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275 Cards in this Set
- Front
- Back
A widespread increase in melanin may be caused by _____ disease (hypofunction of the adrenal cortex) or some pituitary tumors. More common are local areas of increased or decreased pigment.
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Addison's
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A slightly but uniformly pigmented macule or patch with a somewhat irregular border, usually 0.5 to 1.5 cm in diameter; benign. Six or more such spots, each with a diameter of >1.5 cm, however, suggest neurofibromatosis (p. 188). (The small, darker macules are unrelated.)
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Café-Au-Lait Spot
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Common superficial fungal infection of the skin, causing hypopigmented, slightly scaly macules on the trunk, neck, and upper arms (short-sleeved shirt distribution). They are easier to see in darker skin and in some are more obvious after tanning. In lighter skin, macules may look reddish or tan instead of pale.
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Tinea Versicolor
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Unlike jaundice, _____ does not affect the sclera, which remains white. It is not harmful but indicates the need for assessing dietary intake.
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Carotenemia
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Erythema, is also known as what?
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Red hue, increased blood flow, seen here as the “slapped cheeks” of erythema infectiosum (“fifth disease”).
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Violaceous eruption over the eyelids in the collagen vascular disease dermatomyositis.
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Heliotrope
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Heliotrope
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Violaceous eruption over the eyelids in the collagen vascular disease dermatomyositis.
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Reddish oval ringworm-like lesions
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Pityriasis Rosea
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Silvery scaly lesions, mainly on the extensor surfaces
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Psoriasis
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Tan, flat, scaly lesions
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Tinea Versicolor
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Atopic Eczema (adult form) Appears mainly on ____ surfaces
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flexor
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Small flat spot, up to 1.0 cm
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Macule
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Flat spot, 1.0 cm or larger
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Patch
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Elevated superficial lesion 1.0 cm or larger, often formed by coalescence of papules
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Plaque
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elevated Up to 1.0 cm
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Papule
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Marble-like lesion larger than 0.5 cm, often deeper and firmer than a papule
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Nodule
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Nodule filled with expressible material, either liquid or semisolid
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Cyst
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A somewhat irregular, relatively transient, superficial area of localized skin edema
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Wheal
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Up to 1.0 cm; filled with serous fluid
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Vesicle
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1.0 cm or larger; filled with serous fluid
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Bulla
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Filled with pus
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Pustule
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A minute, slightly raised tunnel in the epidermis, commonly found on the finger webs and on the sides of the fingers. It looks like a short (5-15 mm), linear or curved gray line and may end in a tiny vesicle. Skin lesions include small papules, pustules, lichenified areas, and excoriations.
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Burrow (scabies)
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mycosis fungoides has what pattern/shape?
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geographic
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tinea corporis has what pattern/shape?
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serpignious
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tinea faciale has what pattern/shape?
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annular
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herpes zoster can present as what type of lesion?
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many, but vesicles, (similar to herpes simplex).
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hemiangioma is what type of lesion?
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macule
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café au lait spot is what type of lesion?
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patch
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psoriasis is what type of lesion?
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Plaque, or papule
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dermatofibroma is what type of lesion?
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nodule
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utricaria is what type of lesion?
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wheal
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A thin flake of dead exfoliated epidermis.
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Scale
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The dried residue of skin exudates such as serum, pus, or blood
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Crust
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Visible and palpable thickening of the epidermis and roughening of the skin with increased visibility of the normal skin furrows (often from chronic rubbing)
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Lichenification
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Connective tissue that arises from injury or disease
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Scars
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Hypertrophic scarring that extends beyond the borders of the initiating injury
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Keloids
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ichthyosis vulgaris has what type of lesion?
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scale
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dry skin has what type of lesion?
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scale
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impetigo has what type of lesion?
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crust
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neurodermatitis has what type of lesion?
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Lichenification
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Nonscarring loss of the superficial epidermis; surface is moist but does not bleed
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Erosion
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Aphthous stomatitis, moist area after the rupture of a vesicle, as in chickenpox, is an example of what type of lesion?
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erosion
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Linear or punctate erosions caused by scratching
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Excoriation
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Cat scratches are an example of what type of lesion?
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Excoriation
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A linear crack in the skin, often resulting from excessive dryness
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Fissure
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Athlete's foot presents with what type of lesion?
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Fissure
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A deeper loss of epidermis and dermis; may bleed and scar
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Ulcer
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of venous insufficiency, or syphilitic chancre both have what type of lesion?
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Ulcer
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Acne is a disorder of the _____ follicle.
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pilosebaceous
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what involves 1) proliferation of the keratinocytes at the opening of the follicle; 2) increased production of sebum, stimulated by androgens, which combines with keratinocytes to plug the follicular opening; 3) growth of Propionibacterium acnes, an anaerobic diphtheroid normally found on the skin; 4) and inflammation from bacterial activity and release of free fatty acids and enzymes from activated neutrophils.
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acne
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which bacteria is involved with skin acne?
