Cle206 Bates Ch 6

Front 1

A widespread increase in melanin may be caused by _____ disease (hypofunction of the adrenal cortex) or some pituitary tumors. More common are local areas of increased or decreased pigment.

Back 1

Addison's

Front 2

A slightly but 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 (p. 188). (The small, darker macules are unrelated.)

Back 2

Café-Au-Lait Spot

Front 3

Common superficial fungal infection of the skin, causing hypopigmented, slightly scaly macules on the trunk, neck, and upper arms (short-sleeved shirt distribution). They are easier to see in darker skin and in some are more obvious after tanning. In lighter skin, macules may look reddish or tan instead of pale.

Back 3

Tinea Versicolor

Front 4

Unlike jaundice, _____ does not affect the sclera, which remains white. It is not harmful but indicates the need for assessing dietary intake.

Back 4

Carotenemia

Front 5

Erythema, is also known as what?

Back 5

Red hue, increased blood flow, seen here as the “slapped cheeks” of erythema infectiosum (“fifth disease”).

Front 6

Violaceous eruption over the eyelids in the collagen vascular disease dermatomyositis.

Back 6

Heliotrope

Front 7

Heliotrope

Back 7

Violaceous eruption over the eyelids in the collagen vascular disease dermatomyositis.

Front 8

Reddish oval ringworm-like lesions

Back 8

Pityriasis Rosea

Front 9

Silvery scaly lesions, mainly on the extensor surfaces

Back 9

Psoriasis

Front 10

Tan, flat, scaly lesions

Back 10

Tinea Versicolor

Front 11

Atopic Eczema (adult form) Appears mainly on ____ surfaces

Back 11

flexor

Front 12

Small flat spot, up to 1.0 cm

Back 12

Macule

Front 13

Flat spot, 1.0 cm or larger

Back 13

Patch

Front 14

Elevated superficial lesion 1.0 cm or larger, often formed by coalescence of papules

Back 14

Plaque

Front 15

elevated Up to 1.0 cm

Back 15

Papule

Front 16

Marble-like lesion larger than 0.5 cm, often deeper and firmer than a papule

Back 16

Nodule

Front 17

Nodule filled with expressible material, either liquid or semisolid

Back 17

Cyst

Front 18

A somewhat irregular, relatively transient, superficial area of localized skin edema

Back 18

Wheal

Front 20

Up to 1.0 cm; filled with serous fluid

Back 20

Vesicle

Front 21

1.0 cm or larger; filled with serous fluid

Back 21

Bulla

Front 22

Filled with pus

Back 22

Pustule

Front 23

A 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 or curved gray line and may end in a tiny vesicle. Skin lesions include small papules, pustules, lichenified areas, and excoriations.

Back 23

Burrow (scabies)

Front 24

mycosis fungoides has what pattern/shape?

Back 24

geographic

Front 25

tinea corporis has what pattern/shape?

Back 25

serpignious

Front 26

tinea faciale has what pattern/shape?

Back 26

annular

Front 27

herpes zoster can present as what type of lesion?

Back 27

many, but vesicles, (similar to herpes simplex).

Front 28

hemiangioma is what type of lesion?

Back 28

macule

Front 29

café au lait spot is what type of lesion?

Back 29

patch

Front 30

psoriasis is what type of lesion?

Back 30

Plaque, or papule

Front 31

dermatofibroma is what type of lesion?

Back 31

nodule

Front 32

utricaria is what type of lesion?

Back 32

wheal

Front 33

A thin flake of dead exfoliated epidermis.

Back 33

Scale

Front 34

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

Back 34

Crust

Front 35

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

Back 35

Lichenification

Front 36

Connective tissue that arises from injury or disease

Back 36

Scars

Front 37

Hypertrophic scarring that extends beyond the borders of the initiating injury

Back 37

Keloids

Front 38

ichthyosis vulgaris has what type of lesion?

Back 38

scale

Front 39

dry skin has what type of lesion?

Back 39

scale

Front 40

impetigo has what type of lesion?

Back 40

crust

Front 41

neurodermatitis has what type of lesion?

Back 41

Lichenification

Front 42

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

Back 42

Erosion

Front 43

Aphthous stomatitis, moist area after the rupture of a vesicle, as in chickenpox, is an example of what type of lesion?

Back 43

erosion

Front 44

Linear or punctate erosions caused by scratching

Back 44

Excoriation

Front 45

Cat scratches are an example of what type of lesion?

Back 45

Excoriation

Front 46

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

Back 46

Fissure

Front 47

Athlete's foot presents with what type of lesion?

Back 47

Fissure

Front 48

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

Back 48

Ulcer

Front 49

of venous insufficiency, or syphilitic chancre both have what type of lesion?

Back 49

Ulcer

Front 50

Acne is a disorder of the _____ follicle.

Back 50

pilosebaceous

Front 51

what involves 1) proliferation of the keratinocytes at the opening of the follicle; 2) increased production of sebum, stimulated by androgens, which combines with keratinocytes to plug the follicular opening; 3) growth of Propionibacterium acnes, an anaerobic diphtheroid normally found on the skin; 4) and inflammation from bacterial activity and release of free fatty acids and enzymes from activated neutrophils.

Back 51

acne

Front 52

which bacteria is involved with skin acne?

