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71 Cards in this Set
- Front
- Back
describe morphology
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macules
flat, non-palpable lesions, usu <10 mm dia patch = large macule ex - freckles, tattoos, port-wine stains, rashes of rickettsial infections, rubella, measles |
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describe morphology
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papules
elevated lesions, usu <10mm dia, can be palpated ex - nevi, warts, lichen planus, insect bites, seborrheic and actinic keratoses, some lesions of acne and skin cancers |
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describe morphology
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plaques
palpable lesions >10mm in dia, elevated or depressed may be flat-topped or rounded ex - psoriasis lesions, granuloma annulare |
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describe morphology
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nodule
firm, papules or lesions, extend into dermis or subcutaneous tissue ex - cysts, lipomas, fibromas |
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describe morphology
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vesicles
small, clear, fluid-filled blisters <10mm in dia ex - herpes/varicella, acute allergic contact dermatitis, autoimmune blistering disorders |
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describe morphology
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bullae
clear fluid-filled blisters >10mm in dia ex - burns, bites, irritant, allergic contact dermatitis, drug rxns, inherited disorders of skin fragility, **pemphigus vulgaris and bullous pemphigoid |
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describe morphology
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pustules
vesicles that contain pus ex - may arise in some inflammatory diseases (pustular psoriasis), folliculitis |
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describe morphology
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urticaria (wheals or hives)
elevated lesions caused by localized edema, typically last <24h common ex - hypersensitivity to drugs, stings, bites, autoimmunity less common ex - physical stimuli (e.g. temp, pressure, sunlight) |
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describe morphology
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scales
heaped-up accumulations of horny epithelium ex - psoriasis, pityriasis rosea, seborrheic dermatitis, fungal infxns, chronic dermatitis of any type |
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describe morphology
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crusts (scabs)
consist of dried blood, serum or pus can occur in inflammatory or infections skin diseases **honey colored crusts = impetigo/staph aureus |
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describe morphology
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erosions
open areas of skin resulting from loss of epidermis can be traumatic, inflammatory, infectious **excorations --> linear or abnormally shaped erosions caused by scratching, rubbing, picking |
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describe morphology
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ulcer
result from loss of epidermis and part/all of dermis ex - venous stasis dermatitis, physical trauma, infections, vasculitis (yuuuuuuuuuuck.) |
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describe morphology
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petechiae (around the bruised ankle)
non-blanchable punctate foci of hemorrhage ex - platelet abnormalities, vasculitis, infections (rocky mt spotted fever, meningococcemia) |
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describe morphology
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purpura
larger area of hemorrhage, may be palpable may indicate coagulopathy large areas of purpura may be called ecchymoses (bruises) **palpable purpura --> hallmark of leukocytoclastic vasculitis |
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describe morphology
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atrophy
thinning of skin, may appear dry and wrinkled ex - chronic sun exposure, aging, inflammatory/neoplastic skin diseases (SLE, cutaneous T-cell lymphoma), long-term use of potent topical corticosteroids |
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describe morphology
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scars
areas of fibrosis, replace normal skin after injury some become hypertrophic or thickened/raised **keloids = hypertrophic scars extending beyond original wound margin |
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describe morphology
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telangiectasias (this is on/in basal cell carcinoma)
focus of small, permanently dilated blood vessels ex - most often idiopathic, rosacea, systemic diseases (esp scleroderma), inherited diseases, long-term therapy c topical fluorinated corticosteroids |
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describe secondary morphology
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linear lesion
take on the shape of a straight line ex - contact dermatitis, linear epidermal nevi, lichen striatus |
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describe secondary morphology
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annular lesions
rings w/ central clearing ex - granuloma annulare, some drug eruptions, some dermatophyte infections (ringworm), secondary syphilis |
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describe secondary morphology
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nummular lesions
circular or coin-shaped ex - nummular eczema **differentiate from ringworm --> history of atopy, skin biopsy |
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describe secondary morphology
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target lesions (bull's eye, iris)
ring w/ central duskiness classic for erythema multiforme |
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describe secondary morphology
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serpiginous lesions
linear, branched, curving elements ex - some fungal and parasitic infxns (cutaneous larva migrans) |
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describe secondary morphology
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reticulated lesions
lacy or networked pattern ex - cutis marmorata, livedo reticularis |
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describe secondary morphology
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herpetiform
grouped papules or vesicles arranged like those of herpes simplex infection |
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describe secondary morphology
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zosteriform
clustered in a dermatomal distribution similar to herpes zoster |
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describe texture
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verrucous lesions
irregular, pebbly, rough surface ex - warts, seborrheic keratoses |
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describe texture
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lichenification
thickening of skin with accentuation of normal skin marking **results from repeated rubbing |
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describe texture
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induration
deep thickening of skin hard, resistant feeling. caused by edema, infection, infiltration ex - panniculitis, skin infections, cutaneous metastatic cancer |
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describe texture
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umbilicated
central indentation, usually viral ex - herpes simplex, molluscum contagiosum (pictured) |
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describe texture
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xanthomas
yellowish, waxy lesions ex - occur in lipid disorders |
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describe location/distribution
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psoriasis
frequently affects scalp, extensor surfaces of elbows and knees, umbilicus, gluteal cleft |
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describe location/distribution
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lichen planus
frequently on wrists, forearms, genitals, lower legs |
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describe location/distribution
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vitiligo
may be patchy and isolated or may group around distal extremities and face **the darker skin is this patient's normal hue |
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describe location/distribution