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Propionibacterium acnes, an anaerobic diphtheroid normally found on the skin
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acne Lesions appear in areas with the greatest number of ______ glands, namely the face, neck, chest, upper back, and upper arms. They may be primary, secondary, or mixed.
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sebaceous
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Match the vascular lesion with the description. Color and Size: Fiery red. From very small to 2 cm
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Spider Angioma*
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Match the vascular lesion with the description. Color and Size: Bluish. Size variable, from very small to several inches
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Spider Vein*
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Match the vascular lesion with the description. Color and Size: Bright or ruby red; may become brownish with age. 1-3 mm
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Cherry Angioma
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Match the vascular lesion with the description. Shape: Central body, sometimes raised, surrounded by erythema and radiating legs
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Spider Angioma*
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Match the vascular lesion with the description. Shape: Variable. May resemble a spider or be linear, irregular, cascading
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Spider Vein*
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Match the vascular lesion with the description. Shape: Round, flat or sometimes raised, may be surrounded by a pale halo
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Cherry Angioma
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Match the vascular lesion with the description. Pulsatility and Effect of Pressure: Often seen in center of the spider, when pressure with a glass slide is applied. Pressure on the body causes blanching of the spider.
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Spider Angioma*
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Match the vascular lesion with the description. Pulsatility and Effect of Pressure: Absent. Pressure over the center does not cause blanching, but diffuse pressure blanches the veins.
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Spider Vein*
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Match the vascular lesion with the description. Pulsatility and Effect of Pressure: Absent. May show partial blanching, especially if pressure applied with edge of a pinpoint
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Cherry Angioma
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Match the vascular lesion with the description. Distribution: Face, neck, arms, and upper trunk; almost never below the waist
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Spider Angioma*
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Match the vascular lesion with the description. Distribution: Most often on the legs, near veins; also on the anterior chest
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Spider Vein*
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Match the vascular lesion with the description. Distribution: Trunk; also extremities
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Cherry Angioma
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Match the vascular lesion with the description. Significance: Liver disease, pregnancy, vitamin B deficiency; also occurs normally in some people
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Spider Angioma*
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Match the vascular lesion with the description. Significance: Often accompanies increased pressure in the superficial veins, as in varicose veins
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Spider Vein*
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Match the vascular lesion with the description. Significance: None; increases in size and numbers with aging
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Cherry Angioma
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Match the purpric lesion with the description. Color and Size: Deep red or reddish purple, fading away over time. Petechia, 1-3 mm; purpura, larger
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Petechia/Purpura
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Match the purpric lesion with the description. Color and Size: Purple or purplish blue, fading to green, yellow, and brown with time. Variable size, larger than petechiae, >3 mm
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Ecchymosis
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Match the purpric lesion with the description. Shape: Rounded, sometimes irregular; flat
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Petechia/Purpura
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Match the purpric lesion with the description. Shape: Rounded, oval, or irregular; may have a central subcutaneous flat nodule (a hematoma)
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Ecchymosis
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Of the three listed vascular lesions, which one is not a telangiectasis? Spider Angioma, Vein, and Cherry Angioma
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Cherry Angioma. The spider vein and angiom are dilated small vessels that look red or bluish.
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Match the purpric lesion with the description. Significance: Blood outside the vessels; may suggest a bleeding disorder or, if petechiae, emboli to skin; palpable purpura in vasculitis
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Petechia/Purpura
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Match the purpric lesion with the description. Significance: Blood outside the vessels; often secondary to bruising or trauma; also seen in bleeding disorders
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Ecchymosis
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Superficial, flattened papules covered by a dry scale. Often multiple; can be round or irregular; pink, tan, or grayish. Appear on sun-exposed skin of older, fair-skinned people. Though benign, 1 of every 1000 per year develop into squamous cell carcinoma (suggested by rapid growth, induration, redness at the base, and ulceration). Keratoses on face and hand, typical locations, are shown.
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Actinic Keratosis
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Common, benign, yellowish to brown raised lesions that feel slightly greasy and velvety or warty and have a “stuck on” appearance. Typically multiple and symmetrically distributed on the trunk of older people, but may also appear on the face and elsewhere. In black people, often younger women, may appear as small, deeply pigmented papules on the cheeks and temples (dermatosis papulosa nigra).
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Seborrheic Keratosis
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though malignant, grows slowly and seldom metastasizes. It is most common in fair-skinned adults 40 years or older, and usually appears on the face. An initial translucent nodule spreads, leaving a depressed center and a firm, elevated border. Telangiectatic vessels are often visible.
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Basal Cell Carcinoma
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Usually appears on sun-exposed skin of fair-skinned adults older than 60 years. May develop in an actinic keratosis. Usually grows more quickly than a basal cell carcinoma, is firmer, and looks redder. The face and the back of the hand are often affected, as shown here.
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Squamous Cell Carcinoma
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Benign Nevus
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__
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Benign Nevus, common mole, usually appears in the first few decades. Several nevi may arise at the same time, but their appearance usually remains unchanged. What are the typical features that contrast them with those of atypical nevi and melanoma?
