Term
| What layer is at top of epidermis? |
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Definition
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Term
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Definition
Corneum
Granulosum
Spinosum
Basalis |
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Term
| What cell type makes up 95% of epidermis? |
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Definition
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Term
| 3 specialized cells in epidermis + their functions? |
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Definition
Melanocyte - pigment
Langerhans cell - immune
Merkel cell - tactile stuff |
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Term
| Melanin is produced from _______ aa precursors in the body |
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Definition
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Term
| Melanocytes produce melanosomes which serve which function? |
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Definition
| Delivered into keratinocytes to protect and cap nuclei from UV radiation |
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Term
| Darker skin has no difference in the # of ________ but a difference in the # of ________ |
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Definition
No diff = melanocytes
Diff = melanosomes present in cells |
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Term
| Name for superficial vs. deep dermis |
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Definition
Superficial = papillary
Deep = reticular |
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Term
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Definition
| Hair follicle + sebaceous gland |
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Term
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Definition
Open = blackhead
Closed = whitehead |
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Term
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Definition
| Link keratinocytes together in epidermis |
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Term
| Spongiosis is seen in ________ dermatitis; histologically, it involves... |
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Definition
ACUTE
Involves intercellular edema + microvesicle formation |
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Term
| Difference between hyperkeratosis and acanthosis? |
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Definition
Hyperkeratosis - thickening of corneum (formation of scales)
Acanthosis - thickening of spinosum (hyperplasia of epidermis) |
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Term
| Hyperkeratosis occurs in conjunction with what type of secondary skin lesion/change? |
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Definition
| Scales (hyperkeratosis = thickening of corneum; chronic change to skin) |
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Term
| Two skin conditions which both show hyperkeratosis + acanthosis? |
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Definition
Psoriasis
Chronic dermatitis (lichenification) |
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Term
| Loss of desmosomal connections in epidermis = ? |
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Definition
| Acantholysis (seen in pemphigus vulgaris) |
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Term
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Definition
Size
Colour
Arrangement
Lesion Morphology
Distribution
ALWAYS HAIR AND NAIL CHECK |
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Term
| Types of "Arrangement" of lesions... |
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Definition
Linear
Grouped
Annular
Morbiliform (multiple lesions of different sizes; scarlet fever, roseola)
Reticular (lace like) |
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Term
| Morbiliform arrangement of lesions seen in which diseases? (Two examples) |
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Definition
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Term
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Definition
Atopic Dermatitis (1st to arise)
Asthma
Allergic Rhinitis |
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Term
| DDx for atopic dermatitis |
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Definition
Irritant contact dermatitis
Allergic contact dermatitis
Seborrheic dermatitis
Scabies |
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Term
| 3 phases of atopic dermatitis? |
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Definition
Infantile (0-2)
Childhood (2-puberty)
Adulthood (puberty onwards) |
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Term
| With age, get more involvement of _________ extremities in atopic dermatitis |
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Definition
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Term
| Classic areas for infantile phase of atopic dermatitis? |
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Definition
| Cheeks, scalp, extensor extremities (knees, elbows) |
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Term
| Most common associated findings with atopic dermatitis? |
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Definition
Xerosis - in almost 100% of cases; dry skin
Pruritis - in 100% of cases; lead to excoriation
Ichthyosis Vulgaris - excessive scaling (hyperkeratosis); 50% of cases |
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Term
| What are the ESSENTIAL features of Atopic Dermatitis? |
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Definition
Pruritis
Dermatitis
Morphology
Age specific distribution (always have sparing of axillary and groin regions)
Chronic, relapsing history |
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Term
| Hypothesis of atopic dermatitis? |
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Definition
| Outside-In - genetic predisposition to weakened skin barrier (increased proteolysis), leading to increased water loss and Th1 to Th2 shift (genetic predisposition exacerbated by environment) |
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Term
| Complications of atopic dermatitis? |
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Definition
Secondary infection (impetignization) - usually S. aureus
Eczema herpeticum - medical emergency |
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Term
| DDx for childhood maculopapular rash? |
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Definition
Non-specific viral exanthem
Specific viral exanthem
Drug eruption
Bacteiral infection (scarlet fever) |
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Term
| Forchheimers spots - what are they, when are they seen? |
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Definition
Petechiae on palate + uvula
Seen in scarlet fever post GAS infection |
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Term
| Characterstic rash of scarlet fever --> |
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Definition
Blanchable, erythematous maculopapular rash (pinpoint papules give sandpaper like texture)
Pastia's lines in skin folds (petechiae) |
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Term
|
Definition
Asymmetry
Borders
Colour differences
Diameter
Evolution |
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Term
| Which type of radiation is more carcinogenic? |
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Definition
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Term
| Basal cell carcinoma - morphology |
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Definition
| Pearly white nodule with telangiectasia; can have central ulceration |
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Term
| Squamous cell carcinoma - morphology |
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Definition
| Ulcerated, indurated mass; may see crusting |
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Term
|
Definition
In older individuals
Epidermal hyperplasia = brown, scaly, greasy papules/plaques stuck on trunk |
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Term
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Definition
| Soft, pedunculated papule/nodule (outpouching of dermis + epidermis) |
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Term
| Difference between wart vs. molluscum? |
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Definition
Wart - caused by HPV; scaly, verrucous papule/nodule
Molluscum - caused by pox virus; umbilicated skin papules |
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Term
| Actinic keratosis is a pre-________ lesion |
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Definition
Malignant
Thought to be early form of SCC |
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Term
| Solar/actinic keratosis - morphology |
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Definition
