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169 Cards in this Set
- Front
- Back
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macule
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flat discoloration-small
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patch
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flat discoloration-large >1cm
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papule
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raised bump- small
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nodule
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raised bump- big
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pustule
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pus filled papule (small riased bump
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plaque
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discrete palpable elevation, depression, or textural abnormality
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psoriasis is what kind of morphology?
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plaque
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vessicle
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small blister
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bulla
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large blister
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erythema
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blanchable pink discoloration (dilated capillaries)
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purpura
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non- blanchable red/ purple discoloration (extravasated rbc)
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annular
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ring like
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nummular
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coin/circular shape
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herpetiform
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close grouping of lesions
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zosteriform
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dermatomal
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hirutism
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male-pattern hypertrichosis
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hypertrichosis
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excessive hair anywhere
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alopecia?
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hair loss
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pruritic, annular, pink scaly plaque?
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tinea corporis
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ulcer
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full thickness through epidermis into dermis
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erosion
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partial thickness through epidermis
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sclerosis
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circumscribed/difuse hardening of skin
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shape of eczema
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nummular
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zosteriform, on erythematous base?
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shingles (Herpes zoster)
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herpetiform near lips?
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herpes simplex
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increased risk of acne?
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elevated androgen states- Xyy, polycystic ovaries, hyperandrogenism, hypercortisolism, precosious puberty
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what do you get w/ shave biopsy? Punch?
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epidermis + a little dermis; punch- epdiermis, dermis, fat
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biopsy for melanoma?
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complete removal via excision
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how to diagnose superficial fungal infections?
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potassium hydroxide preperation
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how to diagnose herpes simples or varicella zoaster infection?
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tzanck preparation- multinucleated giant cells
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how to examine for mites?
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use mineral oil
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drug induced acne?
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ides- iodides, bromides; lithium, steroids
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what is a comedone? How is it treated?
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black head/white head- dead skin pulgging follicules; Rx: Retin-A (retinoids)/benzyyl peroxides
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when is acne rx mandatory?
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developing scars from the lesions
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which acne is most likely to scar
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large inflammed cystic nodules
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inflammatory acne papules require what rx?
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antibiotic
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cystic scarring acne rx?
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isotretinoin 9accutane)
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red plaques w/ silvery scale?
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psoriasis
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where is psoriasis most common?
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elbows, knees, scalp
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other common presentations w/ psoriasis?
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thick discolored crumbling nails; psoriasis; pruritis
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topical psoriasis rx?
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corticosteroid, retinoid, calcipotriene, antralin, tar, uv light
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systemic psoriasis rx?
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methotrexate, acitretin (syemic retinoid), cyclosporine, ati-TNF antibody, anti0IL antibody
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importance of cyclosprine as psoriasis rx?
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if you stop it, psoriasis will come back
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uv light rx for psoriasis?
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UVB or uva + psoralen
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drugs that exacerbate sporiasis?
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antimalaria, betablockers, Ca channel blocers, captorpil, Glyburide, lithium (stress, alcohol, strep)
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steroids and psoriasis?
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when tapered too quickky= pustular falre= fevere, malaise, pulmonary edema, heart failure
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red itcy rash w/ elevated IgE
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eczema
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define eczema?
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dermatitis
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eczemaand infection? Psoriasis and infection?
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eczema= suspetible to staph infection b/c of broeken barriers; psoriasis= no infection
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major differences between eczema and psoriasis?
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not associated w/ arthritis, no nail involvement, no scalp involvement, more prone to infection
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typical locations for eczema?
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popliteal and anterior cubital fossa
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dry skin is a type of…
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eczema
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onset of atopic dermatitis
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before 5
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what is seborrheic dermatitis?
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benign flaky condition in skin folds/eyebrows
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disease w/ high prevalence of seborrheic dermatitis?
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HIV, neurologic disorders
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common causes of contact dermatitis
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poison ivy, nickel, neomycin, fragrance, thiomersal, perservatives
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what is asteotic dermatitis?
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excessive dryness of scin= eczema craquele
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rxn of asteotitic dermatitis?
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mositurizer, mild sopas, TMC ointment (not cream)
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t/f skin biopsy is sometimes used to differentiated dermatitis from psoriasis?
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TRUE
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venous stasis dermatitis?
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from lower leg varicosities and venous htn--> redness, pruritis, induration, ulceration
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common causes of impetigo?
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staph aureus> strep pyogenous
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most common bacterial infection in children?