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1. round or oval shape, 2. sharply defined borders, 3, uniform color especially tan or brown, 4, diameter <6mm, 5. flat or raised surface.
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What are the ABCD's for a malignant melanoma?
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Asymmetry, Borders Irregular, Color varation, Diameter greather than 6 mm
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hot tub folliculitis from Pseudomonas manifests as what type of lesion?
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Papules and pustules
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actinic lentigines manifests as what type of lesion?
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Macules on the dorsum of the hand, wrist, and forearm
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(A) Patch (café-au-lait spots), (B) nodules—a combination typical of _______.
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neurofibromatosis
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This malignant tumor may appear in many forms: macules, papules, plaques, or nodules almost anywhere on the body. Lesions are often multiple and may involve internal structures.
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Kaposi's sarcoma in AIDS
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Name the disease that causes the following?: Hyperpigmentation of skin and mucous membranes
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Addison's disease
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Name the disease that causes the following?: Hairy leukoplakia, Kaposi's sarcoma, herpes simplex virus (HSV), human papillomavirus (HPV), cytomegalovirus (CMV), molluscum contagiosum, mycobacterial skin infections, candidiasis and other cutaneous fungal infections, oral and anal squamous cell carcinoma, acquired ichthyosis, bacterial abscesses, psoriasis (often severe), erythroderma, seborrheic dermatitis (often severe)
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AIDS
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Name the disease that causes the following?: Pallor, xerosis, pruritus, hyperpigmentation, uremic frost, metastatic calcification in the skin, calciphylaxis, “half and half” nails, hemodialysis-related skin disease
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Chronic renal disease
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Name the disease that causes the following?: Calcinosis, Raynaud's phenomenon, sclerodactyly, telangiectasias
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CREST syndrome
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Name the disease that causes the following?: Erythema nodosum, pyoderma gangrenosum, enterocutaneous fistulas, aphthous ulcers
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Crohn's disease
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Name the disease that causes the following?: Striae, skin atrophy, purpura, ecchymoses, telangiectasias, acne, moon facies, buffalo hump, hypertrichosis
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Cushing's disease
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Name the disease that causes the following?: Heliotrope rash, Gottron's papules, periungual telangiectasias, alopecia, poikiloderma in sun-exposed areas, Raynaud's phenomenon
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Dermatomyositis
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Name the disease that causes the following?: Necrobiosis lipoidica diabeticorum, diabetic bullae, diabetic dermopathy, granuloma annulare, acanthosis nigricans, candidiasis, neuropathic ulcers, eruptive xanthomas, peripheral vascular disease
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Diabetes
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Name the disease that causes the following?: Skin necrosis, petechiae, ecchymoses, hemorrhagic bullae, purpura fulminans
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Disseminated intravascular coagulation
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Name the disease that causes the following?: Xanthomas (tendon, eruptive, and tuberous), xanthelasma (may occur in healthy people)
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Dyslipidemias
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Name the disease that causes the following?: Erythematous macules to hemorrhagic pustules; lesions in acral distribution that can involve palms and soles
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Gonococcemia
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Name the disease that causes the following?: Skin bronzing and hyperpigmentation
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Hemochromatosis
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Name the disease that causes the following?: Dry, rough, and pale skin; coarse and brittle hair; myxedema; alopecia (lateral third of the eyebrows to diffuse); skin cool to touch; thin and brittle nails
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Hypothyroidism
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Name the disease that causes the following?: Warm, moist, soft, and velvety skin; thin and fine hair; alopecia; vitiligo; pretibial myxedema (in Graves' disease); hyperpigmentation (local or generalized)
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Hyperthyroidism
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Name the disease that causes the following?: Janeway lesions, Osler nodes, splinter hemorrhages, petechiae
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Infective endocarditis
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Name the disease that causes the following?: Mucosal erythema (lips, tongue, and pharynx), strawberry tongue, cherry red lips, polymorphous rash (primarily on trunk), erythema of palms and soles with later desquamation of fingertips
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Kawasaki disease
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Name the disease that causes the following?: Jaundice, spider angiomas and other telangiectasias, palmar erythema, Terry's nails, pruritus, purpura, caput medusae
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Liver disease
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Name the disease that causes the following?: Pallor, exfoliative erythroderma, nodules, petechiae, ecchymoses, pruritus, vasculitis, pyoderma gangrenosum, bullous diseases
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Leukemia/lymphoma
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Name the disease that causes the following?: Pink macules and papules, petechiae, hemorrhagic petechiae, hemorrhagic bullae, purpura fulminans
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Meningococcemia
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Name the disease that causes the following?: Neurofibromas, café au lait, freckling in the axillary and inguinal areas, plexiform neurofibroma
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Neurofibromatoses 1 (von Recklinghausen's syndrome)
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Name the disease that causes the following?: Grey Turner sign, Cullen's sign, panniculitis
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Pancreatitis (hemorrhagic)