| Sand-paper like consistency due to dermis dysplasia; atypical keratinocytes in epidermis |
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Term
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Definition
Epidermal - face, neck, trunk; most common; rupture
Pilar - on scalp; thicker, do not ruptuer, also benign |
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Term
| Dermatofibroma - is it benign? |
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Definition
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Term
| Clinical sign for dermatofibroma? |
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Definition
| Dimple sign/Fitzpatrick's sign - when pinched it should dimple |
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Term
| Pyogenic granulomas are common following? |
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Definition
| Trauma; seen in pregnant women also |
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Term
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Definition
| Lentigo simplex to Junctional nevus to Compound or Intradermal Nevus |
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Term
| What type of melanoma is always invasive? |
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Definition
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Term
| 5 prognostic factors of melanoma |
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Definition
Breslow thickness - from top granular layer to deepest melanoma cell
Presence of mitosis
Ulceration
Sentinel lymph node
Satellite lymph node |
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Term
| Morphology of hemangioma (Campbell de Morgan spots)? |
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Definition
| Dome shaped, violaceous lesions that blanch with pressure; nodular or papular |
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Term
| Keratoacanthoma - morphology |
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Definition
| Looks like small volcano; erupts in sun damaged skin lesions; variant fo SCC (well differentiated SCC) |
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Term
| Most aggressive type of BCC? |
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Definition
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Term
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Definition
| Erythematous, pearly nodules; plaques with telangiectasia |
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Term
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Definition
Nodular/Cystic
Pigmented (DDx w/ melanoma)
Ulcerated
Superficial (DDx w/ eczema) |
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Term
| Two variants or precursors of SCC? |
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Definition
Actinic/solar keratosis
Keratoacanthoma |
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Term
| General rule of actinic keratosis + SCC |
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Definition
| 10% will progress in 10 years from AK to SCC |
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Term
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Definition
SCC in situ (confined to epidermis)
Dysplasia of keratinocytes of epidermis; FULL thickness of epidermis involved |
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Term
| Most common type of melanoma? |
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Definition
| Superficial spreading melanoma |
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Term
| Melanoma present under the nail bed? |
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Definition
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Term
| Most likely melanoma in chemically damaged skin in elderly individual? |
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Definition
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Term
| Subungal melanoma also called - ? |
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Definition
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Term
| Prognostic factors for melanoma? |
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Definition
Tumor size (T1-4; a or b)
Nodal involvement (N0-3)
Mets (M0-M1a-c) |
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Term
| Prognosis if mets from melanoma are to lung vs. other visceral organs? |
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Definition
| Get a 1 yr survival advantage |
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Term
| When do you do shave biopsies for melanoma? |
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Definition
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Term
| Excisional biopsy if melanoma is ________, incisional if it is _____ |
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Definition
Excisional = small
Incisional = large |
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Term
| Margins for melanoma tumor sizes? |
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Definition
<1mm - 1 cm
1-4 mm - 2 cm
>4 mm - 3 cm |
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Term
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Definition
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Term
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Definition
| For suspected bacterial lesions (cellulitis, folliculitis, impetigo) |
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Term
|
Definition
| For confirmation of Herpes infections (simplex, varicella) |
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Term
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Definition
| Used to rule out scabies (rash + pruritis) |
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Term
| 3 phases of wound healing |
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Definition
Inflammatory (1-4)
Proliferative (4-42)
Remodeling/Maturation (week 3 onwards) |
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Term
| Two most common locations for keloid scars? |
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Definition
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Term
| Primary vs Secondary healing |
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Definition
Primary - wound closed by direct approximation; edges come together completely
Secondary - wound left to heal spontaneously by wound contraction + epithelialization |
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Term
| Classiciation of burns... |
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Definition
Primary = superficial; erythema W/O blisters
Secondary = partial thickness, superficial; blisters
Secondary = partial thickness, deep; white with pink
3rd or 4th = full thickness; hard, waxy, eschar |
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Term
| Burn involving the deep/reticular dermis classified as? |
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Definition
| Partial thickness burn, deep (2nd degree) |
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Term
| Blisters signify which burn classification |
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Definition
| 2nd degree - superficial, partial thickness |
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Term
| Venous vs. Arterial Ulcers |
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Definition
Venous - edematous around ulcer, due to fluid accumulation; surrounding skin is brown; painless; treat with compression
Ischemic/Arterial - no edema, painful; distal; whitish or shiny; need intervention to re-perfuse; DO NOT treat with compression |
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Term
| Difference between impetigo vs. herpes simplex |
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Definition
Impetigo - doesnt cross vermillion border; looks like honey crusts (from S. pyogenes); Rx = penicillin
HHV - crosses border without problem |
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Term
| 3 skin infections caused by staph aureus |
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Definition
Furuncle (boil)
Folliculitis
Bullous impetigo |
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Term
|
Definition
Peau d'orange skin; fiery, red well demarcated area of involvement
From S. pyogenes (Rx = penicillin) |
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Term
| S. pyogenes is always _______ sensitive |
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Definition
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Term
| 3 causes of necrotizing fascitis? |
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Definition
Anaerobes + aerobes - GAS present
S. pyogenes - NO GAS
V. vulnificus (seawater exposure) |
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Term
|
Definition
From poor hygiene
Rx = macrolides |
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Term
| Pediculus humanus capitus |
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Definition
Head lice
Does not descriminate between social classes |
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