Back 52

Propionibacterium acnes, an anaerobic diphtheroid normally found on the skin

Front 53

acne Lesions appear in areas with the greatest number of ______ glands, namely the face, neck, chest, upper back, and upper arms. They may be primary, secondary, or mixed.

Back 53

sebaceous

Front 54

Match the vascular lesion with the description. Color and Size: Fiery red. From very small to 2 cm

Back 54

Spider Angioma*

Front 55

Match the vascular lesion with the description. Color and Size: Bluish. Size variable, from very small to several inches

Back 55

Spider Vein*

Front 56

Match the vascular lesion with the description. Color and Size: Bright or ruby red; may become brownish with age. 1-3 mm

Back 56

Cherry Angioma

Front 57

Match the vascular lesion with the description. Shape: Central body, sometimes raised, surrounded by erythema and radiating legs

Back 57

Spider Angioma*

Front 58

Match the vascular lesion with the description. Shape: Variable. May resemble a spider or be linear, irregular, cascading

Back 58

Spider Vein*

Front 59

Match the vascular lesion with the description. Shape: Round, flat or sometimes raised, may be surrounded by a pale halo

Back 59

Cherry Angioma

Front 60

Match the vascular lesion with the description. Pulsatility and 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.

Back 60

Spider Angioma*

Front 61

Match the vascular lesion with the description. Pulsatility and Effect of Pressure: Absent. Pressure over the center does not cause blanching, but diffuse pressure blanches the veins.

Back 61

Spider Vein*

Front 62

Match the vascular lesion with the description. Pulsatility and Effect of Pressure: Absent. May show partial blanching, especially if pressure applied with edge of a pinpoint

Back 62

Cherry Angioma

Front 63

Match the vascular lesion with the description. Distribution: Face, neck, arms, and upper trunk; almost never below the waist

Back 63

Spider Angioma*

Front 64

Match the vascular lesion with the description. Distribution: Most often on the legs, near veins; also on the anterior chest

Back 64

Spider Vein*

Front 65

Match the vascular lesion with the description. Distribution: Trunk; also extremities

Back 65

Cherry Angioma

Front 66

Match the vascular lesion with the description. Significance: Liver disease, pregnancy, vitamin B deficiency; also occurs normally in some people

Back 66

Spider Angioma*

Front 67

Match the vascular lesion with the description. Significance: Often accompanies increased pressure in the superficial veins, as in varicose veins

Back 67

Spider Vein*

Front 68

Match the vascular lesion with the description. Significance: None; increases in size and numbers with aging

Back 68

Cherry Angioma

Front 69

Match the purpric lesion with the description. Color and Size: Deep red or reddish purple, fading away over time. Petechia, 1-3 mm; purpura, larger

Back 69

Petechia/Purpura

Front 70

Match the purpric lesion with the description. Color and Size: Purple or purplish blue, fading to green, yellow, and brown with time. Variable size, larger than petechiae, >3 mm

Back 70

Ecchymosis

Front 71

Match the purpric lesion with the description. Shape: Rounded, sometimes irregular; flat

Back 71

Petechia/Purpura

Front 72

Match the purpric lesion with the description. Shape: Rounded, oval, or irregular; may have a central subcutaneous flat nodule (a hematoma)

Back 72

Ecchymosis

Front 73

Of the three listed vascular lesions, which one is not a telangiectasis? Spider Angioma, Vein, and Cherry Angioma

Back 73

Cherry Angioma. The spider vein and angiom are dilated small vessels that look red or bluish.

Front 74

Match the purpric lesion with the description. Significance: Blood outside the vessels; may suggest a bleeding disorder or, if petechiae, emboli to skin; palpable purpura in vasculitis

Back 74

Petechia/Purpura

Front 75

Match the purpric lesion with the description. Significance: Blood outside the vessels; often secondary to bruising or trauma; also seen in bleeding disorders

Back 75

Ecchymosis

Front 76

Superficial, flattened papules covered by a dry scale. Often multiple; can be round or irregular; pink, tan, or grayish. Appear on sun-exposed skin of older, fair-skinned people. Though benign, 1 of every 1000 per year develop into squamous cell carcinoma (suggested by rapid growth, induration, redness at the base, and ulceration). Keratoses on face and hand, typical locations, are shown.

Back 76

Actinic Keratosis

Front 77

Common, benign, yellowish to brown raised lesions 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 younger women, may appear as small, deeply pigmented papules on the cheeks and temples (dermatosis papulosa nigra).

Back 77

Seborrheic Keratosis

Front 78

though malignant, grows slowly and seldom metastasizes. It is most common in fair-skinned adults 40 years or older, and usually appears on the face. An initial translucent nodule spreads, leaving a depressed center and a firm, elevated border. Telangiectatic vessels are often visible.

Back 78

Basal Cell Carcinoma

Front 79

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 back of the hand are often affected, as shown here.

Back 79

Squamous Cell Carcinoma

Front 80

Benign Nevus

Front 81

Benign Nevus, common mole, usually appears in the first few decades. Several nevi may arise at the same time, but their appearance usually remains unchanged. What are the typical features that contrast them with those of atypical nevi and melanoma?

Back 81

1. round or oval shape, 2. sharply defined borders, 3, uniform color especially tan or brown, 4, diameter <6mm, 5. flat or raised surface.