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Name the disease that causes the following?: Panniculitis, migratory thrombophlebitis
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Pancreatic carcinoma
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Name the disease that causes the following?: Dry, scaly, shiny atrophic skin; dystrophic, brittle toenails; cool skin; hairless shins; ulcers; pallor; cyanosis; gangrene
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Peripheral vascular disease
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Name the disease that causes the following?: Melasma, increased pigmentation of areolae, linea nigra, palmar erythema, varicose veins, striae, spider angiomas, hirsutism, pyogenic granuloma
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Pregnancy (physiologic changes)
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Name the disease that causes the following?: Psoriasis-like skin and mucous membrane lesions, keratoderma blennorrhagicum, balanitis circinata
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Reiter's syndrome
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Name the disease that causes the following?: Vasculitis, Raynaud's phenomenon, rheumatoid nodules, pyoderma gangrenosum, rheumatoid papules, erythematous to salmon-colored rashes
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Rheumatoid arthritis
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Name the disease that causes the following?: Erythematous rash that begins on wrists and ankles, then spreads to palms and soles; becomes more purpuric as it generalizes
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Rocky Mountain spotted fever
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Name the disease that causes the following?: Thickened, taut, and shiny skin; ulcerations and pitted scars on fingertips; sclerodactyly; telangiectasias; Raynaud's phenomenon
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Scleroderma
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Name the disease that causes the following?: Jaundice, leg ulcers (malleolar regions), pallor
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Sickle cell
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Name the disease that causes the following?: 1°: Chancre (painless) (see p. 516)
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Syphilis
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Name the disease that causes the following?: 2°: Rash (“the great imitator”)—ham- to bronze-colored, generalized, maculopapular rash that involves the palms and soles, pustules, condylomata lata, alopecia (“motheaten”), white plaques on oral and genital mucosa
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Syphilis
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Name the disease that causes the following?: 3°: Gummas, granulomas
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Syphilis
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Name the disease that causes the following?: Photosensitivity, malar (butterfly) rash, discoid rash, alopecia, vasculitis, oral ulcers, Raynaud's phenomenon
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Systemic lupus erythematosus
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Name the disease that causes the following?: Petechiae, ecchymoses
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Thrombocytopenic purpura
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Name the disease that causes the following?: Adenoma sebaceum (angiofibromas), ash-leaf spots, shagreen patch, perungual fibromas
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Tuberous sclerosis
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Name the disease that causes the following?: Erythema nodosum, pyoderma gangrenosum
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Ulcerative colitis
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which virus is responsible for the following?: Oral ulcers; macules, papules, and vesicles on hands, feet, and buttocks
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Coxsackie A (hand, foot, and mouth)
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which virus is responsible for the following?: Erythema of cheeks (“slapped cheeks”) followed by erythematous, pruritic, reticulated (net-like) rash that starts on trunk and proximal extremities (rash worsens with sun, fever, and temperature changes)
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Erythema infectiosum (fifth disease)
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which virus is responsible for the following?: Erythematous, maculopapular, discrete rash (often fever present) that begins on head and spreads to involve trunk and extremities, petechiae on soft palate
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Roseola infantum (HSV 6) or Rubella
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which virus is responsible for the following?: Erythematous, maculopapular, discrete rash (often fever present) that begins on head and spreads to involve trunk and extremities, petechiae on soft palate
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Rubella (German measles) or Roseola Infantum (HSV 6)
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which virus is responsible for the following?: Erythematous, maculopapular rash that begins on head and spreads to involve trunk and extremities (lesions become confluent on face and trunk, but are discrete on extremities), Koplik spots on buccal mucosa
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Rubeola (measles)
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which virus is responsible for the following?: Generalized, pruritic, vesicular (vesicles on an erythematous base, “dewdrop on a rose petal”) rash begins on trunk and spreads peripherally, lesions appear in crops and are in different stages of healing
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Varicella (chickenpox)
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which virus is responsible for the following?: Pruritic, vesicular rash (vesicles on an erythematous base) in a dermatomal distribution
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Herpes zoster (shingles)
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_____ usually develop over bony prominences subject to unrelieved pressure, resulting in ischemic damage to underlying tissue. Prevention is important: inspect the skin thoroughly for early warning signs of erythema that blanches with pressure, especially in patients with risk factors.
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Pressure (decubitus) ulcers
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___ ___ form most commonly over the sacrum, ischial tuberosities, greater trochanters, and heels.
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Pressure ulcers
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The following are risk factors for what? 1. Decreased mobility, especially if accompanied by increased pressure or movement causing friction or shear stress. 2. Decreased sensation, from brain or spinal cord lesions or peripheral nerve disease. 3. Decreased blood flow from hypotension or microvascular disease such as diabetes or atherosclerosis. 4. fecal or urinary incontinence. 5. presence of a fracture. 6. poor nuritional status or low albumin.
