposed areas
About __% of keratoacanthomas develop into squamous cell carcinomas
25
de novo
lesion that just appears
not arising from a previous lesion- mole
Interventions for keratoacanthomas
Surgical removal
less commonly tx with 5 FU or radiation
keratoacanthomas

Surgical removal
less commonly tx with 5 FU or radiation