Derm Flash Cards

Front 1

macule

Back 1

flat, non-palpable, <1cm

Front 2

patch

Back 2

flat, non-palpable, >1cm

Front 3

papule

Back 3

raised, <1cm

Front 4

nodule

Back 4

raised, >1cm

Front 5

plaque

Back 5

discrete palpable elevation or depression or textural abnormality

Front 6

vesicle

Back 6

blister <1cm

Front 7

bulla

Back 7

blister >1cm

Front 8

erythema

Back 8

blanchable pink discoloration from dilated capillaries

Front 9

purpura

Back 9

non-blanchable red-purple discoloration from extravasated RBCs

Front 10

annular

Back 10

ring-like arrangement

Front 11

nummular

Back 11

coin/circular shape

Front 12

Herpetiform

Back 12

close grouping of lesions

Front 13

Zosterform

Back 13

dermatomal grouping of lesions

Front 14

Shave biopsy

Back 14

used for superficial lesions requiring examination of epidermis and superficial dermis

Front 15

Punch biopsy

Back 15

used for most dermal lesions, rashes and carcinomas, core of tissue consisting of epidermis, dermis, fat

Front 16

Excision biopsy

Back 16

used for carcinomas and pigmented lesions, complete removal of lesion including peripheral and deep margins

Front 17

KOH preparation

Back 17

Diagnosis of superficial fungal infections, positive test shows hyphae

Front 18

Tzanck test

Back 18

Diagnose herpes simplex or zoster, examine scraped cells stained with Giemsa or Wright stain, positive exam shows multinucleated giant cells

Front 19

Mineral oil

Back 19

Mite examination

Front 20

comedone

Back 20

initial lesion in acne, formed from cells os stratum corneum accumulating, plugging hair follicle

Front 21

bacterium in acne

Back 21

Propinobacterium acnes, gram +

Front 22

acne treatment

Back 22

topical retinoids; topical retinoids with topical antibiotics; systemic retinoids and antibiotics

Front 23

eczema

Back 23

inflammatory condition of skin with redness, scaling, pruritis; aka dermatitis; nails unaffected

Front 24

atopic dermatitis

Back 24

childhood onset, chronic, pruritic, dry skin, allergies, asthma; skin red, scaly, thick due to scratching

Front 25

atopic dermatitis treatment

Back 25

Non-scented soap, moisturization, topical corticosteroid, systemic antibiotics for infections; systemic immunosuppression, UV light if refractory

Front 26

contact dermatitis

Back 26

contact with allergen, delayed-type hypersensitivity, focal redness and scaling; treat with topical corticosteroid, systemic if severe

Front 27

seborrheic dermatitis

Back 27

fine flaky, oily, mildly pruritic rash in eyebrows, naso-labial folds, scalp; low potency topical corticosteroids

Front 28

asteotolic dermatitis

Back 28

excessive dryness of skin, cracked appearance' treat with petroleum-based moisturizer

Front 29

venous stasis dermatitis

Back 29

lower leg varicoscities, venous HTN, redness, pruritis, induration, occasional ulceration; treat with graded pressure stockings, removal of varicose veins, leg elevation, topical corticosteroid

Front 30

psoriasis

Back 30

chronic inflammatory disease with circumscribed erythematous scaling plaques that bleed easily when scratched

Front 31

psoriasis induced or exacerbated by…

Back 31

b blockers, Ca channel blockers, Li, antimalarias, glyburide, captopril, interferon, lipid-lowering drugs, stress, alcohol, strep infections

Front 32

psoriasis treatment

Back 32

mild, topical corticosteroids, retinoids, vitamin D, mild soap, moisturization; widespread, UVB, UVA + psoralen, immunosuppression; avoid systemic corticosteroids

Front 33

seborrheic keratoses

Back 33

yellowish to dark brown scaly papules, stuck-on, greasy appearance; can be removed by LN2, curettage if desired

Front 34

dermatosis papulosa nigra

Back 34

variant of seborrheic keratosis on black patients, small fleshy/warty brown papules often on periorbital skin

Front 35

sign of Leser-Trelat

Back 35

sudden appearance of large numbers of seborrheic keratoses in context of (usually gastric) cancer

Front 36

junctional nevi

Back 36

nests arranged along dermoepidermal border, brown macules

Front 37

intradermal nevi

Back 37

nests in dermis, skin-colored dome-shaped papules

Front 38

compound nevi

Back 38

nests along border and in dermis, pigmented, sometimes warty

Front 39

characteristics of benign nevi

Back 39

symmetric, regular borders, even pigment, stable dimensions, unchanging

Front 40

infundibilar/keratinous cysts

Back 40

arise from top portion of hair follicle, lined by squamous epithelium, contain keratin, central punctum (express cheesy foul smelling substance); treat with intralesional steroid injections, if infected use antibioitcs, incision, drainage; complete removal requires excision of entire sac

Front 41

milia

Back 41

infundibular cysts, white tiny papules, de novo on face of result of de-epithelialization