Front 82

What are the ABCD's for a malignant melanoma?

Back 82

Asymmetry, Borders Irregular, Color varation, Diameter greather than 6 mm

Front 83

hot tub folliculitis from Pseudomonas manifests as what type of lesion?

Back 83

Papules and pustules

Front 84

actinic lentigines manifests as what type of lesion?

Back 84

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

Front 85

(A) Patch (café-au-lait spots), (B) nodules—a combination typical of _______.

Back 85

neurofibromatosis

Front 86

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

Back 86

Kaposi's sarcoma in AIDS

Front 87

Name the disease that causes the following?: Hyperpigmentation of skin and mucous membranes

Back 87

Addison's disease

Front 88

Name the disease that causes the following?: Hairy leukoplakia, Kaposi's sarcoma, herpes simplex virus (HSV), human papillomavirus (HPV), cytomegalovirus (CMV), molluscum contagiosum, mycobacterial skin infections, candidiasis and other cutaneous fungal infections, oral and anal squamous cell carcinoma, acquired ichthyosis, bacterial abscesses, psoriasis (often severe), erythroderma, seborrheic dermatitis (often severe)

Back 88

AIDS

Front 89

Name the disease that causes the following?: Pallor, xerosis, pruritus, hyperpigmentation, uremic frost, metastatic calcification in the skin, calciphylaxis, “half and half” nails, hemodialysis-related skin disease

Back 89

Chronic renal disease

Front 90

Name the disease that causes the following?: Calcinosis, Raynaud's phenomenon, sclerodactyly, telangiectasias

Back 90

CREST syndrome

Front 91

Name the disease that causes the following?: Erythema nodosum, pyoderma gangrenosum, enterocutaneous fistulas, aphthous ulcers

Back 91

Crohn's disease

Front 92

Name the disease that causes the following?: Striae, skin atrophy, purpura, ecchymoses, telangiectasias, acne, moon facies, buffalo hump, hypertrichosis

Back 92

Cushing's disease

Front 93

Name the disease that causes the following?: Heliotrope rash, Gottron's papules, periungual telangiectasias, alopecia, poikiloderma in sun-exposed areas, Raynaud's phenomenon

Back 93

Dermatomyositis

Front 94

Name the disease that causes the following?: Necrobiosis lipoidica diabeticorum, diabetic bullae, diabetic dermopathy, granuloma annulare, acanthosis nigricans, candidiasis, neuropathic ulcers, eruptive xanthomas, peripheral vascular disease

Back 94

Diabetes

Front 95

Name the disease that causes the following?: Skin necrosis, petechiae, ecchymoses, hemorrhagic bullae, purpura fulminans

Back 95

Disseminated intravascular coagulation

Front 96

Name the disease that causes the following?: Xanthomas (tendon, eruptive, and tuberous), xanthelasma (may occur in healthy people)

Back 96

Dyslipidemias

Front 97

Name the disease that causes the following?: Erythematous macules to hemorrhagic pustules; lesions in acral distribution that can involve palms and soles

Back 97

Gonococcemia

Front 98

Name the disease that causes the following?: Skin bronzing and hyperpigmentation

Back 98

Hemochromatosis

Front 99

Name the disease that causes the following?: Dry, rough, and pale skin; coarse and brittle hair; myxedema; alopecia (lateral third of the eyebrows to diffuse); skin cool to touch; thin and brittle nails

Back 99

Hypothyroidism

Front 100

Name the disease that causes the following?: Warm, moist, soft, and velvety skin; thin and fine hair; alopecia; vitiligo; pretibial myxedema (in Graves' disease); hyperpigmentation (local or generalized)

Back 100

Hyperthyroidism

Front 101

Name the disease that causes the following?: Janeway lesions, Osler nodes, splinter hemorrhages, petechiae

Back 101

Infective endocarditis

Front 102

Name the disease that causes the following?: Mucosal erythema (lips, tongue, and pharynx), strawberry tongue, cherry red lips, polymorphous rash (primarily on trunk), erythema of palms and soles with later desquamation of fingertips

Back 102

Kawasaki disease

Front 103

Name the disease that causes the following?: Jaundice, spider angiomas and other telangiectasias, palmar erythema, Terry's nails, pruritus, purpura, caput medusae

Back 103

Liver disease

Front 104

Name the disease that causes the following?: Pallor, exfoliative erythroderma, nodules, petechiae, ecchymoses, pruritus, vasculitis, pyoderma gangrenosum, bullous diseases

Back 104

Leukemia/lymphoma

Front 105

Name the disease that causes the following?: Pink macules and papules, petechiae, hemorrhagic petechiae, hemorrhagic bullae, purpura fulminans

Back 105

Meningococcemia

Front 106

Name the disease that causes the following?: Neurofibromas, café au lait, freckling in the axillary and inguinal areas, plexiform neurofibroma

Back 106

Neurofibromatoses 1 (von Recklinghausen's syndrome)

Front 107

Name the disease that causes the following?: Grey Turner sign, Cullen's sign, panniculitis

Back 107

Pancreatitis (hemorrhagic)

Front 108

Name the disease that causes the following?: Panniculitis, migratory thrombophlebitis

