Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
176 Cards in this Set
- Front
- Back
|
Outer HORNY layer
Inner CELLULAR layer |
Epidermis
|
|
|
Nourishes Epidermis
*Connective tissue *Sebaceous glands, *Sweat glands *Hair follicles |
Dermis
|
|
|
Adipose Tissue layer
|
Subcutaneous
|
|
|
SEBACEOUS GLANDS
|
fatty substance secreted onto the skin surface through the hair follicles.
|
|
|
SWEAT GLANDS – two types
|
Eccrine glands
Apocrine glands |
|
|
Apocrine glands
|
axillary & genital regions
usually open into hair follicles stimulated by emotional stress |
|
|
Eccrine glands
|
widely distributed
open directly onto the skin. |
|
|
SKIN: HEALTH HX
|
Have you noticed any changes with
Your skin? Your hair? Your nails? Any rashes, sores, lumps, itching? Have you noticed any moles you are concerned about? Do you have any moles that have changed in SIZE ? SHAPE ? COLOR ? SENSATION ? ANY NEW MOLES? Any Family History of skin cancers? Any Personal History of skin biopsy? Have you ever seen a Dermatologist? Do you use any special skin products? Do you regularly wear sunscreen? |
|
|
Pruritis
|
Itching”
“The Golden Word of Dermatology |
|
|
Dyshydrotic
|
related to water or sweat.
|
|
|
Hyperhydrosis
|
excessive or profuse sweating.
|
|
|
Xerosis
|
excessive or extreme dryness.
|
|
|
Induration
|
process of becoming firm or hard.
|
|
|
Key areas to inspect on a skin exam
|
Scalp
Mouth Eyes Nails |
|
|
Characterized by a widespread or generalized rash
|
Systemic infection or allergic response
|
|
|
Symmetric rashes indicate what type of reaction?
|
Systemic
|
|
|
Intertriginous
|
In the dark places or folds of skin
|
|
|
Along the dermatone
|
Dermatomal
|
|
|
Web like rash
|
reticulated
|
|
|
Generally what is the size of a pencil eraser?
|
6mm
|
|
|
Violaceous
|
Blue in color
|
|
|
What two diseases can have a targeted rash pattern?
|
Lyme disease and syphillus
|
|
|
Manipulates or pulls hair out. Often associated with depression, anxiety,OCD
|
Trichotitomania
|
|
|
Paronychia
|
superficial infection of proximal & lateral nail folds
|
|
|
nail angle > 180*
|
Clubbing of fingers
Usually associated w/ smoking COPD, heart disease |
|
|
punctate depressions of nail
|
Pitting
|
|
|
Transverse Linear Depressions
|
(Beau’s Lines) transverse depressions of nail plates, usually bilateral. Usually systemic illness.
|
|
|
10 Primary lesion types
|
Macule Patch
Papule Plaque Nodule Tumor Vesicle Bulla Pustule Wheal |
|
|
4 secondary lesion types
|
Scale Crust
Fissure Ulcer |
|
|
< 1cm spot different in color; flat - neither elevated nor depressed.
Example: Freckles, flat nevi |
MACULE
|
|
|
> 1cm spot different in color; flat - neither elevated nor depressed.
Example: Vitiligo |
Patch
|
|
|
– circumscribed superficial solid elevation < 1cm
Example: Elevated nevi, warts, lichen planus |
Papule
|
|
|
circumscribed, superficial firm, rough elevation > 1cm; confluence of papules with flat - topped surface.
Example: Psoriasis |
Plaque
|
|
|
– palpable solid round or elevated mass/lesion > 1cm
This may be above or beneath the skin |
Nodule
|
|
|
palpable solid round or elevated mass/lesion > 2cm
|
Tumor
|
|
|
circumscribed, superficial elevation, papule with clear fluid <.5cm
Example: Herpes Zoster |
Vesicle
|
|
|
circumscribed, superficial elevation, papule with clear fluid >.5cm; thin & translucent with serum, lymph fluid, blood or extracellular fluid within.