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impetigo
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define impetigo?
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infection in uncontrolled dermatitis
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dermatitis progressing to yellow crusted plaques that are hot, red, oozing, and painful
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impetigo
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pustules on erythematous base are indicative of…
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impetigo
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t/f impetigo is contagious?
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TRUE
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systemic rx for impetigo?
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penicillin, cephalosporin (1st generation), mupirocin ointment
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rash that gets worse w/ steroid?
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tenia corpis
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what type of tissue does tinea invade?
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fully keratinized tissue (skin, hair, nails)
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what is tinea on the face? Groin? Feet? Scalp?nailus?
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facie, cruris, pedis, captis, un unguium
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rxn of tinea?
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topical antifungals or systemic antifungals
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complication of tinea?
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secondary bacterial infection, esp on feet and in diabetics/inc infection risk
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lab for fungal infection? Results in tinea?
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KOH prep; branching petae hyphae
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red moist eroded skin under body folds?
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check for cutaneous yeast infection
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beefy eroded oozing plaque?
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yeast
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what is kerion?
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special plaque of tinea capitis- big, yellow, eroded, can cause scars
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verruca vulgaris?
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common warts
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common causes of warts?
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HPV 1-4 (epithelial hyperplasia)
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condyloma acuminata?
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benign genital and anal warts from HPV 6 & 11
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wart Rx?
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nitrogen cryotherapy
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how to tell a seed wart?
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skin lines are gone (dots are new formed blood vessels)
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pink papules w/ whitish umbiulicated centers?
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mulluscum
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causes of mulluscum
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poxvirus- MC virus
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transmission of molluscum
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skin-skin contact; fomites
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Rx for molluscum
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liquid nitrogen, curettage, blistering agent
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most common human tumor?
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seborrheic keratoses
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what is a seborrheic keratosis?
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benign epidermal tumor w/ a rough surface and a stuck on appearance
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who is most likelyt o have seborrheic keratoses?
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elderly white pts
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dermatosis papulosa nigra?
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seborrheic keratosis on face of black people
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sign of leser-trelat?
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concomitant malignancy of a seborrheic keratoses (usuallu) gastric- sudden pruritic seborrheic keratoses
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what are malanocytic nevi?
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moles- benign neoplasmas of melanocyte
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junctional nevi?
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dark, flat
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intradermal nevi
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skin colored, dome
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compound nevi
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dark, dome
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difference between intrademal nevi and BCC?
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BCC is translucent, telangiectatic, and dynamic
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feature of keratinous cyst?
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central punctum w/ foul smelling stuff coming out
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histology of keratinous cyst?
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granulomatous inflammation
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when is a keratinous (infundibular) cyst inflammated?
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redness extends beyond border)
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what are milia?
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tiny, white keratinous cyst
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t/f lipomas can get inflammed?
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FALSE
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even if a lipoma is benign, when can it signify a problem?
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if midline, could be underlying spinal defects!
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who often has angiomas?
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newborns/premies (benign tumors of vessels)
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what can happen when an angioma gets really big?
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kasaback-merritt syndrome: traps platelets causing a coagulopathy
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t/f cherry angiomas go away over time?
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FALSE
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pyogenic granulation tissue? Rx?
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acquired, reactive hemangioma w/ excessive granulation tissue; has to be surgically removed
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t/f hemangiomas go away over time?
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TRUE
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most common complication of angioma?
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ulceration
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what are dermatofibromas?
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dermal aggregates of fibroblast hitocytes, and collagen
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how to tell if it is a dermatofibbroma?
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dimple sign
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multiple eruptive dermatofibromas seen in
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SLE, HIV
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what are acrochordons?
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skin tag
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most common type of cancer in the US?
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non-melanoma skin cancer
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uva vs. uvb penetrates deeper? Immediate change? Cause of cancer?
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uva= deeper, uva= immediate tan (changes melanin, while uvb induces melanin production), uva= melanomas, uvb= BCC and SCC
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what is the most common precancerous lesion?
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actinic keratosis
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most common cancer in US?
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BCC
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importance of Moh's surgery?
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100% margin control
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when is moh's done?
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high risk tumors; conservation of tissue is important(Hzone faces, nose, ears, yeyes, genitals, lips, shins); recurrent
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second most common form of skin cancer?
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SCC
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what % of malignant melanomas come from pre-existing nevi?
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50%
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most frequent cuase of death from skin cancer?