Back 108

Pancreatic carcinoma

Front 109

Name the disease that causes the following?: Dry, scaly, shiny atrophic skin; dystrophic, brittle toenails; cool skin; hairless shins; ulcers; pallor; cyanosis; gangrene

Back 109

Peripheral vascular disease

Front 110

Name the disease that causes the following?: Melasma, increased pigmentation of areolae, linea nigra, palmar erythema, varicose veins, striae, spider angiomas, hirsutism, pyogenic granuloma

Back 110

Pregnancy (physiologic changes)

Front 111

Name the disease that causes the following?: Psoriasis-like skin and mucous membrane lesions, keratoderma blennorrhagicum, balanitis circinata

Back 111

Reiter's syndrome

Front 112

Name the disease that causes the following?: Vasculitis, Raynaud's phenomenon, rheumatoid nodules, pyoderma gangrenosum, rheumatoid papules, erythematous to salmon-colored rashes

Back 112

Rheumatoid arthritis

Front 113

Name the disease that causes the following?: Erythematous rash that begins on wrists and ankles, then spreads to palms and soles; becomes more purpuric as it generalizes

Back 113

Rocky Mountain spotted fever

Front 114

Name the disease that causes the following?: Thickened, taut, and shiny skin; ulcerations and pitted scars on fingertips; sclerodactyly; telangiectasias; Raynaud's phenomenon

Back 114

Scleroderma

Front 115

Name the disease that causes the following?: Jaundice, leg ulcers (malleolar regions), pallor

Back 115

Sickle cell

Front 116

Name the disease that causes the following?: 1°: Chancre (painless) (see p. 516)

Back 116

Syphilis

Front 117

Name the disease that causes the following?: 2°: Rash (“the great imitator”)—ham- to bronze-colored, generalized, maculopapular rash that involves the palms and soles, pustules, condylomata lata, alopecia (“motheaten”), white plaques on oral and genital mucosa

Back 117

Syphilis

Front 118

Name the disease that causes the following?: 3°: Gummas, granulomas

Back 118

Syphilis

Front 119

Name the disease that causes the following?: Photosensitivity, malar (butterfly) rash, discoid rash, alopecia, vasculitis, oral ulcers, Raynaud's phenomenon

Back 119

Systemic lupus erythematosus

Front 120

Name the disease that causes the following?: Petechiae, ecchymoses

Back 120

Thrombocytopenic purpura

Front 121

Name the disease that causes the following?: Adenoma sebaceum (angiofibromas), ash-leaf spots, shagreen patch, perungual fibromas

Back 121

Tuberous sclerosis

Front 122

Name the disease that causes the following?: Erythema nodosum, pyoderma gangrenosum

Back 122

Ulcerative colitis

Front 123

which virus is responsible for the following?: Oral ulcers; macules, papules, and vesicles on hands, feet, and buttocks

Back 123

Coxsackie A (hand, foot, and mouth)

Front 124

which virus is responsible for the following?: Erythema of cheeks (“slapped cheeks”) followed by erythematous, pruritic, reticulated (net-like) rash that starts on trunk and proximal extremities (rash worsens with sun, fever, and temperature changes)

Back 124

Erythema infectiosum (fifth disease)

Front 125

which virus is responsible for the following?: Erythematous, maculopapular, discrete rash (often fever present) that begins on head and spreads to involve trunk and extremities, petechiae on soft palate

Back 125

Roseola infantum (HSV 6) or Rubella

Front 126

which virus is responsible for the following?: Erythematous, maculopapular, discrete rash (often fever present) that begins on head and spreads to involve trunk and extremities, petechiae on soft palate

Back 126

Rubella (German measles) or Roseola Infantum (HSV 6)

Front 127

which virus is responsible for the following?: Erythematous, maculopapular rash that begins on head and spreads to involve trunk and extremities (lesions become confluent on face and trunk, but are discrete on extremities), Koplik spots on buccal mucosa

Back 127

Rubeola (measles)

Front 128

which virus is responsible for the following?: Generalized, pruritic, vesicular (vesicles on an erythematous base, “dewdrop on a rose petal”) rash begins on trunk and spreads peripherally, lesions appear in crops and are in different stages of healing

Back 128

Varicella (chickenpox)

Front 129

which virus is responsible for the following?: Pruritic, vesicular rash (vesicles on an erythematous base) in a dermatomal distribution

Back 129

Herpes zoster (shingles)

Front 130

_____ usually develop over bony prominences subject to unrelieved pressure, resulting in ischemic damage to underlying tissue. Prevention is important: inspect the skin thoroughly for early warning signs of erythema that blanches with pressure, especially in patients with risk factors.

Back 130

Pressure (decubitus) ulcers

Front 131

___ ___ form most commonly over the sacrum, ischial tuberosities, greater trochanters, and heels.

Back 131

Pressure ulcers

Front 132

The following are risk factors for what? 1. Decreased mobility, especially if accompanied by increased pressure or movement causing friction or shear stress. 2. Decreased sensation, from brain or spinal cord lesions or peripheral nerve disease. 3. Decreased blood flow from hypotension or microvascular disease such as diabetes or atherosclerosis. 4. fecal or urinary incontinence. 5. presence of a fracture. 6. poor nuritional status or low albumin.

