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Clinical Exam Ch.8
LECOM OMS1
259
Medical
Professional
11/29/2011

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Term
Precursors in the ___ produce vitamin D
Definition
skin
Term
What are the 2 major layers of the epidermis and what is their major function?
Definition
stratum corneum- protection and water retention. cellular stratum- synthesizes keratin.
Term
What connects the epidermis to the dermis?
Definition
The basement membrane
Term
Where are melanin and keratin synthesized?
Definition
In the stratum germinativum
Term
What epidermal layer is only present in palms and soles?
Definition
stratum lucidum
Term
Epidermis and cutaneous adipose tissue are separated by _____.
Definition
Dermis
Term
What are dermal papillae?
Definition
Upward projections of dermis that provide nourishment to the epidermis.
Term
What is contained in the dermis besides blood vessels?
Definition
Elastin, collagen, reticular fibers, sensory nerve and nerves of the ANS.
Term
What connects the dermis to underlying organs?
Definition
The hypodermis which is composed loose CT and fatty cells.
Term
What is the function of eccrine glands?
Definition
regulate body temperature by secreting water directly onto the surface of the skin
Term
Where are eccrine glands found?
Definition
found throughout the body except lip margins, eardrums, nail beds, and glans penis
Term
What is the function of apocrine glands?
Definition
Secrete an odorless white fluid in response to emotional stimuli.
Term
Where are apocrine glands found?
Definition
axilla, nipples, anogenital region, eyelids, and external ears
Term
Which glands are responsible for body odor?
Definition
Body odor is created by bacterial composition of apocrine sweat.
Term
What is the function of sebaceous glands?
Definition
secrete sebum to keep hair from drying out
Term
Where are sebaceous glands found?
Definition
associated with hair
Term
What stimulates sebum production?
Definition
hormones, especially testosterone
Term
How is hair formed?
Definition
By epidermal cells that invaginate into the dermal layer
Term
What provides blood supply to the base of a hair follicle?
Definition
the papilla
Term
Name and describe the 2 types of hair found in adults.
Definition
vellus: short, fine, nonpigmented. teriminal: coarse, long, pigmented.
Term
What are the cyclic changes of hair growth?
Definition
anagen (growth), catagen (atrophy), and telogen (rest)
Term
What marks the distal end of the nail matrix?
Definition
the lunula
Term
What is the eponychium?
Definition
the cuticle- it is composed of stratum corneum
Term
What is the paronchium?
Definition
The soft tissue surrounding the nail border.
Term
What is vernix caseosa?
Definition
A mixture of sebum and cornified epidermis that covers the infant at birth.
Term
What is lanugo?
Definition
fine hairs that cover the infant- shed 10-14 days after birth
Term
What sweat glands are functioning in a 1 month old baby?
Definition
eccrine but not apocrine
Term
What happens to the skin and sweat glands of pregnant women?
Definition
They increase in number and function, respectively.
Term
What happens in the sweat glands and skin of older adults?
Definition
They decrease in function, and thickness, respectivley.
Term
What changes are seen in the hair of older adults?
Definition
Terminal scalp hair changes to vellus hair, men's nose and ear hair transitions to terminal hair, and there is an overall loss of trunk and limb hair.
Term
What confers the highest risk for melanoma?
Definition
previous melanoma, changing or atypical nevi, 1st degree relative with melanoma,
Term
What confers increased risk for melanoma?
Definition
more than 50 nondysplastic nevi, nevi greater than 15cm, immune supression, blistering sunburns, pale skin
Term
What are the risk factors for basal and squamous cell carcinoma?
Definition
age 50+, UVA UVB exposure, freckles, blistering sunbuns, repeated irritation, precancerous dermatoses, or exposure to arsenic, creosote, coal tar, petroleum, or radioactivity
Term
Name some medications for hair loss.
Definition
minoxidil, propecia, DHT inhibitors
Term
What are taxanes and anthracyclines?
Definition
chemotherapy drugs
Term
When should sunscreen be applied?