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Pressure ulcers
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which stage of a pressure ulcer is the following description for?: Pressure-related alteration of intact skin, with changes in temperature (warmth or coolness), consistency (firm or boggy), sensation (pain or itching), or color (red, blue, or purple on darker skin; red on lighter skin)
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Stage I
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which stage of a pressure ulcer is the following description for?: Partial-thickness skin loss or ulceration involving the epidermis, dermis, or both
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Stage II
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which stage of a pressure ulcer is the following description for?: Full-thickness skin loss, with damage to or necrosis of subcutaneous tissue that may extend to, but not through, underlying muscle
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Stage III
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which stage of a pressure ulcer is the following description for?: Full-thickness skin loss, with destruction, tissue necrosis, or damage to underlying muscle, bone, or supporting structures
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Stage IV
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type of hair loss? Clearly demarcated round or oval patches of hair loss, usually affecting young adults and children. There is no visible scaling or inflammation.
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Alopecia Areata
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type of hair loss? Hair loss from pulling, plucking, or twisting hair. Hair shafts are broken and of varying lengths. More common in children, often in settings of family or psychosocial stress.
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Trichotillomania
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type of hair loss? Round scaling patches of alopecia. Hairs are broken off close to the surface of the scalp. Usually caused by fungal infection from tinea tonsurans. Mimics seborrheic dermatitis.
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Tinea Capitis (“Ringworm”)
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A finidng in or near the nails?: A superficial infection of the proximal and lateral nail folds adjacent to the nail plate. The nail folds are often red, swollen, and tender. Represents the most common infection of the hand, usually from Staphylococcus aureus or Streptococcus species, and may spread until it completely surrounds the nail plate. Creates a felon if it extends into the pulp space of the finger. Arises from local trauma due to nail biting, manicuring, or frequent hand immersion in water.
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Paronychia
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A finidng in or near the nails?: Clinically a bulbous swelling of the soft tissue at the nail base, with loss of the normal angle between the nail and the proximal nail fold. The angle increases to 180° or more, and the nail bed feels spongy or floating. The mechanism is still unknown but involves vasodilatation with increased blood flow to the distal portion of the digits and changes in connective tissue, possibly from hypoxia, changes in innervation, genetics, or a platelet-derived growth factor from fragments of platelet clumps. Seen in congenital heart disease, interstitial lung disease and lung cancer, inflammatory bowel diseases, and malignancies.19
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Clubbing of the Fingers
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A finidng in or near the nails?: A painless separation of the whitened opaque nail plate from the pinker translucent nail bed. Starts distally and progresses proximally, enlarging the free edge of the nail. Local causes include trauma from excess manicuring, psoriasis, fungal infection, and allergic reactions to nail cosmetics. Systemic causes include diabetes, anemia, photosensitive drug reactions, hyperthyroidism, peripheral ischemia, bronchiectasis, and syphilis.
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Onycholysis
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A finidng in or near the nails?: Nail plate turns white with a ground-glass appearance, a distal band of reddish brown, and obliteration of the lunula. Commonly affects all fingers, although may appear in only one finger. Seen in liver disease, usually cirrhosis, congestive heart failure, and diabetes. May arise from decreased vascularity and increased connective tissue in nail bed.
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Terry's Nails
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A finidng in or near the nails?: Trauma to the nails is commonly followed by nonuniform white spots that grow slowly out with the nail. Spots in the pattern illustrated are typical of overly vigorous and repeated manicuring. The curves in this example resemble the curve of the cuticle and proximal nail fold.
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White Spots (Leukonychia)
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A finidng in or near the nails?: Curving transverse white bands that cross the nail parallel to the lunula. Arising from the disrupted matrix of the proximal nail, they vary in width and move distally as the nail grows out. Seen in arsenic poisoning, heart failure, Hodgkin's disease, chemotherapy, carbon monoxide poisoning, and leprosy.20
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Transverse White Bands (Mees' Lines)
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A finidng in or near the nails?: Transverse depressions of the nail plates, usually bilateral, resulting from temporary disruption of proximal nail growth from systemic illness. As with Mees' lines, timing of the illness may be estimated by measuring the distance from the line to the nail bed (nails grow approximately 1 mm every 6 to 10 days). Seen in severe illness, trauma, and cold exposure if Raynaud's disease is present.20,21
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Transverse Linear Depressions (Beau's Lines)
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A finidng in or near the nails?: Punctate depressions of the nail plate caused by defective layering of the superficial nail plate by the proximal nail matrix. Usually associated with psoriasis but also seen in Reiter's syndrome, sarcoidosis, alopecia areata, and localized atopic or chemical dermatitis.20
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Pitting
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primary or secondary lesions? macule, papule, patch, plaque, vesicle, bulla, pustule, nodule, wheal
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primary
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primary or secondary lesions? scale, crust, erosion, ulcer, fissure, atrophy, scar, lichenification
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secondary
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what is the term for "hardening or induration"?
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sclerosis
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What is the wvaelength for Wood's light?