Back 132

Pressure ulcers

Front 133

which stage of a pressure ulcer is the following description for?: Pressure-related alteration of intact skin, with 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 133

Stage I

Front 134

which stage of a pressure ulcer is the following description for?: Partial-thickness skin loss or ulceration involving the epidermis, dermis, or both

Back 134

Stage II

Front 135

which stage of a pressure ulcer is the following description for?: Full-thickness skin loss, with damage to or necrosis of subcutaneous tissue that may extend to, but not through, underlying muscle

Back 135

Stage III

Front 136

which stage of a pressure ulcer is the following description for?: Full-thickness skin loss, with destruction, tissue necrosis, or damage to underlying muscle, bone, or supporting structures

Back 136

Stage IV

Front 137

type of hair loss? Clearly demarcated round or oval patches of hair loss, usually affecting young adults and children. There is no visible scaling or inflammation.

Back 137

Alopecia Areata

Front 138

type of hair loss? 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 138

Trichotillomania

Front 139

type of hair loss? Round scaling patches of alopecia. Hairs are broken off close to the surface of the scalp. Usually caused by fungal infection from tinea tonsurans. Mimics seborrheic dermatitis.

Back 139

Tinea Capitis (“Ringworm”)

Front 140

A finidng in or near the nails?: A 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 Staphylococcus aureus or Streptococcus species, and may spread until it completely surrounds the nail plate. Creates a felon if it extends into the pulp space of the finger. Arises from local trauma due to nail biting, manicuring, or frequent hand immersion in water.

Back 140

Paronychia

Front 141

A finidng in or near the nails?: Clinically a bulbous swelling of the soft tissue at the nail base, with loss of the normal angle between the nail and the proximal nail fold. The angle increases to 180° or more, and the nail bed feels spongy or floating. The mechanism is still unknown but involves vasodilatation with increased blood flow to the distal portion of the digits and changes in connective tissue, possibly from hypoxia, changes in innervation, genetics, or a platelet-derived growth factor from fragments of platelet clumps. Seen in congenital heart disease, interstitial lung disease and lung cancer, inflammatory bowel diseases, and malignancies.19

Back 141

Clubbing of the Fingers

Front 142

A finidng in or near the nails?: A painless separation of the whitened opaque nail plate from the pinker translucent nail bed. Starts distally and progresses proximally, enlarging the free edge of the nail. Local causes include trauma from 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 142

Onycholysis

Front 143

A finidng in or near the nails?: 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 one finger. Seen in liver disease, usually cirrhosis, congestive heart failure, and diabetes. May arise from decreased vascularity and increased connective tissue in nail bed.

Back 143

Terry's Nails

Front 144

A finidng in or near the nails?: 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. The curves in this example resemble the curve of the cuticle and proximal nail fold.

Back 144

White Spots (Leukonychia)

Front 145

A finidng in or near the nails?: 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.20

Back 145

Transverse White Bands (Mees' Lines)

Front 146

A finidng in or near the nails?: Transverse depressions of the nail plates, usually bilateral, resulting from temporary disruption of proximal nail growth from systemic illness. As with Mees' lines, timing of the illness may be estimated by measuring the distance from the line to the nail bed (nails grow approximately 1 mm every 6 to 10 days). Seen in severe illness, trauma, and cold exposure if Raynaud's disease is present.20,21

Back 146

Transverse Linear Depressions (Beau's Lines)

Front 147

A finidng in or near the nails?: 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.20

Back 147

Pitting

Front 148

primary or secondary lesions? macule, papule, patch, plaque, vesicle, bulla, pustule, nodule, wheal

Back 148

primary

Front 149

primary or secondary lesions? scale, crust, erosion, ulcer, fissure, atrophy, scar, lichenification

Back 149

secondary

Front 150

what is the term for "hardening or induration"?

Back 150

sclerosis

Front 151

What is the wvaelength for Wood's light?

Back 151

360 nm

Front 152

what solution do you put skin scrapings?

Back 152

KOH

Front 153

Shingles - aka?

Back 153

Herpes zoster (shingles)

Front 154

Erythema multiforme is caused by what?

Back 154

allergic reaction

Front 155

What does the acronym MMRISK stand for?

Back 155

M oles – atypical (dysplastic)
M oles - numerous
R ed hair & freckling
I nability to tan
S unburn – especially in childhood
K indrid – family history

Front 156

What is the most common cancer?

Back 156

basal cell carcinoma

Front 157

parvovirus b19 might cause what skin reaction of the face?

Back 157

slapped cheek disease (5th's disease)

Front 158

lentigines on lips & oral mucosa, usually associated with GI polyps

Back 158

Peutz-Jeghers Syndrome

Front 159

dry scaly lips is seen with what disease?

Back 159

Actinic cheilitis

Front 160

deep fissures in corners of mouth, riboflavin deficiency or overclosure of month is seen in what disease?

Back 160

Angular cheilitis –

Front 161

where might you find Verruca vulgaris?

Back 161

soles, considered a wart

Front 162

where might you find Dermatophytes ?

Back 162

palms and soles, (a fungus)

Front 163

There are about ___ miles of nerves in the adult skin

Back 163

45

Front 164

The largest human organ is the skin, with a surface area of about ___ square feet.

Back 164

25

Front 165

Each square inch of human skin consists of ____ feet of blood vessels.

Back 165

twenty

Front 166

A fingernail or toenail takes about __ months to grow from base to tip.