Definition
20 min before exposure as well as 2-3 hours after, and after swimming
Term
What equipment is needed for a skin exam?
Definition
ruler, flashlight, magnifying lens, woods lamp
Term
What provides the best light for color variations?
Definition
daylight
Term
What provides the best light for contour?
Definition
tangential light
Term
What are corns?
Definition
lesions often found on pressure points which are circumscribed, painful, hard, and smooth
Term
Describe a soft corn.
Definition
caused by bone against soft tissue (between 4th and 5th toes)
Term
Describe a hard corn.
Definition
aka callous, caused by bony prominence over weight bearing area, hyperkeratinized and nontender
Term
What races have pigmentary demarcation lines?
Definition
70% of blacks and 11% of whites
Term
Who are predisposed to nevi?
Definition
Caucasians aged 40-50
Term
What are nonpigmented striae?
Definition
stretch marks
Term
What are dysplastic nevi?
Definition
mole with irregular border greater than 5mm usually on the trunk
Term
What distinguishes a melanoma from a nevus?
Definition
border is more irregular, usually greater than 6mm, color variation within lesion
Term
What are the features of a halo nevus?
Definition
depigmented halo around mole
Term
What is the occurrence of a halo nevus?
Definition
back of young adult
Term
Should a halo nevus be removed?
Definition
usually benign but biopsy is indicated
Term
What are the features of a intradermal nevus?
Definition
Dome shaped with peduncles or hairs
Term
What is the occurrence of a intradermal nevus?
Definition
cells of dermis
Term
Should an intradermal nevus be removed?
Definition
no
Term
What are the features of a junction nevus?
Definition
flat or slightly elevated, dark brown
Term
What is the occurrence of a junction nevus?
Definition
nevus cells lining dermoepidermal junction
Term
Should a junction nevus be removed?
Definition
remove if exposed to repeated trauma
Term
What are the features of a compound nevus?
Definition
slightly elevated brownish papule with an indistinct border
Term
What is the occurrence of a compound nevus?
Definition
nevus cells lining dermis and dermoepidermal junction
Term
Should a compound nevus be removed?
Definition
remove if exposed to repeated trauma
Term
What is the occurrence of a hairy nevus?
Definition
may be present at birth or develop later
Term
Should a hairy nevus be removed?
Definition
should be removed if changes occur
Term
What is the color of a normal mole / dysplastic mole?
Definition
uniform tan or brown / mixture of colors
Term
What is the shape of a normal mole / dysplastic mole?
Definition
clear border / irregular border
Term
What is the surface of a normal mole / dysplastic mole?
Definition
smooth flat or raised / smooth, scaly, or pebly
Term
What is the size of a normal mole / dysplastic mole?
Definition
<6mmHg / >6mmHg
Term
What are the numbers of a normal mole / dysplastic mole?
Definition
10-40 / normal or > 100
Term
What is the location of a normal mole / dysplastic mole?
Definition
above waist on sun-exposed surfaces / anywhere but most commonly on back
Term
What is an ecchymoses?
Definition
aka bruise, caused by injury
Term
What is a petichae?
Definition
a discoloration not caused by trauma and < 0.5 cm
Term
What is a purpora
Definition
a discoloration not caused by trauma and > 0.5 cm
Term
What is a telangictasia?
Definition
name given to both capillary spiders and spider angiomas: permanenty dilated small blood vessels
Term
How do you distinguish capillary spiders from spider angiomas?
Definition
capillary spiders: when blanched refill erratically. spider angiomas: when blanched refill unformly from the center outward
Term
What can cause generalized brown skin?
Definition
pituitary, adrenal, or liver disease
Term
What can cause localized brown skin?
Definition
nevis or neurofibromatosis
Term
What can cause white skin?
Definition
albinism or vitiligo
Term
What can cause localized red skin?
Definition
inflammation
Term
What can cause generalized red skin?
Definition
fever, viral exanthem, urticaria, polycythemia
Term
What can cause increased generalized yellow skin?
Definition
liver disease
Term
What can cause increased generalized yellow skin except for sclera?