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360 nm
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what solution do you put skin scrapings?
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KOH
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Shingles - aka?
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Herpes zoster (shingles)
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Erythema multiforme is caused by what?
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allergic reaction
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What does the acronym MMRISK stand for?
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M oles – atypical (dysplastic)
M oles - numerous R ed hair & freckling I nability to tan S unburn – especially in childhood K indrid – family history |
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What is the most common cancer?
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basal cell carcinoma
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parvovirus b19 might cause what skin reaction of the face?
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slapped cheek disease (5th's disease)
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lentigines on lips & oral mucosa, usually associated with GI polyps
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Peutz-Jeghers Syndrome
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dry scaly lips is seen with what disease?
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Actinic cheilitis
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deep fissures in corners of mouth, riboflavin deficiency or overclosure of month is seen in what disease?
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Angular cheilitis –
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where might you find Verruca vulgaris?
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soles, considered a wart
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where might you find Dermatophytes ?
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palms and soles, (a fungus)
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There are about ___ miles of nerves in the adult skin
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45
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The largest human organ is the skin, with a surface area of about ___ square feet.
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25
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Each square inch of human skin consists of ____ feet of blood vessels.
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twenty
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A fingernail or toenail takes about __ months to grow from base to tip.
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6
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generalized red flush; widespread miliarial (heat) rash; doesn't feel well
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mercury poisioning
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cutis marmorata
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transient mottling (marks with spots or smear of color) when infant is exposed to decreased temperature
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erythema toxicum
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pink papular rash with vesicles superimposed on thorax, back, butt, abdomen; may appear 24-48 hours and resolves after several days; expected color change in infant
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harlequin color change
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clearly outlined color change as infant lies on side, dependent half becomes pink and upper half is pale
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mongolian spots
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irregular areas of deep blue pigmentation; usually in sacral or gluteal region
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telangiectatic nevi (stork bites)
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flat deep pink localized areas on back of neck
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epidermal verrucous nevi
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warty lesions in linear or whorled pattern, pigmented or skin color; associated with skeletal, CNS and ocular abnormalities
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cafe au lait patches
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flat, evenly pigmented spots varying in color from light brown to black; associated with neurofibromatosis, pulmonary stenosis, temporal lobe dysrhythmia, tuberous sclerosis
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supernumerary nipples
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associated with renal abnormalities
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hair collar sign
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ring of long dark coarse hair surrounding midline scalp nodule; associated with neural tube closure defects of scalp
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persistent pruritus
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may indicated chronic renal failure, cholestatis liver disease, Hodgkin disease, DM
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vernix caseosa
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whitish, moist, cheese-like substance that covers newborn infants
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milia
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small whitish, discrete papules on the face, sebacceous glands are immature and become clogged
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Dennie-Morgan fold
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an extra crease or pleat of skin below the eye due to chronic rubbing and inflammation
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molluscum fibrosum
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cutaneous tags that are a result of epithelial hyperplasia
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skin changes in pregnancy:
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striae gravidarum; telangiectasis; hemanigomas; cutaneous tags; increase in pigmentation; chloasma (mask of pregnancy)
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itching in pregnancy can occur due to:
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stretching of the skin; jaundice; pregnancy-specific dermatosis
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expected lesions in the older adult:
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cherry angiomas; seborrheic keratoses; sebaceous hyperplasia; cutaneous tags (acrochordon); cutaneous horns; senile lentigines
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seborrheic keratoses
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pigmented, raised, warty lesions; must be distinguished from actinic keratoses which have the potential to be malignant
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senile lentigines
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irregular, round, gray-brown lesions with a rough surface; may be called age or liver spots
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why does the hair turn gray or white?