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malignant melanoma
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t/f black and white people have the same # of melanocytes?
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TRUE
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t/f blacka nd white people have the same amounts of pigment?
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FALSE
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if you have ever used a tanning bed, risk for melanoma increases by?
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75%
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when to do a shave biopsy?
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NMSC is suscpected
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when to do a punch biopsy?
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small pigmented lesions
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when to do excisional biopsy?
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Melanoma,evaluated borders of pigment lesion
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when to do an incisional biopsy?
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large lesion, excision not needed for diagnosis
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barlow's ris?
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low< 1cm, intermediate 1-4 cm, high >4 cm
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What disease affect the epidermis?
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tanning, vitiligo
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what diseases affect the basement membrane zone?
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blistering disease
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1 melanocyte/ ? Keratinocytes?
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40
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melanocytes are derived from?
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neural crest cells
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why is dark skin darker?
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eumelanin instead of pehomelanin; more stage 4 melanosomes
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Uva energy? Wavelength? Penetration?
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low energy, long wavelength, deep penetration
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most abundant form of UV exposure from sun?
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uva= deeper, uva= immediate tan (changes melanin, while uvb induces melanin production), uva= melanomas, uvb= BCC and SCC
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what cells does tanning affect?
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melanocytes and keratinocyte (making keratinocytes stimulate melanocytes)
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single UV exposure does what?
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redistributes melanosomes to protect keratinocytes
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repeated UV exposure does what?
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causes melanocytes to increase in size, number, and activity + increased transfer to keratinocytes
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what makes up the basement membrane?
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lamina lucida/lamina densa
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where is collagen? How is it attached?
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below lamina densa; attached via anchoring fibers
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lossin epidermal layer causes…
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superficial erosion
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loss @ basement membrane cuases…
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tense blister
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what are desmoglans?
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keratinocyte adhesions in intracellular space
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what is pemphigus?
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intraepidermal blisters and acantholysis
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which pemphigus disease is more superficial?
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foliacious (@ epidermal granular layer)
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which pemphigus disease is deeper?
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vulgaris (@ epidermal suprabasalar layer)
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t/f basal cell are intact w/ pemphigus vulgaris?
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TRUE
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blistering dieases from superficical to deep?
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phemphigus (epidermal dysadhesion), bullous pemphigoid (basal-BM separation); Epidermolysis Bullosa Acquisita (BM-dermal separation)
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pemphigus etiology/pathogenesis?
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retraction of tonofilaments; sissolution of desmosomes (nikolskys's sign); IF-IgG auto abs +/- C3 at cell surface of keratinocytes
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what is nikolsky's sign? In what disease is it seen?
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lateral retraction extends blistering area. Seen in pemphigus
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BP antigens attack where?
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hemidesomsomes- basal keratinocytes to BM
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upper antigen on salt split skin?
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BPAg
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lower antigen on salt split skin?
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Collagen VII- EBA
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erythema nodosum?
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reactive inflammation of deep subcutaneous fat
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etiologies of erythema nodosum?
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infection (tb, strep); Meds- OC; pregnancy; Sarcoidosis-loggren syndrome
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t/f you can get sarcoidosis on skin w/ out internal disease?
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TRUE
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Lofgren's syndrome?
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fever+ pulmonary sarcoidosis + erythema nodosum
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most common mucocutaneous findings w/ graves?
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eye disease: protrusion, exophthalmos, eyelid swelling, limited extraoccular movements
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who gets acute cutaneous lupus eruthematous? What does it look like?
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ONLY seen in SLE;non-scarring malar rash
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how many pts w/ SCLE have SLE?
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50%
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most chronic form of cutaneous lupus eruthematous?
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discoid lupus
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unique feature of chronic cutaneous lupus eruthematous?
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results in scarring (discoid lupus)
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% of people who have systemic disease w/ chronic cutaneous lupus erythematous?
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rare: 5-10%
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pathognomonic signs of dermatomyositis?
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heliotrope rash; gottron papules
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localized scleroderma?
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aka morphea, self-limiting linear skin colored plaques w/ out systmeic disease
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en coup de sabre?
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linear scleroderma on the forehead
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2 main forms of systemic scleroderma?
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CREST (limited) and progressive
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halmmark findings of systemic slceroderma?
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sclerodactaly, digital piting scars, clacinous cutis, nail fold capillary changes, telangiectasis, raynaud's, salt and pepr
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constant pressure over how long leads to tissue death
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2 hours
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