Definition
hypothyroidism, increased dietary carotene
Term
What can cause blue skin on lips, mouth, and nail beds?
Definition
CV and pulmonary diseases
Term
Give the definition and cause of purpuras.
Definition
red-purple nonblanching discoloration > 0.5cm caused by intravascular defects and infection
Term
Give the definition and cause of petichae.
Definition
red-purple nonblanching discoloration < 0.5cm caused by intravascular defects and infection
Term
Give the definition and cause of ecchymoses.
Definition
red-purple nonblanchng discoloration of variable size caused by vascular wall destruction, trauma, and vasculitis
Term
Give the definition and cause of spider angioma.
Definition
red central body with radiating spider-like legs that blanch with pressure to the central body caused by liver disease or vitamin B deficeincy
Term
Give the definition and cause of venous star.
Definition
bluish spider that does not blanch with pressure caused by increased pressure in superficial veins
Term
Give the definition and cause of telangeictasia.
Definition
Fine, irregular red lines caused by capillary dilation
Term
Give the definition and cause of capillary hemangioma.
Definition
aka nevus flammeus: red irregular macular patches caused by dilation of dermal capillaries
Term
What is the cause of a rotten apple odor?
Definition
clostridium gas gangrene
Term
What is the cause of a mousy odor?
Definition
proteus infection
Term
What is the cause of a grapelike odor?
Definition
pseudomonas infection (esp burns)
Term
What is the cause of a pungent odor?
Definition
schizophrenia
Term
What is the cause of a stale beer odor?
Definition
TB lymphadenitis (scrofula)
Term
What is the cause of a putrid odor?
Definition
anaerobic infection (scurvy)
Term
What is the cause of a feculent odor?
Definition
intestinal obstruction or peritonitis
Term
What is the cause of a mousy or musty odor?
Definition
PKU
Term
Hyperkeratosis, especially of palms and soles, may be a sign of ____.
Definition
arsenic or other toxic exposure
Term
A magnifying glass with the magnifying power of ___ is used to inspect skin lesions?
Definition
5x-10x
Term
Describe and give an example of a macule.
Definition
flat colored area < 1cm / freckles, moles, petechiae, measles, scarlet fever
Term
Describe and give an example of a papule.
Definition
elevated area < 1cm / wart aka verruca, lichen
Term
Describe and give an example of a patch.
Definition
flat, nonpalpable > 1cm / vitiligo, port-wine stains, mongolian spots, cafe-au-lait
Term
Describe and give an example of a plaque.
Definition
elevated area with flat top > 1cm / psoriasis, seborrhea, actinic keratosis
Term
Describe and give an example of a wheal.
Definition
elevated irregular area of cutaneous transitent edema / insect bites, utricaria, allergic reaction
Term
Describe and give an example of a nodule.
Definition
elevated, firm, circumscribed lesion deeper than a papule 1-2cm / erythema nodosum, lipoma
Term
Describe and give an example of a tumor.
Definition
elevated solid lesion > 2cm / neoplasms, benign tumor, lipoma
Term
Describe and give an example of a vesicle.
Definition
Elevated, circumscribed, filled with serous fluid < 1cm / varicella, herpes zoster aka shingles
Term
Describe and give an example of a bulla.
Definition
vesicle > 1cm / blister, pemphigus vulgaris
Term
Describe and give an example of a pustule.
Definition
similar to vesicle but filled with purulent fluid / impetigo, acne
Term
Describe and give an example of a cyst.
Definition
elevated, encapsulated lesion in dermis or subcutaneous layer / sebaceous cyst, cystic acne
Term
Describe and give an example of a telangeictasia.
Definition
fine, irregular red lines produced by capillary dilation / telangectasia in rosacea
Term
Describe and give an example of a scale.
Definition
heaped up keratinized cells, can be dry or oily / seborrheic dermatitis following scarlet fever or drug reaction
Term
Describe and give an example of a lichenification.
Definition
rough, thickened epidermis secondary to mechanical irritation, often on flexor surface / chronic dermatitis
Term
Describe and give an example of a keloid.
