Bates Chapter 6 With Pictures

Front 1

In this condition, depigmented macules appear on the face, hands, feet, extensor surfaces, and other regions and may coalesce into extensive areas that lack melanin. The brown pigment is normal skin color; the pale areas are this condition. In lighter individuals, macules may look reddish or tan instead of pale

Back 1

Vitiligo

Front 2

condition in which a somewhat bluish color is visible in the tonails and toes. This condition, especially when slight, may be hard to distinguish from normal skin color

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Cyanosis

Front 3

common superficial fungal infection of the skin, causing hypo- or hyper pigmented, slightly scaly macules on the trunk, neck, and upper arms. They are easier to see in darker skin and may be more obvious after tanning. In lighter skin, macules may look reddish or tan instead of pale

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Tinea Versicolor

Front 4

a slightly by uniformly pigmented macule or patch with a somewhat irregular border, usually 0.5 to 1.5 cm in diameter; benign. Six or more such spots, each with a diameter of >1.5 cm, however, suggest neurofibromatosis

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Cafe-Au-Lait Spot

Front 5

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Erythema

Front 6

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Heliotrope

Front 7

this condition makes the skin diffusely yellow. It is seen most reliably in the sclera. It may also be visible in mucous membranes. Causes include liver disease and hemolysis of red blood cells

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Jaundice

Front 8

the yellowishness palm of this condition is compared with a normally pink palm. This condition does not affect the sclera, which remains white. The cause is a diet high in carrots and other yellow vegetables or fruits. It is not harmful but indicates need for assessing dietary intake

Back 8

Carotenemia

Front 9

Reddish oval ringworm-like papules or plagues

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Pityriasis Rosea

Front 10

Silvery scaly papules or plagues, mainly on the extensor surfaces

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Psoriasis

Front 11

Tan, flat, scaly plaques

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Tinea Versicolor

Front 12

Appears mainly on flexor surfaces

(adult form)

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Atopic Eczema

Front 13

ex. ____ epidermal nevus

(patterns & shapes)

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Linear

Front 14

ex. ______ vesicles of herpes simplex

(patterns & shapes)

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Clustered

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ex. mycosis fungoides (patterns & shapes)

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Geographic

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ex. Tinea corporis

(Patterns & Shapes)

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Serpiginous

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ex. _______ plaque of tinea faciale (ringworm)

(Patterns & Shapes)

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Annular, Arciform

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Flat, nonpalpable lesion with changes in skin color, small flat spot, up to 1.0 cm

ex. Hemangioma & Vitiligo

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Macule

Front 19

flat nonpalpable lesion with changes in skin color

flat spot, 1.0 cm or larger

ex. Cafe-Au-Lait Spot

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Patch

Front 20

(type of macule)

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Hemangioma

Front 21

(type of patch)

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Cafe-Au-Lait Spot

Front 22

(type of macule)

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Vitiligo

Front 23

palpable, elevated lesion 1.0 cm or larger, often formed by coalescence of papules

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Plaque

Front 24

(type of plaque)

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Psoriasis

Front 25

(type of plaque)

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Psoriasis

Front 26

palpable elevated, solid bump up to 1.0 cm

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Papule

Front 27

(type of papule)

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Psoriasis

Front 28

(type of nodule)

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Dermatofibroma

Front 29

palpable, elevated solid knot-like bump larger that 0.5 cm, deeper and firmer than a papule

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Nodule

Front 30

palpable elevated solid nodule filled with expressible material, either liquid or semisolid

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Cyst

Front 31

(type of cyst)

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Epidermal Inclusion Cyst

Front 32

a palpable, elevated, somewhat irregular, relatively transient, superficial area of localized skin edema

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Wheal

Front 33

(type of wheal)

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Urticaria

Front 34

palpable elevation up to 1.0 cm; filled with serous fluid

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Vesicle

Front 35

(type of vesicle)

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Herpes Simplex

Front 36

(type of vesicle)