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chronic cutaneous lupus erythematosus - malar rash
characteristic lesions on sun-exposed skin of face, especially forehead, nose, conchal bowl of ear |
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describe location/distribution
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hidradentis suppurativa
involves skin containing high density of apocrine glands --> axillae, groin, under breasts |
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describe color
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red skin (erythema)
results from many inflammatory or infectious diseases cutaneous tumors often pink or red superficial vascular lesions may appear red (port wine) |
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describe color
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orange skin
most often seen in hypercarotenemia, usually benign condition of carotene deposition after excess dietary ingestion of B-carotene **white sclera! **yellow skin is typical of jaundice, xanthelasmas and xanthomas, pseudoxanthoma elasticum |
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describe color
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green fingernails
suggests Pseudomonas aeruginosa infxn |
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describe color
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violet skin
may result from cutaneous hemorrhage or vasculitis purple = vascular lesions or tumors (Kaposi's, hemangiomas) lilac color of eyelids or heliotrope eruption = dermatomyositis |
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describe color
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violet skin
may result from cutaneous hemorrhage or vasculitis purple = vascular lesions or tumors (Kaposi's, hemangiomas) lilac color of eyelids or heliotrope eruption = dermatomyositis |
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describe color
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shades of blue/silver/grey
result from deposition of drugs or metals in the skin minocycline, amiodarone, silver ischemic skin = purple/blue deep dermal nevi = blue |
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describe color
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black skin
may be melanocytic, including nevi and melanoma black eschars = collections of dead skin that can arise from vascular infarctions --> infxn |
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describe this clinical sign
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dermatographism
appearance of urticarial wheal after focal pressure up to 5% of normal pts exhibit this sign |
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describe this clinical sign
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darier's sign
rapid swelling of lesion when stroked occurs in pts with urticaria pigmentosa or mastocytosis |
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describe this clinical sign
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nikolsky's sign
epidermal shearing occurring w/ gentle lateral pressure on seemingly uninvolved skin in pts w/ toxic epidermal necrolysis and some autoimmune bullous diseases |
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describe this clinical sign
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auspitz sign
pinpoint bleeding after scale is removed from plaques in psoriasis |
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This is a lesion found on a 60 y/o farmer. How would you definitively diagnose it?
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obtain good hx, skin screening for similar lesions.
this is actinic keratosis - punch biopsy for definitive dx |
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describe this clinical sign
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koebner phenomenon
development of lesions within area of trauma frequently exhibited in psoriasis |
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Describe this lesion. What do you think caused it?
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wheal with central puncture --> allergic reaction to bee sting
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What do you suspect caused this?
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tick bite --> rocky mountain spotted fever
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What do you suspect caused this?
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tick bite --> rocky mountain spotted fever
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Rash due to mistreatment of ___ with ___.
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mono with amoxicillin
misdiagnosed as strep |
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This is a typical childhood illness that has recently started to decrease in occurence due to vaccination. Dx?
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varicella, chicken pox
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This childhood illness was thought to be eradicated by immunizations, but has shown reoccurrence in college populations. Dx?
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measles --> booster now recommended.
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Dx? Organism responsible? Tx?
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acne vulgaris --> Propionibacterium acnes
systemic tx --> erythromycin/minocycline comedolytic agents --> benzoyl peroxide/tretinoin |
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6 m/o presents with rash, has been mouth breather since birth.
What is Dx? What test would be abnormal in this pt? |
atopic dermatitis (type I hypersensitivity rxn) --> RIST test (used to measure IgE) would be elevated
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30 y/o man with pruritic, hypopigmented rash.
Dx? Workup? Tx? |
Dx - Tinea versicolor
Workup - KOH prep Tx - Ketoconazole tablets |
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32 y/o HIV+ male
Initial work-up? Dx? |
KOH prep
Dx - Malassezia furfur |
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32 y/o female taking OCPs
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melasma
**pmhrt does not cause this! |
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Dx.
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seborrheic keratosis
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2 y/o developed these lesions on face over past 3 days. afebrile.
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impetigo
(due to group A strep) |
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56 y/o pt who has a recent onset of focal seizures of the simple partial type due to meningioma.
what does this pt have? |
neurofibromatosis
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What is the name of this macular lesion?
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café-au-lait spots
**commonly associated with neurofibromatosis |
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pruritic lesions on 9 y/o
what is dx? initial work-up? |
do KOH prep from scrapings of the leading edge of lesion
pt has Tinea corporis (ringworm) *spaghetti + meatballs on slide |
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lesion on the face of a 54 y/o farmer.
dx? work-up? |
nodular melanoma / exicisional biopsy of lesion
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What would cause these lesions?
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pathognomonic erythematous rash in pattern of bull's eye --> Lyme disease
**erythema migrans!! |
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This is the rash on the shoulder of a 9-mo-old. What is your diagnosis?
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prickly heat
result of blocked sweat ducts --> heat rash looks liks small red or pink pimples |
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Dx and Tx of this nodule?
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Dx - dermatofibroma
common benign skin tumor - small, slow-growing, firm, consists of proliferation of scar-like tissue Tx - simple excision is curative |
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The skin lesion noted on this patient's nose is a classic example of...?
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basal cell carcinoma
usu appears as "sore that doesn't heal" --> bleeding/scabbing sore most often on face and neck locally invasive, don't metastasize tx - scrape/burn/excise |
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Dx and Tx?
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Dx - poison ivy
Tx - topical steroids, oral prednisone, IM decadron/kenalong if severe, anti-histamine for itching |
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What would be a high index of suspicion for a differential in this child if he had a low grade fever and flu-like symptoms?
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fifth's disease (parvo B19)
**slapped face |