Definition
irregular, elevated, progressively-enlarging scar caused by excessive collagen formation during wound healing / keloid formation following surgery
Term
Describe and give an example of a scar.
Definition
fibrous tissue that replaces skin following laceration / healed wound or incisions
Term
Describe and give an example of a excoriation.
Definition
loss of epidermis with a linear or hollowed-out, crusted area / scratch or scabies
Term
Describe and give an example of a fissure.
Definition
linear crack or break / athlete's foot, cracks at the
Term
Describe and give an example of a erosion.
Definition
follows rupture of vesicle or bulla / varicella, variola after rupture
Term
Describe and give an example of a ulcer.
Definition
concave loss of epidermis and dermis- decubiti, stasis ulcers
Term
Describe and give an example of a crust.
Definition
Dried liquid of varied color / scab on abrasion, eczema
Term
Describe and give an example of a atrophy.
Definition
skin thinning / striae or aged skin
Term
What skin lesions are found in regional areas?
Definition
acne vulgaris, herpes zoster, psoriasis
Term
What skin lesions are found in generalized areas?
Definition
utricaria, disseminated drug erruptions
Term
What skin lesions are found in localized areas?
Definition
impetigo, herpes simplex, tinea corporis
Term
What skin lesions are round/ discoid shaped?
Definition
nummular eczema
Term
What skin lesions are oval shaped?
Definition
pitoryiasis rosacea
Term
What skin lesions are annular shaped?
Definition
tinea corporis, sarcoidosis
Term
What skin lesions are zosteriform (following a nerve) shaped?
Definition
herpes zoster
Term
What skin lesions are polycyclic shaped?
Definition
psoriases,utricaria
Term
What skin lesions are linear shaped?
Definition
contact dermatitis
Term
What skin lesions are iris/ target shaped?
Definition
erythema multiform
Term
What skin lesions are stellate shaped?
Definition
meningococcal septicemia
Term
What skin lesions are serpinginous shaped?
Definition
cutatnia larva migrans
Term
What skin lesions are reticulate shaped?
Definition
polyarteriris nodosa, lichen planus lesions of erythema infectiosum
Term
What skin lesions are morbilloform shaped?
Definition
measles, roseola, drug eruptions
Term
What lesions have a discrete border?
Definition
psoriasis
Term
What lesions have an indistinct border?
Definition
nummular eczema
Term
What lesions have a active border?
Definition
tinea eruptions
Term
What lesions have an irregular border?
Definition
malignant melanoma
Term
What lesions have a raised border?
Definition
basal cell carcinoma
Term
What lesions have a advancing border?
Definition
cellulitis
Term
What lesions show central clearing with an erythematous border?
Definition
tinea eruptions
Term
What lesions show desquamaination changes?
Definition
rash of toxic shock syndrome
Term
What lesions show keratinic changes?
Definition
aka hypertrophic stratum corneum, calluses and warts
Term
What lesions show punctuation changes?
Definition
basal cell carcinoma
Term
What lesiosn show telangectasia changes?
Definition
basal cell carcinoma, actinic keratosis
Term
What lesions show black pigmentation?
Definition
malignant melanoma
Term
What lesions show pearly-white pigmentation?
Definition
basal cell carcinoma
Term
What lesions show purple pigmentation?
Definition
purpora, kaposi syndrome
Term
What lesions show violaceous pigmentation?
Definition
erysipelas
Term
What lesions present on sun-exposed areas?
Definition
lupus erythematous, viral exanthem, and porphyria
Term
What lesions present on cloth-covered areas?
Definition
contact dermatitis and milaria
Term
What lesions present on flexor surfaces?
Definition
atopic dermatitis, intertrigo, candidiasis, and tinea cruris
Term
What lesions present on extensor surfaces?
Definition
psoriasis
Term
What lesions present on truncal areas?
Definition
pitoryiasis rosacea (Xmas tree pattern), atopic dermatitis, drug reaction
Term
What lesions present on face, surface, and back areas?
Definition
acne vulgaris, drug-induced acne, Cushing syndrome
Term
Use a broad spectrum sunscreen of SPF ____ or higher.