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melanocytes stop functioning
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lentigo
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brown macule that appears in sun-exposed areas
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corn
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flat or slightly elevated; smooth, hard surface; "soft": caused by pressure of bony prominence against softer tissue;"hard": sharply delineated with conical appearance where pressure is exerted
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callus
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area of hyperkeratosis, not usually tender
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eczematous dermatitis
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epidermal breakdown due to intracellular vesiculation, has 3 stages: acute: erythematous, pruritic weeping vesicles subacute: erythema and scaling chronic: thick lichenified pruritic plaques
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furnicle
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acute localized staphylococcal infection; begins as a follicular abscess and spreads to surrounding dermis and subcut tissue, becomes a pustule, may rupture or need surgery
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folliculities
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staph infection of hair follicle and surrounding dermis, pustule
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cellulitis
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strep or staph infection of skin and subcut tissue; lymphatic streaks and lymphadenopathy may be present
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tinea
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noncandidal fungal infection, usually classified according to anatomic location: cruris (groin/thigh), unguium (nails)
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pityriasis rosea
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self-limiting inflammation of unknown cause, primary round plaque with scaling with eruption weeks later with a distribution along the ribs giving a Christmas tree pattern, not contagious
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psoriasis
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disease of keratin synthesis, dry silvery scaling papules/plaques
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rosacea
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chronic inflammatory disorder characterized by telangiectasia, erythema, papules, pustules in central area of the face; tissue hypertrophy of the nose (rhinophyma) may occur, comedomes are never present
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drug eruptions
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discrete/confluent erythematous maculopapules, pruritus
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herpes zoster (shingles)
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viral infection usually of a single dermatome, red swollen plaques or vesicles filled with purulent fluid. pain in the dermatome can start days before the rash
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herpes simplex
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viral infection, tenderness, pain, paresthesia, mild burning
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cutaneous anthrax
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spore forming bacterium, pruritic macule or papule that enlarges into an ulcer, central necrosis, associated with lymphangitis and lymphadenopathy
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smallpox
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variola virus, direct transmission by infected saliva, most infectious during 1st week, rash first appears on mouth/pharynx/face/forearms and spreads to trunk and legs; starts as flat red lesions that evolve at same rate then become vesicular, pustular and crust
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basal cell carcinoma
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most common form of skin cancer, arises in basal layer of epidermis, warning signs include: open sore, reddish patch, shiny nodule, pink growth and scarlike area
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squamous cell carcinoma
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second most common skin cancer, arises in the epithelium, soft mobile elevated masses with a surface scale, warning signs: wartlike growth, scaly red patch, open sore, elevated growth with a central depression
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malignant melanoma
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skin cancer that develops from melanocytes
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kaposi sarcoma
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malignant tumor of endothelium and epithelial layer of skin, soft vascular bluish-purple and painless lesions, macular or papular, opportunistic infection in those with HIV, can have lesions on skin, GI tract, lungs liver lymph nodes bones etc
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alopecia areata
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hair shaft is poorly formed and breaks off at the skin surface
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paronychia
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inflammation of the paronychium produces redness swelling and tenderness at the lateral and proximal nail folds, purulent drainage
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tinea unguium
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fungal infection of the nail, hyperkeratotic debris accumulates in nail plate causing it to turn yellow or white and the nail to separate from the nail bed (onycholysis), nail plate crumbles
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subungual hematoma
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caused by trauma to the nail plate causing immediate bleeding and pain
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leukonychia punctata
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white spots on the nail due to minor injury or manipulation of the cuticle
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habit-tic deformity
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caused by biting or picking the proximal nail fold of the thumb with the index finger, results in horizontal sharp grooving in a band that extends to tip of nail
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koilonychia (spoon nails)
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central depression of the nail with lateral elevation of the nail plate that produces a concave curvature and spoon appearance, associated with iron deficiency, syphillis, fungal dermatoses and hypothyroidism
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beau lines
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transverse depressions at the base of the lunulae in all the nails, associated with coronary occlusion, hypercalcemia and skin disease, caused by stress that temporarily interrupts nail formation
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white banding (terry nail)
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transverse white bands covering the nail except for a narrow zone at the distal tip, associated with cirrhiosis and hypoalbuminemia
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psoriasis
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pitting, onycholysis, discoloration and subungual thickening, yellow scaly debris accumulates, can cause splinter hemorrhage
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warts
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epidermal neoplasms caused by viral infection, can occur at nail fold and extend under the nail
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digital mucous cysts
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contain a clear, jelly like substance and occurs on the dorsal surface of the distal phalanx, longitudinal groove may occur
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pruritic urticarial papules and plaques of pregnancy (PUPPP)
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benign dermatosis that usually arises in the 3rd trimester of a 1st pregnancy, begins on abdomen and spreads to thighs buttocks and arms, halos of blanching surround the papules, larger bullae don't occur and not periumbilical (herpes)
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herpes gestationis
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rare autoimmune disorder of pregnancy, not related to the viral infection, initially periumbilical erythematous urticarial patches and plaques, progress to vesicle and blisters, pruritus, can develop necrosis of affected skin and kidney damage
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seborrheic dermatitis
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chronic recurrent erythematous scaling eruption localized where sebaceous glands are concentrated; craddle cap
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miliaria (prickly heat)
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irregular red macular rash caused by occlusion of sweat ducts during periods of heat
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impetigo
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highly contagious staph or strep infection of the epidermis, causes pruritis, burning and regional lymphadenopathy, starts as a macule then changes to a vesicle or bulla, crusts
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acne vulgaris
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stagnation of sebum and comedo formation in the pilosebaceous follicle with bacterial invasion
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reddened patchiness
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suggest richer capillary bed, caused by capillary hemangioma, nevus flammeus or vasculosus and telangiectatic nevus
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chickenpox
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fever mild malaise and pruritic maculopapular skin eruption that becomes vesicular, occurs with several stages of maturity at one time, complications include conjunctival involvement, bacterial infection, viral pneumonia, encephalitis, aseptic meningitis, myelitis, Guillain-Barre, Reye syndrome
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measles (rubeola)
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prodromal fever, conjunctivitis, coryza and bronchitis followed by a red blotchy rash, Koplik spots on buccal mucosa, macular then maculopapular, complications include infection of resp tract and CNS
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german measles (rubella)
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mild and febrile, maculopapular rash, starts with fever, coryza, sore throat and cough, macular then papular rash, Forschheimer spots on soft palate, infection during 1st trimester can cause congenital rubella syndrome
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trichotillomania
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loss of scalp hair caused by physical manipulation, can lead to trichobezoar (lump of hair in stomach after being swallowed)
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bruises
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when associated with abuse it occurs over soft tissue. ACCIDENTS are usually over bony tissue
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burns
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common are stocking and glove distribution indicating placement into a hot water or surface. Splash marks indicate accident.