Back 166

6

Front 167

generalized red flush; widespread miliarial (heat) rash; doesn't feel well

Back 167

mercury poisioning

Front 168

cutis marmorata

Back 168

transient mottling (marks with spots or smear of color) when infant is exposed to decreased temperature

Front 169

erythema toxicum

Back 169

pink papular rash with vesicles superimposed on thorax, back, butt, abdomen; may appear 24-48 hours and resolves after several days; expected color change in infant

Front 170

harlequin color change

Back 170

clearly outlined color change as infant lies on side, dependent half becomes pink and upper half is pale

Front 171

mongolian spots

Back 171

irregular areas of deep blue pigmentation; usually in sacral or gluteal region

Front 172

telangiectatic nevi (stork bites)

Back 172

flat deep pink localized areas on back of neck

Front 173

epidermal verrucous nevi

Back 173

warty lesions in linear or whorled pattern, pigmented or skin color; associated with skeletal, CNS and ocular abnormalities

Front 174

cafe au lait patches

Back 174

flat, evenly pigmented spots varying in color from light brown to black; associated with neurofibromatosis, pulmonary stenosis, temporal lobe dysrhythmia, tuberous sclerosis

Front 175

supernumerary nipples

Back 175

associated with renal abnormalities

Front 176

hair collar sign

Back 176

ring of long dark coarse hair surrounding midline scalp nodule; associated with neural tube closure defects of scalp

Front 177

persistent pruritus

Back 177

may indicated chronic renal failure, cholestatis liver disease, Hodgkin disease, DM

Front 178

vernix caseosa

Back 178

whitish, moist, cheese-like substance that covers newborn infants

Front 179

milia

Back 179

small whitish, discrete papules on the face, sebacceous glands are immature and become clogged

Front 180

Dennie-Morgan fold

Back 180

an extra crease or pleat of skin below the eye due to chronic rubbing and inflammation

Front 181

molluscum fibrosum

Back 181

cutaneous tags that are a result of epithelial hyperplasia

Front 182

skin changes in pregnancy:

Back 182

striae gravidarum; telangiectasis; hemanigomas; cutaneous tags; increase in pigmentation; chloasma (mask of pregnancy)

Front 183

itching in pregnancy can occur due to:

Back 183

stretching of the skin; jaundice; pregnancy-specific dermatosis

Front 184

expected lesions in the older adult:

Back 184

cherry angiomas; seborrheic keratoses; sebaceous hyperplasia; cutaneous tags (acrochordon); cutaneous horns; senile lentigines

Front 185

seborrheic keratoses

Back 185

pigmented, raised, warty lesions; must be distinguished from actinic keratoses which have the potential to be malignant

Front 186

senile lentigines

Back 186

irregular, round, gray-brown lesions with a rough surface; may be called age or liver spots

Front 187

why does the hair turn gray or white?

Back 187

melanocytes stop functioning

Front 188

lentigo

Back 188

brown macule that appears in sun-exposed areas

Front 189

corn

Back 189

flat or slightly elevated; smooth, hard surface; "soft": caused by pressure of bony prominence against softer tissue;"hard": sharply delineated with conical appearance where pressure is exerted

Front 190

callus

Back 190

area of hyperkeratosis, not usually tender

Front 191

eczematous dermatitis

Back 191

epidermal breakdown due to intracellular vesiculation, has 3 stages: acute: erythematous, pruritic weeping vesicles subacute: erythema and scaling chronic: thick lichenified pruritic plaques

Front 192

furnicle

Back 192

acute localized staphylococcal infection; begins as a follicular abscess and spreads to surrounding dermis and subcut tissue, becomes a pustule, may rupture or need surgery

Front 193

folliculities

Back 193

staph infection of hair follicle and surrounding dermis, pustule

Front 194

cellulitis

Back 194

strep or staph infection of skin and subcut tissue; lymphatic streaks and lymphadenopathy may be present

Front 195

tinea

Back 195

noncandidal fungal infection, usually classified according to anatomic location: cruris (groin/thigh), unguium (nails)

Front 196

pityriasis rosea

Back 196

self-limiting inflammation of unknown cause, primary round plaque with scaling with eruption weeks later with a distribution along the ribs giving a Christmas tree pattern, not contagious

Front 197

psoriasis

Back 197

disease of keratin synthesis, dry silvery scaling papules/plaques

Front 198

rosacea

Back 198

chronic inflammatory disorder characterized by telangiectasia, erythema, papules, pustules in central area of the face; tissue hypertrophy of the nose (rhinophyma) may occur, comedomes are never present

Front 199

drug eruptions

Back 199

discrete/confluent erythematous maculopapules, pruritus

Front 200

herpes zoster (shingles)

Back 200

viral infection usually of a single dermatome, red swollen plaques or vesicles filled with purulent fluid. pain in the dermatome can start days before the rash

Front 201

herpes simplex

Back 201

viral infection, tenderness, pain, paresthesia, mild burning

Front 202

cutaneous anthrax

Back 202

spore forming bacterium, pruritic macule or papule that enlarges into an ulcer, central necrosis, associated with lymphangitis and lymphadenopathy

Front 203

smallpox

Back 203

variola virus, direct transmission by infected saliva, most infectious during 1st week, rash first appears on mouth/pharynx/face/forearms and spreads to trunk and legs; starts as flat red lesions that evolve at same rate then become vesicular, pustular and crust