Definition
SPF 30
Term
The sudden appearance of pigmented white bands in nails may indicate _____.
Definition
melanoma
Term
Proximal subungal fungal nail infection is associated with _____.
Definition
HIV
Term
Diffuse darkening of nails may arise from _____.
Definition
antimalarial drugs, candidal infection, hyperbilirubinemia, or trauma
Term
Green-black nail discoloration is associated with ____.
Definition
pseudomonas infection
Term
Causes of blue nails include ____.
Definition
cyanosis, melanoma, silver poisining, medication, and Wilson disease (Cu metabolism defect)
Term
Longitudinal splinter hemorages in nails may indicate ______.
Definition
endocarditis, vasculitis, and severepsoriasis
Term
Transverse rippling of the nail plate is caused by ____.
Definition
inflammation of chronic paronychia of chronic eczema
Term
After injury of the nail matrix it takes ____ for the nail to resume normal appearance.
Definition
6 months
Term
Depressions occuring in all the nails are usually a response to ____.
Definition
Syphilis, high fever, peripheral vascular disease, or uncontrolled diabetes mellitus
Term
Nail pitting is most commonly seen with ____.
Definition
psoriasis
Term
The nail bed angle should measure _____ degrees.
Definition
160 degrees
Term
In clubbing, the angle of the nail approaches or exceedss ____ degrees.
Definition
180 degrees
Term
Nail clubbing is associated with _____.
Definition
respiratory and CV diseases, cirrhosis, colitis, and thyroid disease
Term
Separation of the nail plate from the bed is common in ____.
Definition
psoriasis, trauma, candidial or pseudomonas infections,
Term
Beau lines are ____.
Definition
transverse nail grooving
Term
Koilonychia is ____.
Definition
upward curving "spoon nail"
Term
Onycholisis is _____.
Definition
asymmetric separation of the nail bed
Term
Paronychia is ____.
Definition
soft tissue infection around a nail
Term
Anonychia is
Definition
absence of a nail
Term
Physiologic jaundice may be present to a mild degree in ____% of infants at birth.
Definition
0.50
Term
What are expected color changes of the newborn?
Definition
acrocyanosis, cutis marmorata, erythema toxicum, mongolian spots, and salmon patches
Term
What is acrocyanosis?
Definition
cyanosis of hands and feet
Term
What is cutis marmorata?
Definition
transient mottling when cold
Term
What is erythema toxicum?
Definition
pink papular rash with vesicles- appears in 1-2 days and dissapears a few days after
Term
What are mongolian spots?
Definition
irregular areas of deep blue pigmentation- seen in non White infants
Term
What are salmon patches?
Definition
aka stork bites, localized pink areas
Term
What are the risk facors for infant hyperbilirubinemia?
Definition
TSB or TcB >75%, other hemolytic disease, premature, breast-fed, Asian, male, discharged within 72 hrs.
Term
Faun tail nevus is associated with ____.
Definition
spina bifida occulta
Term
Epidermal verrucus nevi is associated with ______.
Definition
can be in wither linear or whorled pattern- skeletal, CNS, and occular abnormalities
Term
Cafe au lait macules are associated with ______.
Definition
>5mm: neurofibromatosis, pulmonary stenosis, temporal lobe dysrhythmia, tuberous sclerosis
Term
Freckling in the axillary or inguinal area is associated with ______.
Definition
neurofibromatosis
Term
Ash leaf macule is associated with ______.
Definition
white macules associates with tuberous sclerosis
Term
Facial port wine stain is associated with ______.
Definition
oclurar defects such as glaucoma, angiomatous malformation of meninges such as Sturge-Kalischer-Weber syndrome
Term
Port wine stain of limb or trunk is associated with ______.
Definition
when accompanied with varicosities and soft tissue hypertrophy, associated with orthopedic problems (Klippel-Trenaunay-Weber Syndrome)
Term
Congenital lymphedema without transient hemangiomas is associated with ______.