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Herpes Zoster

Front 37

palpable elevation 1.0 cm or larger; filled with serous fluid

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Bulla

Front 38

(type of bulla)

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Insect Bite

Front 39

(type of bulla)

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Insect Bite

Front 40

palpable elevation filled with pus (yellow proteinaceous fluid filled with neutrophils)

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Pustule

Front 41

(type of pustule)

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Acne

Front 42

(type of pustule)

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Small Pox

Front 43

a palpable, elevated, minute, slightly raised tunnel in the epidermis, commonly found on the finger webs and on the sides of the fingers. It looks like a short (5-15 mm), linear ir curved gray line and may end in a tiny vesicle. Skin lesions include small papules, pustules, lichenified areas, and excoriations. With a magnifying lens, look for the _____ of the mite that causes scabies.

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Burrow (scabies)

Front 44

(type of burrow)

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Scabies

Front 45

a thin flake of dead exfoliated epidermis

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Scale

Front 46

(type of scale)

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Icthyosis Vulgaris

Front 47

(type of scale)

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Dry Skin

Front 48

the dried residue of skin exudates such as serum, pus, or blood

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Crust

Front 49

(type of crust)

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Impetigo

Front 50

visible and palpable thickening of the epidermis and roughening of the skin with increased visibility of the normal skin furrows (often from chronic rubbing)

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Lichenification

Front 51

(type of Lichenification)

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Neurodermatitis

Front 52

increased connective tissue that arises from injury or disease

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Scars

Front 53

(type of scar)

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Hypertrophic Scar from Steroid Injections

Front 54

hypertrophic scarring that extends beyond the borders of the initiating injury

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Keloids

Front 55

(type of ____)

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Keloid on the ear lobe

Front 56

nonscarring loss of the superficial epidermis; surface is moist but does not bleed

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Erosion

Front 57

(example of erosion)

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Aphthous stomatitis

Front 58

linear or punctate erosions caused by scratching

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Excoriation

Front 59

(example of excoriation)

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Cat Scratches

Front 60

A linear crack in the skin, often resulting from excessive dryness

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Fissure

Front 61

(example of a fissure)

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Athlete's Foot

Front 62

a deeper loss of epidermis and dermis; may bleed and scar

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Ulcer

Front 63

(type of ulcer)

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Syphilitic chancre

Front 64

disorder that affects 85% of adolescents in the U.S. Disorder of the pilosebacceous unit that involves proliferation of the keratinocytes at the opening of the follicle; increased production of sebum, stimulated by androgens, which combines with keratinocytes to plug the follicular opening. Lesions appear in areas with the greatest number of sebacceous glands, namely the face, neck, chest, upper back, and upper arms.

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Acne vulgaris

Front 65

(type of primary lesion)

open and closed comedones, occasional papules

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Mild Acne

Front 66

(type of primary lesion) comedones, papules, pustules

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Moderate Acne

Front 67

(type of primary lesions)

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Severe Cystic Acne

Front 68

(type of seconary lesions)

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Acne with Pitting and Scars

Front 69

Color & Size: Fiery red. From very small to 2 cm

Shape: Central body, sometimes raised, surrounded by erythema and radiating legs

Pulsating & Effect of Pressure: Often seen in center of the spider, when pressure with a glass slide is applied. Pressure on the body causes blanching of the spider

Distribution: Face, neck, arms, and upper trunk; almost never below the neck

Significance: Liver disease, pregnancy, vitamin B deficiency; also occurs normally in some people

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Spider Angioma

Front 70

Color & Size: Bluish. size variable, from very small to several inches

Shape: Variable. May resemble a spider or be linear, irregular, cascading

Pulsatility and Effect of Pressure: Absent. Pressure over the center doesn't cause blanching, but diffuse pressure blanches the veins

Distribution: Most often on the legs, near veins; also on the anterior chest

Back 70

Spider Vein

Front 71

Color & Size: bright or ruby red; may become purplish with age. 1-3 mm

Shape: Round, flat or sometimes raised, may be surrounded by a pale halo

Pulsatility and Effect of Pressure: Absent. May show partial blanching, especially if pressure applied with edge of pinpoint

