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143 Cards in this Set
- Front
- Back
- 3rd side (hint)
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What are the 5 types of pigmented nevi (moles)?
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1. Halo nevus
2. Intradermal nevus 3. Junction nevus 4. Compound nevus 5. Hairy nevus |
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What are the features of a halo nevus? Where does it usually occur?
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-Sharp, oval or circular depigmented halo around a mole
-Usually on back in young adult |
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Features of a Intradermal nevus? Occurrence?
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-Dome shaped, raised, flesh to black color, may be pedunculated or hair bearing
-Cells limited to dermis |
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Features of a Junction nevus?
Occurrence? |
-Flat or slightly elevated, dark brown
-Nevus cells lining dermoepidermal junction |
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Features of Compound nevus? Occurrence?
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-Slightly elevated brownish papulae; indistinct border
-Nevus cells in dermis and lining dermoepidermal junction |
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Features of Hairy nevus?
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May be present at birth, may cover larger area; hair growth may occur after several years
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What are typical features of normal moles?
-Color -Shape -Size -Number -Location |
-Uniformly tan or brown; all moles look alike on same person
-Round/oval clear border -Smooth flat spot or bump -Less than 6 mm -10 to 40 moles scattered over body -Above waist on sun exposed body surfaces |
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What are typical features of dysplastic moles?
-Color -Shape -Size -Number -Location |
-Mixture of different colored moles that don't look alike
-Irregular borders may include notches; fade into surrounding skin and include a flat portion -Smooth, slightly scaly or rough pebbly appearance -Larger than 6 mm -May or may not have increased number -Anywhere on body, most commonly on back; may also appear below waist on scalp, breast and buttocks |
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Brown cutaneous color change
-Cause? -Conditions leading to generalized and localized distributions? |
Cause: Darkening of melanin pigment
Generalized: Pituitary, adrenal, liver disease Localized: Nevi, neurofibromatosis |
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White cutaneous color change
-Cause? -Generalized and localized conditions? |
Cause: Absence of melanin
Generalized: Albinism Localized: Vitiligo |
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Red cutaneous color change
-Causes (2)? -Generalized and localized conditions? |
Causes: Increased cutaneous blood flow or increased intravascular red blood cells
Localized: Inflammation Generalized: Fever, viral exanthem, uticaria, polycythemia |
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Yellow cutaneous color change
-2 generalized causes? -Generalized conditions for each cause? Which cause affects sclera? |
Causes: Increased bile pigmentation (jaundice) or increased carotene pigmentation
Conditions for jaunice: Liver disease. Conditions for carotene pigmentation: Hypothyroidism, increased intake of vegetables with carotene. Jaundice will affect sclera, carotene pigmentation will not |
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Blue cutaneous color change
-Cause? -Distribution? -2 conditions? |
Cause: Increased unsaturated hemoglobin secondary to hypoxia
Distribution: Lips, mouth, nail beds Conditions: Cardiovascular and pulmonary disease |
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Purpura
-Description -Causes (2) |
Red-purple nonblanchable discoloration greater than 0.5 cm diameter
Cause: Intravascular defects, infection |
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Petechia
-Description -Causes (2) |
Red-purple nonblanchable discoloration less than 0.5 cm diameter
Causes: Intravascular defects and infection |
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Ecchymoses
-Description -Cause (3) |
Red-purple, nonblanchable, variable size
Causes: Vascular wall destruction, trauma, vasculitis |
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Spider angioma
-Description -Cause (3) |
Red central body with radiating spiderlike legs that blanch with pressure to central body
Causes: Liver disease, vitamin B deficiency, idiopathic |
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Venous star
-Description -Cause (1) |
Bluish spider, linear or irregularly shaped, does not blanch with pressure
Cause: Increased pressure in superficial veins |
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Telangiectasia
-Description -Cause (1) |
Fine, irregular red line
Cause: Dilation of capillaries |
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Capillary hemangioma
-Description -Cause (1) |
Red irregular macular patches
Cause: Dilation of dermal capillaries |
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Rotten apples odor
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Clostridium gas gangrene
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Mousy odor
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Proteus infection
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Grapelike odor
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Pseudomonas infection (especially burns)
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Pungent odor
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Schizophrenia
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Stale beer
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Tuberculous lymphadenitis (scrofula)
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Putrid odor
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Anaerobic infection; scurvy
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Feculent odor
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Intestinal obstruction, peritonitis
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Mousy, musty odor
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Phenylketonuria
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Macule description
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Flat, circumscribed area that is a different color, less than 1 cm in diameter
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Papule description
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Elevated, firm, circumscribed area; less than 1 cm in diameter
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Patch description
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Flat, nonpalpable, irregular shaped macule greater than 1 cm in diameter
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Plaque
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Elevated firm, and rough lesion with flat top surface greater than 1 cm in diameter
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Wheal
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Elevated, irregular shaped area of cutaneous edema; solid, transient, variable diameter
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Nodule
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Elevated, firm, circumscribed lesion; deeper in dermis than a papule; 1 to 2 cm in diameter
