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Cafe-Au-Lait Spot

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a slightly but uniformly pigmented macule or patch with a somewhat irregular border, usually 0.5-1.5 cm in diameter. benign. six or more such spots, each w/ a diameter of >1.5 cm however, suggest neurofibromatosis.

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Tinea Versicolor

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common superficial fungal infection of skin causing hypo/hyperpigmented slightly scaly macules on the trunk, neck, upper arms. easier to see on darker skin. lighter skin, can look reddish or tan.

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Vitiligo

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depigmented macules appear on the face, hands, feet, extensor surfaces, and other regions and may coalesce into extensive areas that lack melanin. may be hereditary.

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cyanosis

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somewhat bluish color that is visible in toenails, toes, fingernails, fingers. sometimes hard to distinguish

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jaundice

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makes the skin diffusely yellow. most easily and reliably seen in sclera. caused by liver disease and hemolysis of red blood cells.

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carotenemia

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yellowish palm. does not affect sclera. high diet in carrots and other vegetables or fruits causes this. it is not harmful but need to assess dietary intake.

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erythema

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red hue, increased blood flow. slapped cheeks of fifth's disease.

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heliotrope

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violaceous patches over the eyelids in the collagen vascular disease dermatomyositis.

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pityriasis rosea

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reddish oval ringworm-like papules or plaques. Herald patch

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psoriasis

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silvery scaly papules or plaques, mainly on extensor surfaces.

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tinea versicolor

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tan, flat, scaly plaques

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atopic eczema (adult)

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appears mainly on flexor surfaces. lichenification present

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linear

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example=linear epidermal nevus

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geographic

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example=mycosis fungoides

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clustered

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example=grouped vesicles of herpes simplex

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serpiginous

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example=tinea corporis

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annular, arciform

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example=___ plaque of tinea faciale

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macule

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small flat spot up to 1.0 cm. example=hemangioma, vitiligo

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patch

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flat spot, 1.0 cm or larger. example=cafe-au-lait spot, vitiligo

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plaque

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elevated lesion of 1.0 cm or larger. often formed by coalescing papules. example=psoriasis

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papule

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elevated lesion up to 1.0 cm. example=psoriasis

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nodule

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knot-like lesion larger than 0.5 cm, deeper and firmer than a papule. example=dermatofibroma

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cyst

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nodule filled with expressible material, either liquid or semisolid. example=epidermal inclusion cyst

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wheal

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a somewhat irregular, relatively transient, superficial area of localized skin edema. example=urticaria

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vesicle

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up to 1.0 cm. filled with serous fluid. example=herpes simplex, herpes zoster

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bulla

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1.0 cm or larger. filled with serous fluid. example=insect bites

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pustule

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filled with pus (yellow proteinaceous fluid with neutrophils) example=moderate acne, small pox

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burrow

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minute, slightly raised tunnel in the epidermis. commonly found in intertriginous areas. short line that may end in a tiny vesicle. small papules, pustules, lichenified areas, excoriations. example=scabies

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scale

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thin flake of dead exfoliated epidermis. example=dry skin, ichthyosis vulgaris

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crust

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dried residue of skin exudates such as serum, pus, or blood. example=impetigo

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lichenification

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visible and palpable thickening o fth epidermis and roughening of hte skin with increased visibility of the normal skin furrows (chronic rubbing) example=neurodermatitis

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scars

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increased connective tissue that arises from injury or disease. example=hypertrophic scar from steroid injections

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keloids

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hypertrophic scarring that extends beyond the borders of the initiating injury. example=keloid -ear lobe

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erosion

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nonscarring loss of the superficial epidermis. surface moist but doesn't bleed. example=aphthous stomatitis, moist area after vesicle rupture, chickenpox

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excoriation

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linear or punctuate erosions caused by scratching. example=cat scratches

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fissure

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linear crack in the skin resulting from excessive dryness. example=athlete's foot

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ulcer

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deeper loss of the epidermis and dermis. may bleed and scar. example=stasis ulcer of venous insufficiency, syphilitic chancre

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mild acne

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open and closed comedones, occasional papules

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moderate acne

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comedones, papules, pustules

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severe cystic acne

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scarring, cysts

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spider angioma

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fiery red. up to 2 cm. central body that is sometimes raised. .pressure on body causes blanching. found in face, neck, arms and upper trunk;ALMOST NEVER below the waist. suggests liver disease, pregnancy, vitamin B deficiency or may be normal

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spider vein

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bluish, variable size. variable shape (linear, irregular, cascading) no blanching of center but diffuse pressure blanches outside. found in the legs, also anterior chest. accompanies increased pressure in superficial veins

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cherry angioma

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bright/ruby red 1-3 mm. round, flat, or raised, surrounded by pale halo sometimes. partial blanching. found on trunk and extremities. no clinical significance

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petechia/purpura

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deep red, purple. fading over time. 1-3 mm. rounded, irregular, flat. no blanching. found anywhere. suggests blood outside vessels (bleeding disorder or emboli)

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ecchymosis

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purple, purplish blue. fading to green,yellow & brown w/ time. >3 mm. rounded, oval or irregular. may have central flat nodule. no blanching. found anywhere. suggests bruising/trauma/bleeding disorders.