Distribution: Trunk; also extremeties

Significance: None; increases in size and numbers with aging

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Cherry Angioma

Front 72

Color & Size: Deep red or reddish purple, fading away over time. Petechia, 1-3 mm; purpura are larger

Shape: Rounded, sometimes irregular; flat

Pulsatility and Effect of Pressure: Absent

Distribution: Variable

Significance: Blood outside the vessels; may suggest a bleeding disorder or, if petechiae, emboli to skin; palpable purpura in vasculitis

Back 72

Petechia/ Purpura

Front 73

Color & Size: Purple or purplish blue, fading to green, yellow, and brown with time. Variable in size, larger than petechiae, >3 mm

Shape: Rounded, oval, or irregular; may have a central subcutaneous flat nodule (a hematoma)

Pulsatility and Effect of Pressure: Variable

Significance: Blood outside vessels; often secondary to bruising or trauma; also seen in bleeding disorders

Back 73

Ecchymosis

Front 74

superficial, hyperkeratotic papules. Often multiple; can be round or irregular; pink, tan, or grayish. Appear on sun-exposed skin of older, fair-skinned people. Considered to be dysplastic or precancerous; one of every 1,000 per year develop into squamous cell carcinoma. Usually found on the face and hands

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Actinic Keratosis

Front 75

common, benign, whitish-yellowish to brown raised papules or plaques that feel slightly greasy and velvety or warty and have a "stuck on" appearance. Typically multiple and symmetrically distributed on the trunk of older people, but may also appear on the face and elsewhere. In black people, often in younger women, may appear as small, deeply pigmented papules on the cheeks and temples

Back 75

Seborrheic Keratosis

Front 76

Though malignant, grows slowly and almost never metastasizes. It is common in fair-skinned adults 40 years or older, and usually appears on the face. An initial red macule or papule may develop a depressed center and a firm, elevated border. Telangiectatic vessels are often visible

Back 76

Basal Cell Carcinoma

Front 77

Usually appears on sun-exposed skin of fair-skinned adults older than 60 years. May develop in an actinic keratosis. Usually grows more quickly than a basal cell carcinoma, is firmer, and looks redder. The face and the dorsum of the hand are often affected, as shown here

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Squamous Cell Carcinoma

Front 78

common mole. usually appears in the first few decades. Several nevi may arise at the same time, but their appearance usually remains unchanged.

Typical Features:

-round or oval shape

-sharply defined borders

-uniform color, especially skin-colored, tan or brown

-diameter <6 mm but >10 mm if congenital

-flat or raised surface

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Benign Nevus

Front 79

Atypical moles that are varied in color but often dark and larger than 6 mm, with irregular borders that fade into the surrounding skin. Found primarily on the trunk. May number more than 50 to 100.

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Atypical (dysplastic) Nevi

Front 80

asymmetric, with irregular borders, variations in color, diameter >6 mm, evolution in size, symptom or morphology

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Malignant Melanoma

Front 81

ABCDE's of Melanoma

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Asymmetry, Borders, Color, Diameter (>6mm), Evolution

Front 82

macules on the dorsum of the hand, wrist, and forearm

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Solar lentigines

Front 83

papules and pustules

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folliculitis from Pseudomonas

Front 84

pustules on the palm

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pustular psoriasis

Front 85

vesicles

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Chickenpox

Front 86

A) Bulla

B) target lesion

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erythema multiforme

Front 87

A) Telangiectasia

B) Nodule

C) Ulcer

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Squamous Cell Carcinoma

Front 88

A) Vesicle

B) Pustule

C)Erosions

D) crust

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Infected Atopic Dermatitis

Front 89

A) Excoriation

B) Lichenification on the leg

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Atopic Dermatitis

Front 90

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Wheals (urticaria)

Front 91

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Psoriasis

Front 92

malignant tumor may appear in many forms: macules,papules, plaques, or nodules almost anywhere on the body. Lesions are often mulitiple and may involve internal structures.

