Term
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Definition
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Case Description:
Started 2 days ago; No new detergents; Its very itchy; 1st noticed in mid back and spread to entire body but its not on palms or soles; Nothing makes itching better or worse, tried calmine lotion but cannot put all over; Allergic to PCN; It is bad the entire day, night itching is worse b/c trying to go to sleep; When he took PCN had this reaction years ago; No fever, no chills, no nausea or vomitting, havent been sick recently; Dentist gave him cephlex has a cross reactivity with PCN
What is the diagnosis? |
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Term
1. Evolution of Lesions
2. Symptoms associated with the eruption
3. Current or recent medications
4. Associated systemic symptoms
5. Ongoing or previous illnesses
6. Contact exposures
6. History of allergies
7. Presence of photo sensitivity
8. Review of systems |
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Definition
| What are the 8 steps a part of the history portion of the dermatology exam? |
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Term
| Site of Onset, Manner in which eruption progressed or spread, Duration,Periods of resolution or improvement in chronic eruptions |
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Definition
| During the first part of history taking, what 4 things do you want to find out out about the evolution of lesions? |
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Term
| Any itching, burning, pain, numbness; What, if anything, has relieved symptoms; time of day when symptoms are most severe |
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Definition
| what questions do you want to ask that may be symptom associated with the eruption? |
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Term
| malaise, fever, arthralgias |
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Definition
| What are possible associated systemic symptoms seen in dermatologic problems? |
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Term
| plants, metal, new detergents, soaps, etc. |
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Definition
| What are examples of contact exposures that could cause skin problems? |
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Term
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Definition
| During General Examination of the skin, what do you rely heavily on? |
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Term
| a well-illuminated room with the patient completely disrobed |
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Definition
| What type of place should a general examination of the skin take place in and how should the patient present themselves? |
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Term
| Thorough exam with precise descriptions of the skin and narrowed with pertinent facts from history |
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Definition
| On what basis should the differential diagnosis be generated? |
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Term
| Lab, diagnostic procedures, skin biopsy |
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Definition
| What can be used, when appropriate, to clarify the diagnosis? |
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Term
Type(s) of primary lesion;
Arrangement of lesions;
Distribution of eruption;
Shape of individual lesions |
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Definition
| What are the four basic features of cutaneous lesions? |
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Term
| Size, Shape, Color, Texture, Elevation or Depression, Exudates (color, odor, amount, consistency), Configuration/Arrangement (annular, grouped, linear), Location and Distribution (generalized or localized) |
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Definition
| What are characteristics of lesions that you need to document? |
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Term
| The lesion is spread everywhere on the body, not one specific area. |
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Definition
| What does generalized lesion mean? |
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Term
| The lesion is right over a specific area, not spread all over the body. |
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Definition
| What does localized lesion mean? |
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Definition
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This is a multiple polygonal, discrete, flat-topped, violaceous papules and plaques located on the anterior aspect of the left wrist and distal forearm. What is this disease? |
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Term
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Definition
| I am a flat, colored lesion, <1 cm in diameter, not raised above the surface of the surrounding skin. What type of primary skin lesion am I? |
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Term
| freckles, flat moles, petechiae, measles |
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Definition
| Name examples of macules on the skin. |
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Term
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Definition
[image]
flat, <1 cm, not raised above surface of skin (example = petechiae) |
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Term
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Definition
| I am a flat lesion, >1 cm in diameter, with a color different from the surrounding skin. What type of primary skin lesion am I? |
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Term
| vitiligo (tends to be symmetrical), port wine stains-infants, Mongolian spots, café-au lait patch-neurofibrometosis |
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Definition
| Name examples of patch skin lesions. |
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Term
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Definition
[image]
This is a large, flat lesion. What type of primary skin lesion is this? |
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Term
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Definition
| What are the 2 types of flat primary skin lesions? |
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Term
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Definition
| Macules and Patches differ from one another only in what? |
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Term
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Definition
[image]
I am a small, solid lesion, <1 cm in diameter, raised above the surface of the surrounding skin and am palpable. What type of lesion am I? |
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Definition