Front 42

lipomas

Back 42

benign adipose tumors, soft, mobile, subcutaneous nodules, no central punctum, no inflammation; if midline back, may signal spinal dysraphism

Front 43

pyrogenic granuloma

Back 43

acquired reactive hemangioma; friable moist papule, develops after minor trauma, exuberant granulation tissue, surgical removal/destruction required

Front 44

verruca vulgaris

Back 44

common wart, scalpy papule/plaque, irregular spiked surface, new blood vessels visible as small dark dots; treat with LN2

Front 45

condyloma acuminata

Back 45

benign genital and anal warts; HPV 6, 11; treat with LN2, imiquimod topical cream

Front 46

hirsuitism

Back 46

male-pattern hypertrichosis

Front 47

hypertrichosis

Back 47

excessive hair

Front 48

alopecia

Back 48

hair loss

Front 49

erosion

Back 49

partial sloughing

Front 50

ulcer

Back 50

full thickness sloughing, will scar

Front 51

sclerosis

Back 51

circumscribed or diffuse hardening of skin

Front 52

atrophy

Back 52

thinning or diminution of epidermis and/or subcutaneous tissue

Front 53

profilaggrin

Back 53

major protein of keratohyaline granules in epidermis; if defective, skin barrier function defects

Front 54

involucrin, loricrin

Back 54

epidermal proteins cross-linked by transglutaminases; if defective, trans-epidermal water loss

Front 55

ictyhosis

Back 55

disorders of confication with skin scaling

Front 56

icthyosis vulgaris

Back 56

fine adherent sclaes of extremities and trunks with flexural sparing, hyperlinear palms and soles; filaggrin loss of function; diminished or absent stratum granulosum, semidominant

Front 57

lamellar icthyosis

Back 57

large skin scales caused by hyperproliferative hyperkeratosis (colloidon baby); transglutaminase defect resulting in poor cross-linking of involucrin, loricrin, autosomal recessive; normal or thickened granular layer

Front 58

vitiligo

Back 58

loss of melanocytes in depigmented patches, autoimmune with antibodies to tyrosinase-related proteins

Front 59

BPAG1 (BP230)

Back 59

antigen in bullous pemphigoid

plakin promiting adhesion of intermediate filament cytoskeleton to plasma membrane plaque

Front 60

BPAG2 (BP180)

Back 60

antigen in bullous pemphigoid

type II transmembrane collagen associated with anchoring filament complexes of basal keratinocytes

Front 61

pemphigus foliacious

Back 61

flacid bullae on erythematous base, scaling, intra-epidermal substratum corneum blister, Nikolsky's sign, antibodies to desmoglein 1; treat with corticosteroids and corticosteroid-sparing agents

Front 62

pemphigus vulgaris

Back 62

intraepidermal suprabasal blisters with Nikolsky's sign, common oral lesions, antibodies to desmoglein 3; treat with corticosteroids, corticosteroid-sparing agents

Front 63

bullous pemphigoid

Back 63

subepidermal blister above lamina densa, tense bullae, rare oral involvement, antibodies against BPAG 1 and 2 in hemidesmosomes, contains eosinophils; treat with corticosteroids, immunosuppression

Front 64

epidermolysis bullosa acquisita

Back 64

subepidermal blister below lamina densa, on skin and mucous membranes in areas of trauma, scarring in form of milia, antibodies aainst type VII collagen; treat with oral corticosteroids, colchicine, dapsone, immunosuppression

Front 65

Ehlers-Dnalos

Back 65

collagen defects, hyperextensible and fragile skin, easy brusing

Front 66

Ehlers-Danlos IV

Back 66

Mutaitons in collagen III, most severe; arterial fragility, delayed wound healing

Front 67

Ehlers-Danlos I

Back 67

Mutations in collagen V, minor collagen

Front 68

Ehlers-Danlos VI

Back 68

Mutations in lysyl hydroxylase

Front 69

Cutix Laxa

Back 69

Loose hyperextensible skin, apperance of premature aging, may have extracutaneous manfestations (emphysema, arterial stenosis), autosomal dominant elastin mutations, premature elastin degradation, aberrant elastin (Marfan's)

Front 70

Pseudoxanthoma elasticum

Back 70

Abnormal calcified elastic fibers in mid dermus producint yellowish papules, skin laxity, retinoid angioid streaks; mutatin in ABC proteins

Front 71

acantholysis

Back 71

cell-cell separation

Front 72

Nikolsky's sign

Back 72

Expansion of blister with lateral pressure

Front 73

chronic cutaneous lupus erythematosus/discoid lupus

Back 73

erythema, scaling, hypopigmentation, alopecia, scarring, telangiectasias; localized less severe than widespread (above and below neck)

Front 74

subacute cutaneous lupus erythematosus

Back 74

prominent photosensitivity, may have papules with scales, psoriaform (joint sparing), may be annular, can be atrophic; commonly have SLE