Example: Bullous Pemphigoid |
Bulla
|
|
|
circumscribed elevations of the skin, papule with cloudy fluid
Examples: Acne, Impetigo |
Pustule
|
|
|
– rounded or flat-topped, pale-red papule or plaque characteristically evanescent, disappearing within hours; round, gyrate or irregular.
Example: Hive |
Wheal
|
|
|
- elevated, circumscribed, encapsulated lesion; in dermis or subcutaneous layer; filled with liquid or semi-solid material.
Example: Acne |
Cyst
|
|
|
Small (up to 4 mm), circumscribed, non-palpable deposits of blood or blood pigments.
|
PETECHIAE
|
|
|
- Larger (greater than 4 mm), circumscribed deposits of blood or blood products in the skin. Example: Bruises
|
PURPURA
|
|
|
Shedding, dead epithelial cells that may be dry or greasy. Examples: Dandruff, Psoriasis
|
SCALES
|
|
|
Abrasion of the skin resulting in loss of epidermis; usually superficial and traumatic.
Examples: Scratched insect bites, scabies |
EXCORIATION
|
|
|
- Linear crack or break in the epidermis; may be moist or dry
|
FISSURE
|
|
|
Diffuse area of thickened epidermis secondary to persistent rubbing, itching, or skin irritation with resultant increase in the skin lines and markings; often involves flexor surface of extremities.
Example: Atopic dermatitis |
LICHENIFICATION
|
|
|
Irregularly shaped, elevated, progressively enlarging scar; grows beyond the boundaries of the wound; caused by excessive collagen formation during healing
|
KELOID
|
|
|
Small and short or long and tortuous tunnels in the epidermis.
Example: Small and short burrows - scabies Long and tortuous burrows - creeping eruptions |
BURROW
|
|
|
- Plug of whitish or blackish sebaceous and keratinous material lodged in the pilosebaceous follicle usually seen on the face, the chest and/or back.
Example: Acne/ Blackhead |
COMEDOME
|
|
|
Whitish papules, 1-2 mm in diameter with no visible opening onto the skin surface.
Example: Whiteheads/acne, healed burns, healed bullous disease states, face of newborn babies |
MILIA
|
|
|
- Dilated superficial blood vessels that appear as fine irregular red lines.
Example: Spider angiomas |
TELANGIECTASIS
|
|
|
used to describe inflammatory conditions of the skin, which appear erythematous and scaly with ill-defined borders.
Example: Atopic dermatitis |
ECZEMATOUS
|
|
|
used to describe conditions, which manifest themselves as papules or plaques with scales.
Example: Psoriasis |
PAPULOSQUAMOUS
|
|
|
Male Pattern Baldness
vs Female Pattern Baldness |
Male pattern baldness - androgenetic alopecia, usually gradual.
Female baldness – more diffuse, widening partings & thinning of hair over the scalp. |
|
|
Areas of alopecia associated with "normal "changes with aging
|
hair loss from the vertex and frontotemporal regions
|
|
|
greatest single factor to changes in skin
|
Sun exposure
|
|
|
Properties of aging skin-6
|
Epidermis thins.