Front 204

basal cell carcinoma

Back 204

most common form of skin cancer, arises in basal layer of epidermis, warning signs include: open sore, reddish patch, shiny nodule, pink growth and scarlike area

Front 205

squamous cell carcinoma

Back 205

second most common skin cancer, arises in the epithelium, soft mobile elevated masses with a surface scale, warning signs: wartlike growth, scaly red patch, open sore, elevated growth with a central depression

Front 206

malignant melanoma

Back 206

skin cancer that develops from melanocytes

Front 207

kaposi sarcoma

Back 207

malignant tumor of endothelium and epithelial layer of skin, soft vascular bluish-purple and painless lesions, macular or papular, opportunistic infection in those with HIV, can have lesions on skin, GI tract, lungs liver lymph nodes bones etc

Front 208

alopecia areata

Back 208

hair shaft is poorly formed and breaks off at the skin surface

Front 209

paronychia

Back 209

inflammation of the paronychium produces redness swelling and tenderness at the lateral and proximal nail folds, purulent drainage

Front 210

tinea unguium

Back 210

fungal infection of the nail, hyperkeratotic debris accumulates in nail plate causing it to turn yellow or white and the nail to separate from the nail bed (onycholysis), nail plate crumbles

Front 211

subungual hematoma

Back 211

caused by trauma to the nail plate causing immediate bleeding and pain

Front 212

leukonychia punctata

Back 212

white spots on the nail due to minor injury or manipulation of the cuticle

Front 213

habit-tic deformity

Back 213

caused by biting or picking the proximal nail fold of the thumb with the index finger, results in horizontal sharp grooving in a band that extends to tip of nail

Front 214

koilonychia (spoon nails)

Back 214

central depression of the nail with lateral elevation of the nail plate that produces a concave curvature and spoon appearance, associated with iron deficiency, syphillis, fungal dermatoses and hypothyroidism

Front 215

beau lines

Back 215

transverse depressions at the base of the lunulae in all the nails, associated with coronary occlusion, hypercalcemia and skin disease, caused by stress that temporarily interrupts nail formation

Front 216

white banding (terry nail)

Back 216

transverse white bands covering the nail except for a narrow zone at the distal tip, associated with cirrhiosis and hypoalbuminemia

Front 217

psoriasis

Back 217

pitting, onycholysis, discoloration and subungual thickening, yellow scaly debris accumulates, can cause splinter hemorrhage

Front 218

warts

Back 218

epidermal neoplasms caused by viral infection, can occur at nail fold and extend under the nail

Front 219

digital mucous cysts

Back 219

contain a clear, jelly like substance and occurs on the dorsal surface of the distal phalanx, longitudinal groove may occur

Front 220

pruritic urticarial papules and plaques of pregnancy (PUPPP)

Back 220

benign dermatosis that usually arises in the 3rd trimester of a 1st pregnancy, begins on abdomen and spreads to thighs buttocks and arms, halos of blanching surround the papules, larger bullae don't occur and not periumbilical (herpes)

Front 221

herpes gestationis

Back 221

rare autoimmune disorder of pregnancy, not related to the viral infection, initially periumbilical erythematous urticarial patches and plaques, progress to vesicle and blisters, pruritus, can develop necrosis of affected skin and kidney damage

Front 222

seborrheic dermatitis

Back 222

chronic recurrent erythematous scaling eruption localized where sebaceous glands are concentrated; craddle cap

Front 223

miliaria (prickly heat)

Back 223

irregular red macular rash caused by occlusion of sweat ducts during periods of heat

Front 224

impetigo

Back 224

highly contagious staph or strep infection of the epidermis, causes pruritis, burning and regional lymphadenopathy, starts as a macule then changes to a vesicle or bulla, crusts

Front 225

acne vulgaris

Back 225

stagnation of sebum and comedo formation in the pilosebaceous follicle with bacterial invasion

Front 226

reddened patchiness

Back 226

suggest richer capillary bed, caused by capillary hemangioma, nevus flammeus or vasculosus and telangiectatic nevus

Front 227

chickenpox

Back 227

fever mild malaise and pruritic maculopapular skin eruption that becomes vesicular, occurs with several stages of maturity at one time, complications include conjunctival involvement, bacterial infection, viral pneumonia, encephalitis, aseptic meningitis, myelitis, Guillain-Barre, Reye syndrome

Front 228

measles (rubeola)

Back 228

prodromal fever, conjunctivitis, coryza and bronchitis followed by a red blotchy rash, Koplik spots on buccal mucosa, macular then maculopapular, complications include infection of resp tract and CNS

Front 229

german measles (rubella)

Back 229

mild and febrile, maculopapular rash, starts with fever, coryza, sore throat and cough, macular then papular rash, Forschheimer spots on soft palate, infection during 1st trimester can cause congenital rubella syndrome

Front 230

trichotillomania

Back 230

loss of scalp hair caused by physical manipulation, can lead to trichobezoar (lump of hair in stomach after being swallowed)

Front 231

bruises

Back 231

when associated with abuse it occurs over soft tissue. ACCIDENTS are usually over bony tissue

Front 232

burns

Back 232

common are stocking and glove distribution indicating placement into a hot water or surface. Splash marks indicate accident.