Definition
gonadal dysgenesis caused by ansence of X chromosome producing XO phenotype (Turner Syndrome)
Term
Supernumary nipples are associated with ______.
Definition
renal abnormalities
Term
Hair collar sign is associated with ______.
Definition
isolated cutaneous anomaly that may involve neural tube defects
Term
What is the study of crease patterns on the palms and soles?
Definition
dermatoglyphics
Term
What is cutis marmorata?
Definition
A newborn's mottled appearance is response to changing temperature.
Term
What is the NIH criteria for diagnosing Neurofibromatosis with Cafe au Lait spots?
Definition
Prepubertal: more than 6 spots >5mm / Postpubertal: more than 6 spots >15mm
Term
What are Milia?
Definition
Whitish papules on the face of a 2-3 month infant
Term
What does tenting of a newborn's abdomen for <2 seconds after pinching indicate?
Definition
<5% loss of body weight dehydration
Term
What does tenting of a newborn's abdomen for 2-3 seconds after pinching indicate?
Definition
5%-8% loss of body weight dehydration
Term
What does tenting of a newborn's abdomen for 3-4 seconds after pinching indicate?
Definition
9%-10% loss of body weight dehydration
Term
What does tenting of a newborn's abdomen for >4 seconds after pinching indicate?
Definition
>10% loss of body weight dehydration
Term
What is chloasma?
Definition
mask of pregnancy
Term
____ after delivery, the mother sheds hair which will regrow in _____.
Definition
2-4 months / 6-12 months
Term
Describe a Stage I Decubitus Ulcer
Definition
Nonblanchable erythema of intact skin
Term
Describe a Stage II Decubitus Ulcer
Definition
Partial-thickness skin loss involving epidermis or dermis
Term
Describe a Stage III Decubitus Ulcer
Definition
Full-thickness skin loss, subcutaneous tissue damaged or necrotic, fascia intact
Term
Describe a Stage IV Decubitus Ulcer
Definition
Extends into bone or muscle
Term
What are acrochordon?
Definition
pedunculated skin tags
Term
What are solar lentigines?
Definition
liver spots
Term
What is trichobezoar?
Definition
An obstructive clump of swallowed hair in the stomach
Term
Describe eczematous dermatitis.
Definition
intercellular edema and epidermal breakdown, with history of allergies.
Term
What is the objective data for the acute, subacute, and chronic stages of eczematous dermatitis, respectively?
Definition
erythematous, prutitic, weeping vesicles / erythema and scaling / thick, lichenified, pruritic plaques
Term
What is the objective data for atopic dermatitis?
Definition
lichenified plaques of childhood: lesions of flexures, nape, and dorsal limbs / of puberty onward: flexures, head and neck
Term
Describe folliculitis.
Definition
Follicular-based pustules. Risk factors include: mechanical irritation, immunosuppression, dermatitis, antibiotics, diabetes mellitus, or EGRF inhibitor meds
Term
What is the objective data for folliculitis?
Definition
pustule 1-2cm
Term
Describe a furuncle.
Definition
aka boil, commonly caused by staphylococcus aureus, acute onset, tender nodule that becomes pustular
Term
Describe cellulitis.
Definition
most cases caused by streptococcus pyogenes or staphylococcus aureus, red hot tender irregular break in skin, may have fever, lymphangitic streaks and regional lymphadenopathy
Term
Describe Tinea.
Definition
Aka dermatophytosis, infection spread by direct contact, organisms survive on dead keratin, may report pruritis.
Term
What is the objective data of tinea?
Definition
Varied, may be papular, pustular, vesicular, erythematous or scaling. Microscopic skin exam with KOH shows hyphae
Term
Describe Pitriasis Rosea.
Definition
Sudden onset of herald patch with eruption 1-3 weeks later, pruritis may be present, erythematous with fine scaling, soles and face usually not involved, truck lesions usually in christmas tree pattern
Term
Describe Psoriasis
Definition
Multifactorial with genetic component marked by increased keratin production with scale, may have pruritis, well-circumscribed, silvery scaling papules and plaqes, commonly on back, buttocks, extensor surfaces, and scalp.