Number of melanocytes decreases. Number of remaining melanocytes increase in size. Large pigmented spots may appear in sun-exposed areas. Elastosis – reduced strength & elasticity. Blood vessels of dermis become more fragile. |
|
|
Definition of Acne Rosacea
|
Chronic acneiform disorder characterized by vascular dilation of the central face
Etiology unknown; believed to be a vascular disorder Occurs in about 5% of the US |
|
|
Clinical presentation of pts with Acne Rosacea- 5
|
Onset typically between the ages of 30-50 and in fair skinned people
Patients characteristically have facial flushing, especially with increases in skin temperature, ingestion of hot or spicy food, and alcohol consumption Overtime, flushing frequently develops into persistent erythema and fine telangiectasis; edema, papules and pustules appear, typically on the central portion of the face; Eyelids and nasolabial folds may become edematous giving a “baggy” look Rhinophyma: red bulbous nose of rosacea; occurs mostly in men Blepharitis can occur as well as dry eye syndrome |
|
|
What are 1/2 &1/2 nails associated with
(1/2 cracked and brittle 1/2 not) |
Renal insufficiency
|
|
|
Oral Treatments for Acne Rosacea
|
Tetracycline 500mg BID for 4-6 weeks; reduce dose to QD when significant improvement occurs; continue to taper as remission occurs
Erythromycin 500mg BID for 4-6 weeks; follow same pattern Doxycycline 100mg po QD tapering to every other or every 3rd day ALL ASSOCIATED W/ STOMACH UPSET |
|
|
Topical Treatments for Acne Rosacea
|
***Metronidazole 0.75% Gel or Cream (Metrogel and Metrocream): apply BID; use gel in patients with oily skin and cream with dry skin; women can apply make up over the meds****
Sulfacet R Lotion: apply BID Clindamycin Lotion: apply BID |
|
|
the formation of comedones, papules, pustules, nodules, and/or cysts as a result of obstruction and inflammation of pilosebaceous units (hair follicles and their accompanying sebaceous gland)
|
Acne Vulgaris
Most common |
|
|
Four key factors are responsible for the development of acne
|
follicular epidermal hyper-proliferation with subsequent plugging of the follicle
excess sebum (produced by androgen dependent sebaceous glands) the presence and activity of Propionibacterium acnes inflammation |
|
|
Is there a correlation between food and sebum production? (as a cause in acne)
|
No therefore pts should be advised to eat a well balanced diet
|
|
|
Open comedones
|
Blackheads
|
|
|
Closed comedones
|
Whiteheads
|
|
|
3 stages of acne
|
Early stage,Comedonal acne
Mild inflammatory Inflammatory Acne final phase |
|
|
Treatment for comedonal acne early stage
|
topical retinoid
|
|
|
Treatment for mild inflammatory to severe acne
|
topical retinoid + oral ATB, benzoyl peroxide
|
|
|
Treatment for Cystic/nodula acne
|
Vitamin A analog
|
|
|
Which acne drugs should not be given in pregnancy?
|
Retinoids
|
|
|
Major side effect of oral ATB for acne
|
Photosensitivity
|
|
|
Catergory X acne medication
|
Accutane
|
|
|
labs to monitor with accutane use
|
lipids(can elevate triglycerides) cbc, pregnancy
|
|
|
What 2 factors should guide the decision of whether to use orla or topical ATB in the tx of acne?
|
extent of skin involovement
severity of inflammation |
|
|
2 drugs that can be used to tx acne in pregnancy
|
Alpha hydroxy acid products
Erythromycin phosphate gel |
|
|
how much steriod cream is needed for whole body use?
|
30-45 grams
|
|
|
Also referred to as Eczema
|
Atopic Dermatitis
|
|
|
Atopic Triad
|
Asthma
Allergic Rhinitis Atopic Dermatitis |
|
|
Clinical Presentation of atopic dermatitis
|
Generally begins in infancy/childhood, has periods of remission, exacerbation, & resolves by age 30
Abnormally dry skin with extreme pruritus Once itch-scratch cycle established, lesions are created Skin becomes dry and scaly (xerosis) Several patterns: Erythematous papular lesions that become confluent Diffuse erythema and scaling Lichenification (thickening of skin with accentuation of skin lines) Dennie-Morgan lines |
|
|
What is the criteria for dx atopic dermatitis?
|
Three out of four major criteria:
Family history of Atopy Typical distribution for age group Chronic or chronically relapsing dermatitis Pruritis “the itch that rashes” |
|
|
What lab elevation is seen in 74% of pts with atopic dematitis?