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Tumor
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Elevated and solid lesion; may or may not be clearly demarcated; deeper in dermis; greater than 2 cm in diameter
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Vesicle
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Elevated, circumscribed, superficial, not into dermis; filled with serous fluid, less than 1 cm in diameter
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Bulla
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Vesicle greater than 1 cm in diameter
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Pustule
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Elevated, superficial lesion; similar to a vesicle but filled with purulent fluid
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Cyst
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Elevated, circumscribed, encapsulated lesion; in dermis or subcutaneous layer; filled with liquid or semisolid material
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Telangiectasia
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Fine, irregular, red lines produced by capillary dilation
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SECONDARY LESIONS
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Result from later evolution of or external trauma to a primary lesion
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Scale
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Heaped-up, keratinized cells; flaky skin; irregular; thick or thin; dry or oily; variation in size
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Lichenification
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Rough, thickened epidermis secondary to persistent rubbing, itching, or skin irritation; often involves flexor surface of extremity
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Keloid
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Irregular-shaped, elevated, progressively enlarging scar; grows beyond the boundaries of the wound; caused by excessive collagen formation during healing
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Scar
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Thin to thick fibrous tissue that replaces normal skin following injury or laceration to the dermis
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Excoriation
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Loss of the epidermis; linear hollowed out, crusted area
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Fissure
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Linear crack or break from the epidermis to the dermis; may be moist or dry
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Erosion
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Loss of part of the epidermis; depressed, moist, glistening; follows rupture of a vesicle or bulla
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Ulcer
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Loss of epidermis and dermis; concave; varies in size
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Crust
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Dried serum, blood, or purulent exudates; slightly elevated; size varies; brown, red, black, tan, or straw-colored
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Atrophy
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Thinning of skin surface and loss of skin markings; skin translucent and paper-like
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MORPHOLOGIC CHARACTERISTICS OF SKIN LESIONS
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Distribution
Shape/Arrangement Border/Margin Associated Changes w/in Lesion Pigmentation |
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3 types of skin lesion distributions and their descriptions
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1. Localized: Lesion appears in one small area
2. Regional: Involves a specific region of the body 3. Generalized: Widely distributed or in numerous areas simultaneously |
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Shape/Arrangement
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Round/discoid
Oval Annular Zosteriform Polycyclic Linear Iris/target lesion Stellate Serpinginous Reticulate Morbilliform |
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Round/discoid
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Coin shaped (no central clearing)
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Nummular eczema
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Oval
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Ovoid Shape
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Pityriasis rosea
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Annular
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Round, active margins w central clearing
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Tinea corporis, sarcoidosis
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Zosteriform (dermatomal)
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Following a nerve or segment of the body
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Herpes zoster
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Polycyclic
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Interlocking or coalesced circles (formed by enlargement of annular lesion)
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Psoriases, uticaria
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Linear
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In a line
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Contact dermatitis
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Iris/target lesion
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Pink macules with purple central papules
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Erythema, multiforme
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Stellate
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Star shaped
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Meningococcal septicemia
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Serpiginous
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Snakelike or wavy like track
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Cutanea larva migrans
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Retciulate
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Netlike or lacy
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Polyarteritis nodosa, lichen planus lesions of erythema infectiosum
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Morbilliform
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Measles like: maculopapular lesions that become confluent on the face or body
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Measles, roseola, drug eruption
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Border/Margin
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Discrete
Indistinct Active Irregular Border raised above Advancing |
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Discrete
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Well demarcated or defined, able to draw a line around it with confidence
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Psoriasis
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Indistinct
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Poorly defined, have borders that merge into normal skin or outlying ill-defined papules
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Nummular eczema
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Active