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stasis dermatitis
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erythematous scaling weeping patches, secondary to edema of chronic peripheral vascular disease
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solar keratosis (senile actinic keratoses)
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slightly raised erythematous lesion, secondary to chronic sun damage and has malignant potential
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morbilliform
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maculopapular lesions that become confluent on the face and body
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target lesion
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pink macules with purple central papules
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punctation
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central umbilication or dimpling
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yellow discoloration of the nail
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nail color caused by psoriasis or fungal infection or chronic resp disease
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darkening of the nail
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nail color caused by antimalarial drug therapy, candidal infection, hyperbilirubinemia and chronic trauma
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green-black discoloration of the nail
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nail color caused by Pseudomonas infection (no pain) or subungual hematoma (pain)
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single blue-black nail
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nail color caused by melanoma or bruising/bleeding from trauma
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generalized blue nails
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nail color caused by cyanosis due to asthma, cardiac disorders or anemia, silver poisioning, med side effect, Wilson disease (inherited)
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Longitudinal red or brown streaks
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nail abnormalities caused by splinter hemorrhage, may occur with psoriasis of nail matrix or injury to prox nail fold (habit-tic deformity)
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Longitudinal white streaks or transverse white bands
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systemic disorder cause this nail abnormality
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Longitudinal ridges and grooves
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expected nail abnormality or caused by lichen planus
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Transverse grooves
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repeated trauma causes this nail abnormality
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Transverse rippling of nail plate
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chronic inflammation with chronic paronychia or eczema cause this nail abnormality
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Transverse depression at base of lunula
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stress temporarily interrupts nail formation causing this nail abnormality
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Depression in nail
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syphilis, high fevers, peripheral vascular disease, DM can cause this nail abnormality
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Pitting
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psoriasis causes this nail abnormality
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Broadening and flattening
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secondary syphilis causes this nail abnormality
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halo nevus
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this nevus is usually benign, can occur with melanoma
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intradermal nevus
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this nevus has no indications for removal except cosmetic
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junction and compound nevi
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these nevi should be removed if exposed to repeated trauma
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hairy nevus
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this nevus should be removed if changes occur
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size of a normal mole
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less than 6 mm
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tumor
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elevated and solid lesion; may or may not be clearly demarcated; deeper in dermis; greater than 2 cm in diameter
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atrophy
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thinning of skin surface and loss of skin markings; skin translucent and paper-like
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faun tail nevus
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tuft of hair overlying the spinal column at birth; may be associated with spina bifida occulta
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Elephantiasis
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massive accumulation of lymphedema throughout body from widespread inflammation and obstruction of lymphatics by filarial worms
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Wuchereria bancrofti or Brugia malayi
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common filiarial worms that cause elephantiasis
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Lymphangioma and cystic hygroma
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results of obstruction of developing lymph vessels
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Lymphedema
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hypoplasia and maldevelopment of lymph system
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Milroy disease
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primary lymphedema
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serum sickness
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Urticaria and other rashes, lymphadenopathy, joint pain, fever, facial edema; 7-10 days after provoking substance, can recur
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Pneumocystis carinii pneumonia
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common opportunistic infection in AIDS
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cat scratch disease
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Most common cause of subacute or chronic inflammation in kids
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roseola infantum (HHV-6)
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Fever followed by morbilliform rash; Usually 7-12 mo old
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toxoplasmosis
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Single enlarged and nontender node; hx of eating raw meat
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Epstein-Barr virus (mono)
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Sx: pharyngitis, fever, fatigue, malaise, splenomegaly, hepatomegaly, rash; Anterior and posterior cervical are most common affected nodes
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Epstein-Barr virus
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Virus found in Burkitt lymphoma and nasopharyngeal carcinoma
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acute suppurative lymphadenitis
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caused most often by strep and staph bacteria
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Actinomycotic adenitis
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dental disease causing acute suppurative lymphadenitis
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Pasteurella multocida infection
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cat scratch disease
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Virchow node
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in L supraclavicular region indicative of abdominal or thoracic malignancy
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which of the following is NOT a function of the skin?
1. Protection - microbial & foreign matter, radiation 2. Retard fluid loss 3. Regulate temperature 4. Sensory input 5. Produce vitamin D 6. Produce Vitamin C 7. Regulate blood pressure 8. Excrete sweat, urea, & lactic acid 9. Express emotions |
Produce Vitamin C
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