|
Serum IgE
|
|
|
Treatment for atopic dermatitis
|
Keep environment slightly cool and well humidified
Avoid frequent hand washing Daily soaks in tepid water with mild soaps Wear 100% cotton clothes; avoid wool and synthetics Use fragrance free laundry products Emotional stress can worsen, but not cause the disorder Systematic lubrication of the skin should be done daily; more frequently in winter months Bathing should always be followed immediately by emollients Ointments are most moisturizing, but greasy; Lotions are least moisturizing, but used more Examples: Moisturel Lotion, Eucerin, Lubriderm, Keri, Aquaphor, Vaseline Rx Lotions: Amlactin or Lac Hydrin |
|
|
Found on upper arms, anterior thighs, and the buttocks typically common in patients with Atopic dermatitis
Appears as small, pinpoint, follicular papules and pustules Skin feels rough and dry; hair in the center of the papule/pustule confirms follicular location Aggravated by cold, dry climates, and is associated with extremely dry skin |
Keratosis Pilaris
|
|
|
Disruption to the skin on palms and soles, and fingers
sm blisterlike formations |
Disyhidrosis (Pompholyx)
|
|
|
Clinical Presentation of Disyhidrosis (Pompholyx)
|
Acute Phase: itchy vesicles on the palms, sides of fingers, and soles
Chronic Phase: after 3-4 weeks, vesicles slowly resolve, and are replaced by scaling, redness, and lichenification Waves of vesiculation may occur Moderate to severe itching usually precedes the vesicles and can continue Typically affects adults |
|
|
Treatment for Disyhidrosis (Pompholyx)
|
Skin patch testing can be done if allergy is suspected or it continues (i.e. nickel)
Topical Corticosteroids Oral Antibiotics (i.e.: Erythromycin x 10 days) Cold wet compresses: leave in place for 30 minutes at least 3-4 times a day (helps with itching & to minimize scaling/redness) Oral Steroids for severe cases Refer to Dermatology if no improvement within a week or two |
|
|
Skin inflammation
due to irritants (irritant contact dermatitis) or allergens (allergic contact dermatitis) |
Contact Dermatitis
|
|
|
Clinical Presentation of contact dermatitis
|
Irritant
Intensity of inflammation is r/t the concentration of the irritant and exposure time Mild irritants cause erythema, dryness, and fissuring Chronic exposure can cause oozing, weeping lesions More common than allergic contact dermatitis Common causes: bath soaps, dishwashing soaps, bathroom cleansers, window cleaners, alcohol, glues, cement, deodorant |
|
|
Clinical Presentation of allergic contact dermatitis
|
Hypersensitivity reaction
May correspond exactly to contactant (nickel in jewelry, clothing, fabric, etc…) Poison Ivy, Oak, and Sumac produce more cases of allergic contact derm than all other contactants combined; classic lesions are vesicles and blisters on erythematous base; linear lesions from leaves brushing on skin or from scratching the skin thus streaking the oleoresin; can also have diffuse patterns from contaminated pets or burning plants |
|
|
For alllergic and contact dermatitis what is the first step of treatment?
|
identifying the offending agent and limit or eliminate further exposure
|
|
|
inflammation of the skin of the lower legs caused by chronic venous insufficiency
|
Stasis dermatitis
|
|
|
Symptoms of stasis dermatitis
|
itching, scaling, hyper-pigmentation, and sometimes ulceration
|
|
|
Treatment of stasis dermatitis
|
Treatment is directed at the chronic venous insufficiency
|
|
|
If untreated what can stasis dermatitis progress to?
|
frank skin ulceration, thickened fibrotic skin, or lipodermatosclerosis (a painful induration, which if severe gives the lower leg an inverted “coke-bottle” shape with enlargement of the calf and narrowing at the ankle).
|
|
|
Where do drug eruptions usually start?
|
On the trunk of the body`
|
|
|
Nikolsky Sign
|
- epidermis sloughs with lateral pressure; indicates serious eruption that may constitute a medical emergency
is almost always present in toxic epidermal necrolysis[ |
|
|
Stevens-Johnson Syndrome (SJS)
|
— also called erythema multiforme major — is a rare, serious disorder of the skin and mucous membranes
Often, Stevens-Johnson syndrome begins with several days of flu-like symptoms, followed by inflammation of mucous membranes and a painful red or purplish rash that spreads and blisters, eventually causing the top layer of skin to die and shed Although the cause isn't always clear, Stevens-Johnson syndrome usually is a specific type of allergic reaction in response to medication or infection Considered an emergency medical condition that requires hospitalization |
|
|
Typical symptoms include red patches with purple-gray centers (target lesions) that suddenly appear on arms, legs, face, palms, soles and on the body
Target Lesions |
Erythema Multiforme
|
|
|
is one of the most common early cutaneous manifestations of HIV infection
|
Seborheic Dermatitis
|
|
|
fine, dry, white or yellow scale, on an inflammed base
|
Seborheic Dermatitis
|
|
|
Hallmark sign of impetigo
|
honey crusted lesions
|
|
|
Is rheumatic heart disease a sequelae of impetigo or ecthyma?