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Margine of lesion shows greater activity than center
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Tinea eruptions
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Irregular
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Non-smooth or notched margin
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Malignant melanoma
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Border raised above
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Center of lesion is depressed compared ot the edge
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Basal cell carcinoma center
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Advancing
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Expanding at margins
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Cellulitis
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Associated changes w/in lesions
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Central clearing
Desquamation Keratotic Punctation Telangiectasias |
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Central clearing
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An erythematous border surrounds lighter skin
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Tinea eruptions
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Desquamation
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Peeling or slouthing of skin
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Rash of toxic shock system
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Keratotic
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Hypertrophic stratum corneum
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Punctation
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Central umbilication or dimpling
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Telangiectasias
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Dilated blood vessels within lesion blanch completely, may be markers of systemic disease
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Pigmentation
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Flesh
Pink Erythematous Salmon Tan-brown Black Pearly Purple Violaceous Yellow White |
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Flesh
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Same tone as surrounding skin
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Neruofibroma, some nevi
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Pink
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Light red undertones
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Eczema, pityriasis rosea
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Erythematous
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Dark pink to red
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Tinea eruptions, psoriasis
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Salmon
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Orange=pink
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Psoriasis
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Tan-brown
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Light to dark brown
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Most nevi, pityriasis versicolor
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Black
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Black for blue-black
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Malignant melanoma
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Pearly
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Shiny white, almost iridescent
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basal cell carcinoma
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Purple
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Dark red-blue-violet
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Purpura, Kaposi sarcoma
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Violaceous
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Light violet
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Erysipelas
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Yellow
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Waxy
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Lipoma
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White
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Absent of color
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Lichen planus
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4 lesions in sun exposed areas
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1. Sunburn
2. Lupus erythematosus 3. Viral exathem 4. Porphyria |
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2 lesions in clothed areas
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1. Contact dermatitis
2. Miliaria |
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4 lesions in flexor aspects of extremities
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1. Atopic dermatitis
2. Intertrigo 3. Candidiasis 4. Tina cruris |
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Lesion in extensor aspect of extremities
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Psoriasis
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3 lesions in stocking/glove areas
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1. Viral exanthem/atopic dermatitis
2. Tinea pedis 3. Poststreptococcal infection |
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3 lesions in truncal area
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1. Pityriasis rosea
2. Atopic dermatitis 3. Drug reaction |
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3 lesions in face, shoulder, and back
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1. Acne vulgaris
2. Drug-induced acne 3. Cushing syndrome |
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Vellus hair is ________.
Distribution? |
Fine
Covers the body |
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Terminal hair is ________.
Distribution? |
Coarse
Covers scalp, pubic, axillary areas, arms/legs, and beards |
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Yellow nail discoloration (3)
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Psoriasis
Fungal infection Chronic respiratory distress |
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Proximal subungual fungal infection (1)
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HIV infection
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Diffuse darkening of nail (4)
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Antimalarial drug therapy
Candidal infection Hyperbilirubinemia Chronic trauma |
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Green-black nail discoloration
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Pseudomonas infection
-painless |
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Generalized (multiple) blue nails
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Cyanosis
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White spots on nails
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Cuticle manipulation (mild trauma)
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Longitudinal white streaks/transverse white bands
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Systemic disorder
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Single nail distress?
Multiple nail distress? |
Injury
Systemic disease |
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Clubbing is associated with what 2 kinds of disease?