Term
Describe Rosacea.
Definition
Episodes of variable duration over the course of years, never itches but has stinging pain, can be triggered by exposure, emotion, or food / alcohol.
Term
What is the objective data of rosacea?
Definition
Eruptions on forehead, cheeks and nose. Telangectasia, erythema, papules, and pustules on central face. Resembles acne but with no comedones. Rinophyma (nose hypertrophy) possible.
Term
Describe Herples SImplex.
Definition
Type I oral and Type II genital, tenderness, pain, parastheisas, grouped vesicles erupt then crust lasting 2-6 weeks
Term
Describe drug eruptions.
Definition
Immunologically mediated: IgE, cytotoxic, immune complex, cell-mediated hypersensitivity. Non-immunologically mediated: direct release of mast cell mediators. Rash appears from 1-several days after drug, pruritis, discrete of confluent erythematous macules and papules that fade in 1-3weeks
Term
Describe Acnthosis Nigricans.
Definition
Caused by insulin resistence, hyperinsulinism, malignant form results from insulin-like growth activity of TGF-alpha which stimulates keratinocyte proliferation. Youth = benign or inherited, older adult = malignant.
Term
What is the objective data of Acnthosis Nigricans?
Definition
symmetric thickening of the skin on flexural areas such as the armpit, hands or mucosal surfaces may mean malignancy
Term
Describe cutaneous anthrax.
Definition
Biological warfare with gram positive Bacillus anthracis, non-communicable, 12 incubation on previous abrasion, eventual nevrosis with lymphangitis.
Term
Describe smallpox.
Definition
Possible biological warfare with variola virus. Direct transmission by saliva, incubation 7-17 days after exposure, rash on mucosa that spreads, high fever, headache, back ache.
Term
Describe Basal Cell Carcinoma.
Definition
Most common skin cancer. May be nodular, pigmented, cyctic, sclerosing, and superficial, mostly on exposed areas, sores that are crusty and itchy.
Term
What is the objective data of basal cell carcinoma?
Definition
Shiny nodule of varied color, open sore, scar-like with poor borders
Term
Describe Squamous Cell Carcinoma.
Definition
Second most common skin cancer. Malignant tumor of epithelium. Exposed area, persistent sore or lesion, elevated, wart-like, scaly, open sore.
Term
Describe Malignant Melanoma.
Definition
Lethal cancer of melanocytes. Highly migratory, changing mole, family history, use ABCDEs.
Term
Describe Kaposi's Syndrome.
Definition
A neoplasm of the endothelium and epithelium. Caused by Herpes Virus, associated with HIV, peripheral lymphedema, cutaneous lesions soft vascular and purple, usually on skin but can involve mucosa or any organ.
Term
Describe Alopecia Areata.
Definition
Sudden rapid patchy hair loss of round areas with brittle hair. Regrowth begins in 1-3 months.
Term
Describe Paronychia.
Definition
Bacteria between nail fold and plate, acute or chronic, redness tenderness purulent drainage.
Term
Describe Onchomycosis.
Definition
Nail fungus, discomfort, hyperkeratosis and onycholysis (separation). Unlike, psoriasis, there is no pitting.
Term
Describe Subungal hematoma.
Definition
Blood eruption under nail due to trauma.
Term
Describe Leukonychia Punctata.
Definition
White spots due to trauma.
Term
Describe oncholysis.
Definition
Nail separation due to trauma, candida, pseudomonas, allergic contact dermatitis or hyperthyroidism, painless.
Term
Describe Koilonchia.
Definition
Aka spoon nails due to iron deficiency, syphillis, fungus or hyperthyroidism- nail concavity.
Term
Describe Beau Lines.
Definition
Due to coronary occlusion, hypercalcemia, or skin disease. Transverse depressions at bases of lunula that disappear when nails grow.
Term
Describe White Banding on nails.
Definition
aka Terry Nails, associated with cirrhosis, chronic congestive heart failure, adult-onset diabetes mellitus, and age: transverse white bands cover the nail except for a narrow zone at the distal tip.