|
NO but post strep glomerulonephritis may follow
|
|
|
begins as small superficial vesicles which then rupture leaving erosions covered by moist, honey colored crusts
Multiple lesions usually present Most common sites are face and extremities |
Impetigo
|
|
|
, ulcers form with a dry, dark crust with surrounding erythema; lesions are usually found on legs
|
Ecthyma
|
|
|
Treatment for impetigo/ecthyma
|
For multiple lesions, oral antibiotics are preferred: Dicloxacillin 250mg po QID for 10 days; Erythromycin 250mg po QID for 10 days; Cephalexin 500mg po BID for 10 days
If MRSA is a concern, can treat with Doxycycline (100mg po BID for 10 days) If only a few lesions are noted, can tx. with Mupirocin Ointment (Bactroban) applied TID for 7-10 days or until lesions have cleared (re-evaluate if no response in 3-5 days) Gentle washing of lesions to remove loose crusts can be helpful and need to be done if Bactroban is used Advise good hand washing to reduce likelihood of spread |
|
|
Acute and diffuse inflammation of the skin and sub-q structures characterized by hyperemia, edema, and leukocytic infiltration
|
cellulitis
|
|
|
3 frequent causative agents of cellulitis
|
H.Influenzae, Staph Aureus, and Streptococci
|
|
|
How does cellulitis start?
|
Can develop in apparently normal skin, but trauma to the skin often provides a portal for bacteria
Bacteria invades the dermis and sub-q fat with spread through the lymphatics |
|
|
Indices of an Emergent Cellulitis- 10
|
Extensive cellulitis
Urticaria with Angioedema Anaphylactoid Reactions High fever, or other signs of septicemia Diminished pulses in a cool , swollen, infected extremity Presence of cutaneous necrosis (Toxic Epidermoid Necrolysis: TEN Syndrome) Necrotizing Fasciitis Closed space infections of the hand Periorbital cellulitis (proximity to brain) Immunosuppressed or diabetic patient |
|
|
ATB of choice in an animal bite
|
Augmentin
|
|
|
Bacterial infection of the follicular wall
inflammation of the hair follicle caused by infection, chemical irritation, or injury |
Folliculitis
|
|
|
a deep folliculitis, consisting of a pus filled mass that is painful and firm; most often occurs in areas of friction (waistline, groin, buttocks, axillae)
|
Furuncle (abcess or boil)
|
|
|
groups of infected follicles located deep in the dermis, draining from multiple openings; are painful and occur in areas with thick dermis (back of neck, lateral aspect of thigh); Systemic signs like fever and chills may be present
|
Carbuncles
|
|
|
Skin and mucous membrane infections caused by yeast-like fungus, Candida Albicans
|
Candidiasis
|
|
|
Multiple small circular macules of various colors (white, pink, or brown); often mistaken for vitiligo
|
Tinea Versicolor
|
|
|
Infection by a group of fungi that have the ability to infect and survive only on keratin
|
Dermatophyte Infections: Tinea capitis, corporis, cruris, pedis
|
|
|
affects beards in men
|
Tinea barbae
|
|
|
Jock Itch
|
Tinea Cruris
|
|
|
Athlete’s Foot
|
Tinea Pedis
|
|
|
Skin infestation by mites
|
Scabies
|
|
|
Incubation period of scabies in pts without previous exposure is
|
is 4-6 weeks
|
|
|
Clinical Presentation of scabies
|
Occurs mostly in kids, young adults, and institutionalized pts of all ages (Nursing homes, prisons, etc…)
Primary lesions are burrows (gray or skin colored ridges), vesicles (isolated, pinpoint and filled with serous fluid and maybe mites), and papules (small, isolated, represent hypersensitivity) Secondary lesions with erythema and scaling caused by scratching are present in more chronic cases Common sites: hands (90%), fingerwebs, flexor aspects of wrists, belt line, thigh, navel, intergluteal cleft, penis, areola, and axillae Intense itching, worse at night Generalized urticarial rash can occur, more common in infants and elderly; called Norwegian Scabies and is the result of penetration of the epidermis by hundreds of mites |
|
|
in scabies when is the itching worse/
|
At night
|
|
|
Treatment for scabies
|
Drug of Choice is Permethrin (Elimite) Cream 5%; apply to entire body below head; remove after 8-14 hours by bathing; safe to use in pregnant and lactating pts
|
|
|
What treatment for scabies should not be used in pregnant women or children under the age of 2
|
Lidane
|
|
|
What is a fomite?
