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34 Cards in this Set
- Front
- Back
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Macule
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A flat lesion that differs in color from surrounding skin (< 1 cm in diameter).
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Papule
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An elevated solid lesion that is generally small (< 5 mm in diameter).
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Patch
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A small, circumscribed area differing in color from the surrounding surface (> 1 cm in diameter).
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Plaque
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An elevated solid lesion (> 5 mm in diameter).
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Cyst
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An epithelial-lined sac containing fluid or semisolid material.
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Vesicle
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A fluid-filled, very small (< 0.5-mm), elevated lesion.
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Bulla
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A large vesicle (> 5 mm).
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Wheal (or hive)
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An area of localized edema that follows vascular leakage and usually disappears within hours.
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Erosion
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A circumscribed, superficial depression resulting from the loss of some or all of the epidermis.
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Ulcer
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A deeper depression resulting from destruction of the epidermis and upper dermis.
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Scale
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Abnormal shedding or accumulation of stratum corneum in flakes.
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Crust
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A hardened deposit of dried serum, blood, or purulent exudates.
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Lichenification
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Thickening of the epidermis.
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Scar
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A healing defect of the dermis (the epidermis alone heals without a scar).
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Atopic Dermatitis
Lesions and location by age group Children/Adolescents/Adults/ |
Infants: Erythematous, weeping, pruritic patches on the face, scalp,
and diaper area. Children: Dry, scaly, pruritic, excoriated patches in the flexural areas and neck. Adults: Lichenification and dry, fissured skin, often limited to the hands. |
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Atopic Dermatitis
Cause and diagnosis |
50% have filaggrin defect
4 criteria |
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Seborrheic Dermatitis
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It has a predilection for ar- eas with oily skin such as the scalp, eyebrows, nasolabial folds, and mid chest.
Infants: A thick crust (“cradle cap”) on scalp. Also, can see severe, red diaper rash with yellow scale, erosions, and blisters. Children/adults: Red, scaly patches are seen around the ears, eye- brows, nasolabial fold, midchest, and scalp. The rash is more localized and less dramatic than that seen in infants. Patients with HIV/AIDS can develop severe seborrheic dermatitis Tx - selenium sulfide or zinc pyrithione shampoos, topical antifungals, and/or topical corticosteroids |
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Psoriasis
Definition Lesion description |
Inflammatory dermatosis characterized by erythematous patches and silvery scales due to dermal inflammation and epidermal hyperplasia.
Typical lesion = round, sharply bordered erythematous plaque with silvery scales Lesions classically on extensor surfaces - elbows, knees, scalp, and lumbosacral regions. Koebner’s phenomenon Auspitz sign |
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Psoriatic nail changes
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Nail pitting, “oil spots,” and onycholysis (lifting of the nail plate)
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Types of psoriasis
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Chronic plaque psoriasis
Guttate psoriasis Erythrodermic psoriasis Pustular psoriasis |
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Papulosquamous Skin Disorders
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Psoriasis
Seborrheic dermatitis Lichen planus Pityriasis rosea Pityriasis rubra pillars Parapsoriasis |
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Psoriasis triggers
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β-blockers, lithium, antimalarials
ACEIs?, smoking?, alcohol? |
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Koebner’s phenomenon
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Lesions can be provoked by local irritation or by trauma
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Erythema Multiforme
Causes Lesions Features |
May be idiopathic - many triggered by recurrent HSV infection
Cutaneous reaction - classically: targetoid lesions palms and soles often affected < 10% BSA involvement few or minor systemic symptoms (< SJS/TEN) little/mild mucosal involvement (< SJS/TEN) |
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SJS and TEN
Definition |
Life-threatening exfoliative mucocutaneous diseases
Usually drug induced SJS < 10% BSA involvement TEN > 30% BSA involvement |
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Erythema Multiforme
Cause, Prevention |
Infectious causes most commonly - often HSV infection
Acyclovir for patients with HSV |
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SJS/TEN
Causes |
penicillin's, sulfonamides, seizure medications (e.g., phenytoin, carbamazepine, phenobarbital), quinolones, cephalosporins, allopurinol, and NSAIDs
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Erythema Nodosum
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A panniculitis triggered by:
drugs (sulfonamides, OCPs, various antibiotics) infection (e.g., Streptococcus, Coccidioides, Histoplasmosis, TB) chronic inflammatory diseases (Sarcoidosis, ulcerative colitis, Crohn’s disease). |
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SJS/TEN
Clinical appearance |
Often preceded by a flulike prodrome, skin tenderness, a maculopapular drug rash, or painful mouth lesions
Exam Severe mucosal erosions Widespread erythematous macules Targetoid lesions, flat and atypical (compared with EM) Lesions often become confluent + Nikolsky’s sign and epidermal detachment. Mucous membranes of eyes, mouth, and genitals often become eroded and hemorrhagic |
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Pemphigus Vulgaris
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Antibodies against desmoglein (DG1 and DG3) responsible for keratinocyte adherence
Patients generally middle-aged (40–60) Intraepidermal blister leading to widespread painful erosions of skin and mucous membranes + Nikolsky’s sign Biopsy shows acantholysis Immunofluorescence shows netlike, reticular pattern |
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Bullous Pemphigoid
Definition, who it affects, cause |
Acquired blistering disease, separation at epidermal basement membrane
Most common in patients 60–80 years of age Antibodies developed against BP antigen, in the basement membrane zone (BMZ) |
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Pemphigus Vulgaris treatment
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High dose systemic corticosteroids
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Bullous pemphigoid
Clinical and biopsy appearance |
Presents with firm, stable blisters on erythematous skin
Nikolsky’s sign -- Blisters form crusts and erosions Mucous membranes less commonly involved than pemphigus Skin biopsy shows sub-epidermal blister Immunofluorescence demonstrates linear IgG and C3 at the dermal-epidermal junction. |
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Dermatitis herpetiformis
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Pruritic papules and vesicles on elbows, knees, buttocks, neck, and scalp
Granular IgA seen on dermal papillae Associated with celiac disease |