[image]
I am a larger (1-2 cm), solid, firm lesion raised above the surface of the surrounding skin. |
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Term
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Definition
[image]
I am a solid, raised growth > 2 cm in diameter. |
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Term
| closed comedone, raised mole, or whitehead in acne |
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Definition
| Name examples of a papule. |
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Term
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Definition
| Name examples of a nodule. |
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Term
| neoplasm, lipoma-fatty tumor, soft, mobile |
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Definition
| Name examples of a tumor. |
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Term
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Definition
| nodules and papules differ from one another by what 2 characteristics? |
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Term
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Definition
[image]
I am a Large (>1 cm), flat-topped, raised lesion; edges may either be distinct or gradually blend with surrounding skin. What type of lesion am I? |
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Term
| psoriasis (usually on extensor aspects), eczematous dermatitis (usually on flexor aspects) |
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Definition
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Definition
[image]
I am a small, fluid-filled lesion, < 1 cm in diameter, raised above the plane of surrounding skin. Fluid is often visible and lesions are translucent. What type of lesion am I? |
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Definition
[image]
I am a small lesions filled with purulent fluid, much whiter than clear. |
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Term
| herpes simplex virus or in contact dermatitis (poison ivy) |
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Definition
| Name examples of vesicles. |
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Term
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Definition
| Name examples of pustules. |
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Term
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Definition
[image]
I am a fluid-filled, raised, often translucent lesion, > 1 cm (LARGE) in diameter. What type of lesion am I? |
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Term
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Definition
[image]
I am a soft, raised, encapsulated lesion filled with semisolid or liquid contents. What type of lesion am I? |
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Term
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Definition
[image]
I am a raised, erythematous papule or plaque, usually representing short-lived dermal edema |
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Term
| exercise, heat, stress related, due to medications |
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Definition
| what are causes of wheals? |
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Term
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Definition
[image]
Central arteriole with radiated thin-walled vessels |
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Term
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Definition
[image]
Dilated, superficial blood vessels; small arborizations of superficial blood vessels, such lesions can appear in older persons & have no major significance, other than their cosmetic problem. |
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Term
| Exanthematous drug eruption |
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Definition
[image]
This generalized distribution is a symmetric morbiliform eruption that may eventually become confluent |
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Term
| Varicella-Zoster (chicken pox) |
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Definition
[image]
This is a type of Generalized distribution. |
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Term
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Definition
[image]
this is a generalized distribution disease. |
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Term
| Meningococcemia (fulminant purpura) |
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Definition
[image]
This is a generalized distribution |
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Term
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Definition
[image]
This is a generalized distribution |
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Term
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Definition
| SLE; Photoallergic; Phototoxic; Polymorphous light eruption; and Porphyria cutanea tarda are all skin distributions due to what? |
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Term
| Malar or "Butterfly rash" of SLE |
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Definition
[image]
rash showing prominent, scaly, erythema
Involvement of other sun-exposed sites is also common |
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Term
| Drug-Induced Photosensitivity |
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Definition
[image]
Erythematous reaction to ultraviolet radiation associated with carbamazepine use |
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Term
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Definition
[image]
Blisters and erosions of what sun-exposed distribution? |
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Term
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Definition
[image]
This is a common dermatomal distribution.
Extremely painful, sometimes comes about before rash. Vesicles in dermatomal pattern. Erothoma base |
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Term
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Definition
[image]
This is a common extensor surface distribution on the knees. In addition to naming the condition, what type of lesion is this? |
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Term
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Definition
[image]
This is a common flexor (antecubital & popliteal fossae) distribution.
Hyperpigmentation, lichenification (hardening of skin from repeat rubbing-2ndary problem), and scaling in the antecubital fossae; Very itchy, in flexor aspects |
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Term
| Rocky Mountain Spotted Fever |
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Definition
[image]
This is a common palmar distribution but this particular condition in the picture dos not have to go to the palm.