Front 233

stasis dermatitis

Back 233

erythematous scaling weeping patches, secondary to edema of chronic peripheral vascular disease

Front 234

solar keratosis (senile actinic keratoses)

Back 234

slightly raised erythematous lesion, secondary to chronic sun damage and has malignant potential

Front 235

morbilliform

Back 235

maculopapular lesions that become confluent on the face and body

Front 236

target lesion

Back 236

pink macules with purple central papules

Front 237

punctation

Back 237

central umbilication or dimpling

Front 238

yellow discoloration of the nail

Back 238

nail color caused by psoriasis or fungal infection or chronic resp disease

Front 239

darkening of the nail

Back 239

nail color caused by antimalarial drug therapy, candidal infection, hyperbilirubinemia and chronic trauma

Front 240

green-black discoloration of the nail

Back 240

nail color caused by Pseudomonas infection (no pain) or subungual hematoma (pain)

Front 241

single blue-black nail

Back 241

nail color caused by melanoma or bruising/bleeding from trauma

Front 242

generalized blue nails

Back 242

nail color caused by cyanosis due to asthma, cardiac disorders or anemia, silver poisioning, med side effect, Wilson disease (inherited)

Front 243

Longitudinal red or brown streaks

Back 243

nail abnormalities caused by splinter hemorrhage, may occur with psoriasis of nail matrix or injury to prox nail fold (habit-tic deformity)

Front 244

Longitudinal white streaks or transverse white bands

Back 244

systemic disorder cause this nail abnormality

Front 245

Longitudinal ridges and grooves

Back 245

expected nail abnormality or caused by lichen planus

Front 246

Transverse grooves

Back 246

repeated trauma causes this nail abnormality

Front 247

Transverse rippling of nail plate

Back 247

chronic inflammation with chronic paronychia or eczema cause this nail abnormality

Front 248

Transverse depression at base of lunula

Back 248

stress temporarily interrupts nail formation causing this nail abnormality

Front 249

Depression in nail

Back 249

syphilis, high fevers, peripheral vascular disease, DM can cause this nail abnormality

Front 250

Pitting

Back 250

psoriasis causes this nail abnormality

Front 251

Broadening and flattening

Back 251

secondary syphilis causes this nail abnormality

Front 252

halo nevus

Back 252

this nevus is usually benign, can occur with melanoma

Front 253

intradermal nevus

Back 253

this nevus has no indications for removal except cosmetic

Front 254

junction and compound nevi

Back 254

these nevi should be removed if exposed to repeated trauma

Front 255

hairy nevus

Back 255

this nevus should be removed if changes occur

Front 256

size of a normal mole

Back 256

less than 6 mm

Front 257

tumor

Back 257

elevated and solid lesion; may or may not be clearly demarcated; deeper in dermis; greater than 2 cm in diameter

Front 258

atrophy

Back 258

thinning of skin surface and loss of skin markings; skin translucent and paper-like

Front 259

faun tail nevus

Back 259

tuft of hair overlying the spinal column at birth; may be associated with spina bifida occulta

Front 260

Elephantiasis

Back 260

massive accumulation of lymphedema throughout body from widespread inflammation and obstruction of lymphatics by filarial worms

Front 261

Wuchereria bancrofti or Brugia malayi

Back 261

common filiarial worms that cause elephantiasis

Front 262

Lymphangioma and cystic hygroma

Back 262

results of obstruction of developing lymph vessels

Front 263

Lymphedema

Back 263

hypoplasia and maldevelopment of lymph system

Front 264

Milroy disease

Back 264

primary lymphedema

Front 265

serum sickness

Back 265

Urticaria and other rashes, lymphadenopathy, joint pain, fever, facial edema; 7-10 days after provoking substance, can recur

Front 266

Pneumocystis carinii pneumonia

Back 266

common opportunistic infection in AIDS

Front 267

cat scratch disease

Back 267

Most common cause of subacute or chronic inflammation in kids

Front 268

roseola infantum (HHV-6)

Back 268

Fever followed by morbilliform rash; Usually 7-12 mo old

Front 269

toxoplasmosis

Back 269

Single enlarged and nontender node; hx of eating raw meat

Front 270

Epstein-Barr virus (mono)

Back 270

Sx: pharyngitis, fever, fatigue, malaise, splenomegaly, hepatomegaly, rash; Anterior and posterior cervical are most common affected nodes

Front 271

Epstein-Barr virus

Back 271

Virus found in Burkitt lymphoma and nasopharyngeal carcinoma

Front 272

acute suppurative lymphadenitis

Back 272

caused most often by strep and staph bacteria

Front 273

Actinomycotic adenitis

Back 273

dental disease causing acute suppurative lymphadenitis

Front 274

Pasteurella multocida infection

Back 274

cat scratch disease

Front 275

Virchow node

Back 275

in L supraclavicular region indicative of abdominal or thoracic malignancy

Front 276

which of the following is NOT a function of the skin?
1. Protection - microbial & foreign matter, radiation
2. Retard fluid loss
3. Regulate temperature
4. Sensory input
5. Produce vitamin D
6. Produce Vitamin C
7. Regulate blood pressure
8. Excrete sweat, urea, & lactic acid
9. Express emotions

Back 276

Produce Vitamin C