|
any inanimate object or substance capable of carrying infectious organisms (such as germs or parasites) and hence transferring them from one individual to another. A fomite can be anything (such as a cloth or mop head),
|
|
|
Pediculosis
|
Lice
|
|
|
Chronic, relapsing hyperproliferative inflammatory disorder of the skin of unknown cause
|
Psoriasis
|
|
|
Believed to be a T-lymphocyte mediated disease or immune mediated inflammation
|
Psoriasis
|
|
|
Clinical Presentation of psoriasis
|
Nail-pitting or white scale with erythematous/salmon-colored plaques.
DIP joint most commonly affected |
|
|
Most common sites of psoriasis
|
extensor surfaces of elbows and knees
Scalp, umbilicus, intergluteal cleft are also common sites |
|
|
multiple, scattered papules and plaques, 1-2cm in diameter, with an acute, abruptive onset
|
Guttate form of psoriasis
|
|
|
Is Psoriasis contagious?
|
no
|
|
|
Three major categories of treatment for psoriasis
|
: topical, ultraviolet light, and systemic therapy
|
|
|
Aim of tx for psoriasis
|
to bring it into remission or inactive state
|
|
|
Basic principle for psoriasis
|
daily lubrication and moisturizing of the skin
|
|
|
Common, benign, often asymptomatic, self limiting skin eruption of unknown etiology; evidence suggests it is viral in origin
Herald patch |
Pityriasis Rosea
|
|
|
How long do the lesions of Pityriasis Rosea last?
|
4-8 wks
|
|
|
Where does the herald patch of pityriasis rosea usually appear/
|
on the trunk and precedes the generalized eruption by 7-14 days
|
|
|
What type of distribution is seen with pityriasis rosea?
|
Christmas tree distribution over the trunk
|
|
|
What testing would you do with Pityriasis Rosea and why
|
Always order VDRL/RPR since secondary syphilis can mimic this disorder
|
|
|
What can hasten the disappearance of Pityriasis Rosea?
|
Sunlight exposure to the point of minimal erythema will hasten disappearance of lesions and decrease itching; caution against sunburn
|
|
|
Chronic, inflammatory, cutaneous and mucous membrane reaction pattern with no known cause; usually affects middle aged adults; ages 30-70
|
Lichen Planus
|
|
|
Wickham’s striae
|
a lacy, reticulated pattern of whitish lines in lichen planus
|
|
|
Five Ps of Lichen Planus:
|
pruritic, planar (flat topped), polyangular, purple, papules or plaques
|
|
|
Cutaneous viral infection, usually involving skin of a single dermatome but may involve one or two adjacent dermatomes
|
Herpes Zoster (Shingles)
|
|
|
Caused by reactivation of Varicella virus that has lied dormant in the basal ganglia after primary infection
|
Herpes Zoster (Shingles)
|
|
|
Benign, viral disorder of skin characterized by discrete, white to flesh-colored, dome-shaped papules
|
Molluscum Contagiosum
|
|
|
Caused by poxvirus; spreads by direct contact, including sexual contact and fomites
|
Molluscum Contagiosum
|
|
|
Common cutaneous manifestation of HIV
|
Molluscum Contagiosum
|
|
|
Tiny 2-5mm early lesions are shiny, white to flesh-colored, dome shaped papules with a firm waxy appearance
As lesions mature the center becomes soft and umbilicated; usually have 2-20 lesions Occur in groups; usually on genital areas in adults |
Molluscum Contagiosum
|
|
|
Superficial, flattened papules covered by dry scale.