These erythematous macular lesions will evolve into a petechial rash that will spread centrally |
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Term
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Definition
[image]
This is a common palmar distribution that commonly affects palms and soles with scaling, firm, red-brown papules. |
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Term
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Definition
[image]
Characterized by weeping, deep-seated vesicles and scaling on palms and lateral fingers,
Common Distribution palms, soles, sides of fingers and toes |
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Term
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Definition
[image]
Nodules that are red and very painful
Classic on lower limb
Assoc. with other diseases Sarcoidosis: inflammatory valve diseases
Panniculitis characterized by tender deep-seated nodules and plaques usually located on the lower extremities |
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Term
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Definition
[image]
Large ecchymotic areas extended over backs of legs
A close-up photo showed perifollicular hemorrhages and hyperkeratotic papules in which hair is fragmented and buried (“corkscrew hairs”) |
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Term
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Definition
[image]
Showing central facial erythema with overlying greasy, yellowish scale appearance, similar to dandreff |
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Term
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Definition
[image]
Can also occur other places that are exposed to sun
Consists of hyperkeratotic erythematous papules and scales/patches on sun-exposed skin precancerous.
Arise in middle-aged to older adults and have potential for malignant transformation. |
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Term
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Definition
| What type of arrangement/shape is contact dermatitis such as poison ivy seen as? |
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Term
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Definition
| Lesions that appear at sites of local skin trauma are known as what? |
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Term
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Definition
[image]
Form of urticaria in which whealing occurs in the site and in the configuration of application of stroking (pressure, friction) of the skin
Write on skin and it will wheal up! |
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Term
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Definition
[image]
The red streak extends from the ankle to the groin and follows lymphatic channels.
In this case, the site of infection was the great toe. |
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Term
| Annular; Erythema chronicum migrans of Lyme disease and Tinea corporis |
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Definition
| Ring-shaped lesions with an active border & central clearing have what type of arrangement/shape? What are some examples? |
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Term
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Definition
[image]
It has a central clearing and then erythema center; annular leasion |
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Term
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Definition
[image]
annular and raised border |
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Term
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Definition
[image]
Usually represents a hypersensitivity reaction to drugs or infections (HSV); Target Like; type of iris/target lesion |
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Term
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Definition
[image]
Showing characteristics some are discrete and confluent, edematous, erythematous papules (smaller ones) and plaques (larger ones) - Wheal lesions |
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Term
| circinate; Urticaria and herald patch of pityriasis rosea |
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Definition
| Name of arrangement/shape that is circular lesions; give examples |
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Term
| Nummular; Nummular eczema |
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Definition
| Name of arrangement/shape that is "coin-shaped" lesions; give examples |
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Term
| Guttate; Guttate psoriasis |
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Definition
| Name of arrangement/shape that is Droplike lesions; give examples |
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Term
| Morbilliform; measles and drug eruption |
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Definition
| Name of arrangement/shape that is "measles-like" with small confluent papules coalescing into unusual shape lesions; give examples |
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Term
| Reticulated; livedo reticularis |
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Definition
| Name of arrangement/shape that is "Netlike" lesions; give examples |
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Term
| Herpetiform; herpes simplex |
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Definition
| Name of arrangement/shape that is group vesicles, papules or erosion lesions; give examples |
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Term
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Definition
| Name of arrangement/shape that is denoting an ulcer or other cutaneous lesion that extends with a wavy or serpent-like border lesions |
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Term
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Definition
[image]
Reticulated (lace-like) blanching erythema symmetrically distributed over lower extremities. Common in patients that are pale, associated with vascular problems |
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Term
| Serpiginous Lesions of Creeping Eruption |
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Definition
[image]
What is the arrangement/shape of this lesion called; that is very rare and in 3rd world contries? |
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Term
| scratching, secondary infection, bleeding |
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Definition
| Changes in area of primary pathology often are due to secondary events such as what 3 things? |
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Term
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Definition
| this secondary lesion is a flaky accumulation of excess keratin that is partially adherent to skin. |
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Term
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Definition
| This secondary lesion is Circumscribed collection of inflammatory cells & dried serum on skin surface |
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Term
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Definition
| This secondary lesion is linear, angular, erosions caused by scratching |
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Term
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Definition
| This secondary lesions is Circumscribed, usually depressed, moist lesion resulting from loss of underlying epidermis |
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Term
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Definition
| This secondary lesion has deeper erosion, involving epidermis plus underlying papillary dermis; May leave a scar on healing |
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Term
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Definition
this secondary lesion is
(1) Epidermal-thinning of skin with loss of normal skin surface markings
(2) Dermal-depression of skin surface due to loss of underlying collagen or dermal ground substance |
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Term
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Definition
| This secondary lesions is Collection of fibrous tissue replacing normal dermal constituents |
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Term
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Definition
| this secondary lesion is Thickening of skin with accentuation of normal skin surface markings most commonly due to chronic rubbing |
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Term
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Definition
[image]
Resulting from ear piercing, with firm exophytic flesh-colored to erythematous nodules of scar tissue.