Term
Describe Psoriasis on nails.
Definition
Chronic and recurrent disease of keratin synthesis marked by pitting, oncholysis, sunungal thickening, yellow scaly debris, splinter hemorrhages.
Term
Describe warts on a nail.
Definition
Aka periungal growths, occur at the nail fold and extend under the nail
Term
Describe digital mucous cysts.
Definition
Result from localized fibroblast proliferation, induce longitudinal nail groove, if found on DIP they are probably caused by herniation of tendon sheaths or joint linings related to ganglion and synovial cysts.
Term
Name 2 skin lesions of pregnant women.
Definition
PUPPP and herpes gestationis.
Term
Describe PUPPP.
Definition
aka Pruritic Utricarial Papules and Plaques of Pregnancy: a benign dermatosis that arises late 3rd trimester. Usually resolves after delivery with no recurrence in future pregnancies, marked intense puritic rash that begins on the abdomen (sparing periumbilicus) spreading to thighs, buttocks, and arms. May have white halo around papules, small vesicles only, not on palms and soles (large or on palms and soles suggests herpes)
Term
Describe herpes gestationis
Definition
aka pemgoid gestationis is an autoimmune disorder of pregnancy, mother can develop skin necrosis and kidney damage. Marked by intense unrelenting puritis, Erythematous utricarial patches and plaques progressing to vesicles and blisters found on periumbilicus, palm and soles.
Term
Describe Seborrheic Dermatitis.
Definition
In infants, chronic recurrent erythematous scaling located in areas of high sebaceous gland concentration such as scalp, back, intertrigenous and diaper areas. Most common in first 3 months of life, parent reports greasy scalp with rash, "cradle cap" is yellow, lesions elsewhere are red.
Term
Describe Miliaria Rubra.
Definition
aka prickly heat, caused by sweat duct occlusion in infants: irregular red macular rash usually on covered areas of skin.
Term
Describe Impetigo.
Definition
Common and contageous, caused by staphlococcal or other type of infection, usually on face, small erythematous macule that changes into a thin vesicle or bulla with honey-colored crust, may have regional lymphadenopathy.
Term
Describe Acne Vulgaris.
Definition
Androgens stimulate excess sebum and keratinization is disrupted by impaction of pilosebaceous canal. Noninflammatory = comedones. Inflammatory = paules or nodules.
Term
Describe Varicella.
Definition
aka chickenpox, caused by VZV (varicella zooster virus?), incubation 2-3 weeks, communicatble via droplets/ airborne, communicable window 2 days before crusting, causes fever headache sore throat malaise, maculopapular becoming vesicular. Can appear everywhere, even buccal mucosa or conjunctiva.
Term
Give possible complications of Varicella.
Definition
Secondary bacterial infection, viral pneumonia, encephalitis, aseptic meningitis, myelitis, Guillian-Barre syndrome, and Reye syndrome
Term
Describe Measles.
Definition
aka Rubeola, a virus of respiratory epithelium that spreads in leukocytes to reticuloendothelial system. Communicable from a few days before fever to 4 days after rash. Preventable by immunization. Characteristic prodromal fever, conjunctivitis, coryza, and bronchitis followed by red bloctchy rash on face that spreads.
Term
What is the objective data of Measles?
Definition
Koplik spots (discrete white macular lesions) on buccal mucosa. Rash lasts 4-7 days. Also causes infection of respiratory tract and CNS.
Term
Describe German Measles.
Definition
aka Rubeola, similar to Measles except it causes fever. Contagious 10 days before to 15 days after rash. Forschheimer spots (reddish spots) on soft palate.
Term
Describe Trichtillomania.
Definition
aka hair pulling. Hair has irregular density and border.
Term
Describe Stasis Dermatitis.
Definition
Caused by venous insufficiency in older adults, occurs on lower legs. Marked by sense of fullness or dull aching on lower legs, gradually increases erythema, itch, or pain. Appears red, scaling, weeping, or ulcerous. May be acute, subacute, chronic, or recurrent.
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