Back 92

Kaposi's sarcoma in AIDS

Front 93

combination of

A) Patch

B) Nodules

Back 93

Neurofibromatosis

Front 94

presence of reddened area that fails to blanche with pressure, and changes in temperature (warmth or coolness), consistency (firm or boggy), sensation (pain or itching), or color (red, blue, or purple on darker skin; red on lighter skin)

Back 94

Stage 1 Pressure Ulcer

Front 95

The skin forms a blister or sore. Partial thickness skin loss or ulceration involving the epidermis, dermis, or both

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Stage 2 Pressure Ulcer

Front 96

a crater appears in the skin, with full-thickness skin loss and damage to or necrosis of subcutaneous tissue that may extend to, but not through, underlying muscle

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Stage 3 Pressure Ulcer

Front 97

Full-thickness skin loss, with destruction, tissue necrosis, or damage to underlying muscle, bone, and sometimes tendons and joints

Back 97

Stage 4 Pressure Ulcer

Front 98

clearly demarcated round or oval patches of hair loss, usually affecting young adults and children. no visible scaling or inflammation

Back 98

Alopecia Areata

Front 99

Hair loss from pulling, plucking, or twisting hair. Hair shafts are broken and of varying lengths. More common in children, often in settings of family or psychosocial stress

Back 99

Trichotillomania (Trichotillosis)

Front 100

Round scaling patches of alopecia. Hairs are broken off close to the surface of the scalp. Usually caused by fungal infection from Trichyophyton tonsurans fromm humans, less commonly from microsporum canis from dogs or cats.

Back 100

Tinea Capitis ("Ringworm")

Front 101

superficial infection of the proximal and lateral nail folds adjacent to the nail plate. The nail folds are often red, swollen, and tender. Represents the most common infection of the hand, usually from S. aureus or Strep species. Arises from local trauma due to nail biting, manicuring, or frequent hand immersion in water

Back 101

Paronychia

Front 102

bulbous swelling of the soft tissue at the nail base. Seen in congenital heart disease, interstitial lung disease and lung cancer, inflammatory bowel diseasesm and malignancies

Back 102

Clubbing of the Fingers

Front 103

painless separation of the whitened opaque nail plate from the pinker translucent nail bed. Local causes include excess manicuring, psoriasis, fungal infection, and allergic reactions to nail cosmetics. Systemic causes include diabetes, anemia, photosensitive drug reactions, hyperthyroidism, peripheral ischemia, bronchiectasis, and syphilis

Back 103

Onycholysis

Front 104

nail plate turns white with a ground-glass appearance, a distal band of reddish brown, and obliteration of the lunula. Commonly affects all fingers, although may appear in only on finger. Seen in liver disease, usually cirrhosis, heart failure, and diabetes. May arise from decreased vascularity and increased connective tissue in nail bed

Back 104

Terry's Nails

Front 105

trauma to the nails is commonly followed by nonuniform white spots that grow slowly out with the nail. Spots in the pattern illustrated are typical of overly vigorous and repeated manicuring

Back 105

Leukonychia (white spots)

Front 106

curving, transverse white bands that cross the nail parallel to the lunula. Arising from the disrupted matrix of the proximal nail, they vary in width and move distally as the nail grows out. Seen in arsenic poisoning, heart failure, Hodgkin's disease, chemotherapy, carbon monoxide poisoning, and leprosy

Back 106

Mees' Lines (Transverse White Bands)

Front 107

transverse depressions of the nail plates, usually bilateral, resulting from temporary disruption of proximal nail growth from systemic illness. Seen in severe illness, trauma, and cold exposure if Raynaud's disease is present

Back 107

Beau's Lines (Transverse Linear Depressions)

Front 108

Punctate depressions of the nail plate caused by defective layering of the superficial nail plate by the proximal nail matrix. Usually associated with psoriasis but also seen in Reiter's syndrome, sarcoidosis, alopecia areata, and localized atopic or chemical dermatitis

Back 108

Pitting