Front 75

acute cutaneous lupus erythematosus

Back 75

photosensitivity, malar rash, usually in active SLE

Front 76

scleroderma

Back 76

thickening or hardening of skin with dermal or subcutaneous sclerosis

Front 77

morphea-form sclerosis

Back 77

single or few flesh colored erythematous indurated plaque; localized

Front 78

linear sclerosis

Back 78

band-like, can limit joint mobility if crosses joint; localized

Front 79

systemic sclerosis

Back 79

cutaneous and internal organ fibrosis, sclerodactylym digital pitting scars, pale waxy taut skin, calcinosis cutis, Raynaud's phenomenon, dispigmentation, mat-like teleangiectasias

Front 80

CREST

Back 80

Calcinosis, Raynaud's phenomenon, Esophageal dysmotility, Sclerodactyly, Telangiectasia

Front 81

Dermatoyositis

Back 81

inflammatory myopathy (proximal muscle weakness, elevated enzymes) with heliotrope rash, Gottron papules, periungual telangiectasias, hypertrophy of cuticles, spliter hemorrhages, photosensitivity, shawl sign

Front 82

Shawl sign

Back 82

poikiloderma in photosensitive distribution generally over upper trunk

Front 83

Gottron papules

Back 83

erythematous scaly papules over bony prominences

Front 84

T cell lymphomas

Back 84

in epidermis, slowly progresive, scaling, erythema; can have nodules, look like fungus or psoriasis

Front 85

B cell lympshoms

Back 85

do not infiltrate epidermis, red to purple nodules, can be more aggressive

Front 86

Sweet's syndrome

Back 86

acute febrile neutrophilic dermatosis, painful erythematous plaques with fever, arthralgics, leukocytosis; MDS associated

Front 87

Raynaud's phenomenon

Back 87

hands turn blue, white, then red due to circulatory abnormalities; transient and painful

Front 88

eythema nodusum

Back 88

tender red symmetrical nodules, especially on shints, in young women, due to inflammation in subcutaneous fat (panniculitis); reactive

Front 89

cutaneous sarcoidosis

Back 89

flesh colored to violaceous papules, may coalesce into annular lesions or plaques; frequently on head and neck; if on nose, more likely to have upper respiratory tract/lung involvement

Front 90

risk factors for nonmelanoma skin cancer

Back 90

fair skin, chronic or intermittent sun exposure, red hair, prior history of skin cancer, prior irradiation, PUVA, arsenic expsosure, systemic immunosuppression

Front 91

actinic keratosis

Back 91

in situ dysplasia of keratinocytes; multiple discrete flat or elevated keratotic papules, red, pigmented, or flesh colored

Front 92

actnic chelitis

Back 92

actinic keratosis on lip

Front 93

treatment for actinic keratosis

Back 93

LN2, topical chemotherapeutics (Imiquod, 5-FU), photodynamic therapy, chemical peels, ablative laser

Front 94

basal cell carcinoma

Back 94

waxy semi-translucent nodules around central depression +/- crusting, ulceration, bleeding; larger lesions have rolled border; bleeding without pain or trauma, arise from hair follicle

Front 95

treatment for basal cell carcinoma

Back 95

electrodessication, curettage, excision, Mohs, photodynamic therapy, Imiquimod; not 5-FU

Front 96

Bowen's disease

Back 96

squamous cell carcinoma in situ; erythematous, slightly scaly, crusted, papule to plaque

Front 97

erythroplasia of Queyrat

Back 97

Bowen's disease on glans penis

Front 98

treatment for Bowen's disease

Back 98

Imiquinod, electrodessication, curettage, standard excision, Mohs

Front 99

squamous cell carcinoma

Back 99

superficial, discreted, hard lesions, may be indurated, rounded, elevated base; larger, more deeply nodular, often ulcerative; much higher incidence with immunosuppresion

Front 100

treatment for squamous cell carcinoma

Back 100

Mohs, electrodessication, curettage, radiation (adjunctive or palliative)

Front 101

melanoma

Back 101

cancer from melanocytes

Front 102

ABCDE criteria

Back 102

for melanoma; asymmetry, border irregularity, color variegation, diameter > 6 mm, evolution

Front 103

treatment for melanoma

Back 103

early excision, interferon alpha 2b

Front 104

incisional biopsy

Back 104

used in cases where excisional biopsy not feasible; remove portion of lesion

Front 105

Mohs micrographic surgery

Back 105

tissue sparing technique using horizonal sectioning to view entire peripheral and deep margin

Front 106

infiltrative basal cell carcinoma

Back 106

scar-like sclerotic appearance

Front 107

Indications for Mohs

Back 107

Head, face, neck, hands, shins, genitals, large truncal lesions; Gold standard, highest cure rate in areas where tissue conservation important; Use for recurrent, incompletely excised, or poorly defined lesions

Front 108

highest rate of metastasis in squamous cell carcinoma

Back 108

scars, lip, external ear; perineural invasion has high rate of metastasis and recurrence

Front 109

keratoacanthoma

Back 109

low grade squamous cell carcinoma

Front 110

melanoma: bad prognostic factors

Back 110

presence in lymph node (most important), Breslow depth, old age, axial location

Front 111

lentigo maligna

Back 111

in situ melanoma on chronically sun exposed skin; can be large, progress to melanoma