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Respiratory and cardiovascular
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3 causes of thickening of nails
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Tight fitting shoes
Chronic trauma Fungal infection |
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5 causes for separation of nail plate from nail bed
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1. Psoriasis
2. Trauma 3. Candidal infection 4. Pseudomonas infection 5. Medication |
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Jaundice is a result of?
How long may it persist in a newborn? Where should the physician check? |
Hyperbilirubinemia secondary to liver disease or infection
May persist for 3-4 weeks Check oral mucosa and sclera |
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EXPECTED COLOR CHANGES IN NEWBORNS
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Pg. 178
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Acrocyanosis
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Cyanosis of hands and feet
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Cutis marmorata
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Transient mottling is exposed to decreased temperature
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Erythema toxicum
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Pink papular rash with vesicles superimposed on thorax, back, buttocks and abdomen. Appears 24-48 hrs and resolves after several days
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Mongolian spots
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Irregular areas of deep blue pigmentation. Usually in sacral and gluteal regions
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Salmon patches (Stork bites)
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Flat, deep, pink localized areas usually seen on the mid-forehead, eyelids, upper lip and back of neck
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SKIN LESIONS: EXTERNAL CUES TO INTERNAL PROBLEMS
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PG. 179
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Faun tail nevus
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Tuft of hair overlying spinal column at birth. Usually in lumbosacral area.
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Spina bifida occulta
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Epidermal verrucous nevi
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Warty lesions in a linear or whorled pattern that maybe pigmented or skin colored.
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Skeletal, central nervous system, and ocular abnormalities
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Cafe au lait macules
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Flat, evenly pigmented spiots varying from light to dark brown color Larger than 5 mm in diamter
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Neurofibromatosis
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Freckling in axillary or inguinal area
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Multiple flat pigment macules
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Neurofibromatosis
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Ash leaf macule
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White macules
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Tuberous sclerosis
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Facial port-wine stain associations (2)
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Opthalmic division of trigeminal nerve is associated with ocular defects or angiomatous malformation of the meninges
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Limb/trunk port-wine stain association
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Orthopedic problems
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Congenital lymphedema with or w/o transient hemangiomas association
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Gonadal dysgenesis (defective development)
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Hair collar sign
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Ring of long, dark coarse hair surrounding a midline scalp nodule in infants
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Neural tube closure defect of the scalp
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Transient puffiness in a newborn should disappear after how long?
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2-3 days
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What is mottling?
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Discolored, uneven patches/spots
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Criteria for diagnosing neurofibromatosis in prepubescent?
After puberty? |
6 or more cafe au lait macules more than 5 mm in greatest diameter
6 or more cafe au lait macules more than 15 mm in greatest diameter |
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What are milia?
When are they found? |
Small whitish, discrete papules on the face
First 2-3 months of life |
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Turgor in children is a good indicator of ?
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Hydration and nutrition
-skin will tent if neglected in either of these regards |
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What glands function in newborns?
What glands mature in adolescents? |
Sebaceous
Apocrine |
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What are decubitus ulcers?
What contributes to their association to older adults? |
Pressure sores
Immobility and decreased peripheral vascular circulation |
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Skin of older adults usually appears?
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More transparent, paler
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What is purpura?
Where is commonly found? What contributes to it? |
Purple blood hemmorhage lying under skin
Dorsal surfaces of hands and lower arm Seen in older adults on aspirin therapy |
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TYPES OF LESIONS THAT OCCUR IN HEALTHY OLDER ADULTS
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PG. 185
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Cherry angiomas
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Tiny, bright red, round papules that may become brown with time
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Seborrheic keratoses
Location? Must be distinguished from? |
Pigmented, raised, warty lesions, appearing on the face or trunk.
Must be distinguished from actinic keratoses |
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Sebaceous hyperplasia
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Yellow, flattened papule with central depression
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Cutaneous tags (acrochordon)
Location? |
Small, soft tags of skin, pedunculated
Appear on neck and upper chest |
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Cutaneous horns
Location? |
Small, hard projections of the epidermis
Forehead and face |
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Solar lentigines
Location? |
Irregular, round, gray-brown macules with a rough surface
Sun exposed areas |
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