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actinic keratosis

answer

superficial, hyperkeratotic papules. often multiple. round, irregular, pink, tan, grayish. sun exposed skin. older people, fair skin. dysplastic/ precancerous. turn into SCC 1 in every 1000. face and hand are typical locations

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seborrheic keratosis

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common, benign, whitish-yellowish to brown raised papules or plaques that feel slightly greasy/velvety or warty and have a "stuck on" appearance. trunk, face.

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basal cell carcinoma

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grows slowly. almost never metastasizes. fair skinned, 40 or older, on the face. red macule/papule initially with a depressed center and a firm, elevated border. telangiectatic vessels are usually associated. pearly, translucent, rolled up edges

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squamous cell carcinoma

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sun exposed skin of fair skinned adults over 60 years. develop from AKs. more quickly growing than other cancers like BCC. firmer, redder, face, dorsum of hand.

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benign nevus

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common mole. appears in first few decades. appearance remains unchanged. round, sharp borders, uniform color, small diameter, flat/raised surface. 50-100

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malignant melanoma

answer

ABCDE. sun exposure, blistering sunburns in childhood, fair skin, family history of melanoma, changing moles, age over 50. moles w/ swelling, redness, scaling, oozing, or bleeding, itching, burning, pain.

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macules

answer

solar lentigines present as

question

papules/pustules

answer

hot tub folliculitis presents with

question

pustules

answer

pustular psoriasis presents with

question

vesicles

answer

chickenpox presents with

question

bulla, target lesions

answer

erythema multiforme presents with

question

telangiectasias, nodules, ulcers

answer

squamous cell carcinoma presents with

question

vesicle, pustule, erosion, crust

answer

infected atopic dermatitis presents with

question

excoriation, lichenification on leg

answer

atopic dermatitis presents with

question

wheals

answer

urticaria presents with

question

plaques w/ scale on the knees

answer

psoriasis presents with

question

patch (cafe-au-lai spots), nodules

answer

neurofibromatosis presents with

question

macules/papules/plaques/nodules anywhere on body

answer

kaposis's sarcoma in AIDS

question

stage 1 pressure ulcer

answer

reddened area, does NOT blanch. change in temp, consistency, sensation, color. epidermis still intact

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stage 2 pressure ulcer

answer

skin forms blister/sore. partial-thickness skin loss or ulceration involving epidermis, dermis/both.

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stage 3 pressure ulcer

answer

crater on skin with full-thickness loss and damage to or necrosis of subcutaneous tissue that may extend to but not through the underlying muscle

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stage 4 pressure ulcer

answer

full-thickness skin loss with destruction,tissue necrosis, or damage to underlying muscle, bone, tendons, joints.

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alopecia areata

answer

clearly demarcated round or oval patches of hair loss, usually affecting young adults and children. no scaling or inflammation

question

trichotillomania

answer

hair loss from pulling, twisting, plucking hair. hair shaft broken at various lengths. more common in children

question

tinea capitis

answer

round scaling patches of alopecia. hairs broken off close to surface of scalp. fungal infection.

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paronychia

answer

superficial infection of the proximal and laterla nail folds adjacent to nail plate. red , swollen, tender. staph aureus and strepto bacteria cause acute, candida cause chronic. due to local trauma like nail biting, manicuring or frequent hand immersion in water

question

clubbing of the fingers

answer

bulbous swelling of soft tissue at nail base with angle between nail and proximal nail fold increasing past 180 degrees. nail bed is spongy or floating. caused by vasodilation w/ increased blood flow to distal portion of digits and changes in the connective tissue. hypoxia. seen with congenital heart disease, interstitial lung disease, and lung cancer, inflammatory bowel diseases and malignancies

question

onycholysis

answer

painless separation of whitened opaque nail plate from pinker translucent nail bed. starts distally and progresses proximally, enlarging the free edge of the nail. causes include trauma, manicuring, psoriasis, fungal infection. systemic causes like hyperthyroidism peripheral ischemia, bronchiestasis, syphilis, drug reactions, DIABETES

question

terry's nails

answer

nail plate turns white with ground-glass appearance. distal band of reddish brown. obliteration of lunula. seen in liver disease, heart failure, diabetes. can be in all or just one finger

question

leukonychia (white spots)

answer

trauma followed by non uniform white spots that grow slowly out with the nail. resemble curve of cuticle and proximal nail fold. causes are excessive manicuring.

question

transverse white bands (Mees' Lines)

answer

curving transverse white bands that cross the nail parallel to the lunula. arising from the disrupted matrix of the proximal nail, vary in width and move distally as nail grows out. seen in arsenic poisoning, heart failure, hodgkin's disease, chemo, carbon monoxide poisoning, and leprosy.

question

transverse linear depressions (Beau's Lines)

answer

transverse depressions of the nail plates, usually bilateral. temporary disruption of proximal nail growth from systemic illness timing of illness may be estimated by measuring the distance from the line to the nail bed (nails grow 1 mm every 6-10 days). seen in severe illness, trauma, cold exposure in Raynaud's

question

pitting

answer

punctuate depressions of the nail plate caused by defective layering of the superficial nail plate by the proximal nail matrix. seen in psoriasis, alopecia areata, sarcoidosis, atopic/chemical dermatitis, Reiter's syndroms.

Bates Ch 6 Tables (Dermatology) – Flashcards

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