Occur when you pierce something
Hypertrophic response after Sx. |
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Term
Surface contour
Flat-topped
Pedunculated (on a stalk)
Verrucous(wartlike)
Umbilicated (containing a central depression) |
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Definition
| What are some descriptive terms that describe surface contour? |
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Term
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Definition
[image]
Verrucous intertriginous (in folds of skin) plaques seen in secondary syphilis.
Occurs after shaffer of syphilis
Warding type appearance |
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Term
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Definition
[image]
May be seen in:
TRAUMA
SUBACUTE BACTERIAL ENDOCARDITIS**
VASCULITIS
LEUKEMIA
LUPUS |
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Term
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Definition
[image]
(Transverse grooves on the nail)
May be seen in:
INFECTIONS
POOR NUTRITION
CHEMOTHERAPY**
ALCOHOLISM |
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Term
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Definition
[image]
("Spoon nail")
May be seen in:
IRON DEFICIENCY ANEMIA (chronic) ** |
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Term
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Definition
[image]
("white nails" increased amount)
May be seen in:
CIRRHOSIS**
HEART FAILURE
DIABETES MELLITUS
HYPERTHYROIDISM
MALNUTRITION |
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Term
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Definition
[image]
(white transverse lines)
May be seen in:
ARSENIC POISONING**
THALLIUM POISONING**
CHEMOTHERAPY
HODGKIN’S LYMPHOMA |
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Term
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Definition
[image]
May be seen in:
PSORIASIS |
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Term
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Definition
[image]
May be seen in lung diseases:
BRONCHIECTASIS
EMPYEMA
PULMONARY FIBROSIS
BRONCHOGENIC CARCINOMA**
CYSTIC FIBROSIS |
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Term
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Definition
[image]
Loosening of the nail plate with separation from the nail bed.
May be from:
MINOR TRAUMA TO LONG FINGERNAILS**
PSORIASIS
CANDIDA
PSEUDOMONAS INFECTION
HYPERTHYROIDSIM |
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Term
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Definition
[image]
circular area of hair loss seen in lupus |
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Term
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Definition
[image]
seen in tinea capitus of head |
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Term
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Definition
[image]
wear type braids or ponytail and looses hair |
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Term
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Definition
[image]
patient plucks hair out |
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Term
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Definition
[image]
Hair appears where it shouldn't |
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Term
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Definition
| What is the most important thing about a dermatology exam? |
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Term
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Definition
[image]
these are cherry hemangiomas that are solid raised lesions less than 1 cm, what is the name of the lesion? |
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Term
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Definition
[image]
this is a basal cell carcinoma that is a solid umbilicated flesh colored lesion that is 1.5 cm, what is the name of the lesion?
(do you see the telangectasia?) |
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Term
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Definition
[image]
This is necrotizing fasciitis; these are 2 fluid filled lesions that are >1 cm |
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Term
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Definition
[image]
What is the name of this lesion? |
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Term
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Definition
[image]
Herpes simplex virus; These are small fluid filled lesions less than 1 cm, what is the name of this lesion? |
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Term
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Definition
[image]
Acne, these are small lesions < 1cm that are filled with purulent fluid, what is the name of the lesion? |
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Term
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Definition
[image]
this is a solid raised growth measuring greater than 2 cm, what is the name of this lesion? |
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Term
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Definition
[image]
Freckles; these are flat, colored lesions, < 1 cm in diameter, not raised; what is the name of this lesion? |
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Term
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Definition
[image]
Mongolian Spot; This is a large (>1 cm), flat lesion with a color different from the surrounding skin….what is the name of this lesion? |
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