|
ACTINIC KERATOSIS
|
|
|
3 Malignant cutaneous neoplasms:
|
Squamous Cell Carcinoma (SCC)
Basal Cell Carcinoma (BCC) Malignant Melanoma (MM) |
|
|
Malignant tumors are a result of .....
|
cumulative cellular effects of UV radiation & inability of skin to mount a defense to it
|
|
|
80% of skin cancers
Usually 6th-7th Decade of life |
BASAL CELL
|
|
|
Commonly on the head & neck
“Pearly white” Round/rolled border Flesh colored Central divot Translucent Telangectacias Ulcerates & bleeds Rarely metastasizes |
BASAL CELL
|
|
|
20% of skin cancers
Middle aged & elderly population |
SQUAMOUS CELL CANCER
|
|
|
Sun-exposed areas, thermally burned skin or areas of chronic inflammation
* lower lip is common in smokers Suddenly show up Upper layers of epidermis Crusted & scaly Inflamed or ulcerated CAN metastasize |
SQUAMOUS CELL CANCER
|
|
|
** Can be evolving Actinic Keratosis (AK)**
|
SQUAMOUS CELL CANCER
|
|
|
Most rapidly increasing U.S. malignancy **
Most lethal type |
MALIGNANT MELANOMA
|
|
|
From the pigmented layer of epidermis
Sometimes called “multicolored papules” |
MALIGNANT MELANOMA
|
|
|
HARMM Melanoma Risk Model
|
History of previous melanoma 1.3
Age over 50 1.2 Regular dermatologist absent 1.4 Mole changing 2.0 Male gender 1.4 |
|
|
ABCDE’s for MOLES
|
Asymmetry
Borders Color Variation Diameter > 6mm. Evolving |
|
|
Lesion starts as a macule
Most common on the trunk Middle-age most common Skin-colored or light tan lesion with more pigmentation over time (Varying Color) Flat to raised “Stuck-on” warty-looking lesions Plaque-like White pearly nodules within NOT associated with risk for malignancy |
SEBORRHEIC KERATOSIS
|
|
|
Acrochordon/Cutaneous Papiloma/Soft Fibroma
|
skin tags”
Soft, flesh-colored, tan or brown Small, often along neck line, axilla, groin Very Common Round or oval pedunculated fleshy polyps Tender after trauma or torsion & may crust of bleed ** Increased number with insulin resistance or pregnancy. |
|
|
: hyperpigmented pedunculated papules common on the face of African Americans and Asians; earlier than keratosis, but still a marker of aging; pts may call them moles
|
Dermatosis Papulosa Nigra:
|
|
|
punctate, mature, vascular papules also called senile hemangiomas; marker of aging, but can be seen earlier in life; red to purple non-blanching papules most commonly seen on trunk
|
Cherry Angiomas:
|
|
|
: small tumors composed of enlarged sebaceous glands which appear as soft, yellow papules; occurs on face/forehead; marker of aging and associated with sun exposure; may be confused with basal cell CA
|
Senile Sebaceous Hyperplasia
|
|
|
: lightly pigmented tan macules with irregular borders in sun exposed areas; commonly called liver spots; occurs on face and back of hands
|
Solar Lentigo
|
|
|
an acquired pigmentary disorder of the skin and mucous membranes, and it is characterized by circumscribed depigmented macules and patches
|
Vitiligo
|
|
|
a rare, chronic condition in which fluid-filled blisters (bullae) erupt on the surface of the skin, usually on arms, legs or trunk
|
Bullous Pemphigoid
|
|
|
a bacterial infection usually spread by sexual contact
|
Syphillis
|
|
|
When would S&S of secondary syphilis begin to appear after the appearance of a chancre?
|
two to 10 weeks
, often appearing as rough, red or reddish-brown, penny-sized sores, over the torso, palms and soles Macular, erythematous, non-pruritic |
|
|
What lab do you want to check in a suspected secondary syphilis?
|
RPR
|
