PD E2- Derm

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131 Terms

1
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what is meissner’s corpuscle?

contains unmyelinated nerve ending surrounded by Schwann cells; touch receptors; enriched in fingers and toes

localized in dermis bt epidermal ridges

2
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what are lamellar corpuscles / pacinian corpuscles?

nerve endings in skin responsible for sensitivity to vibration and pressure; responds only to sudden disturbances

3
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what is the epidermis?

most superficial layer of skin; NO blood vessels; outer horny layer composed of dead keratinized cells and inner layer is where melanin and keratin are formed

4
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What are the 5 lays of the epidermis from superficial to deep?

  • stratum corneum

  • stratum lucidum (palms and feet)

  • stratum granulosum

  • stratum spinosum

  • stratum basale

5
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what is the dermis?

lies below the epidermis; well supplied w/ blood; contains sebaceous glands, sweat glands, and hair follicles

6
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what are the layers of the dermis?

papillary layer- contains caps and touch receptors, creates fingerprints

reticular layer- contains pacinian corpuscles/sensory receptors, sweat glands, lymph vessels, and hair follicles; causes cleavage lines pattern

7
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what is the hypodermis?

subcutaneous tissue- loose connective tissue (adipose) that insulates the body; contains blood and lymph vessels, base of hair follicles and sweat glands

8
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what are sudoriferous / eccrine glands?

secrete sweat to maintain body temp

9
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what are apocrine glands?

become active during puberty; secrete pheromones

10
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what are sebaceous glands?

found surrounding hair follicles; secrete sebum to keep hair and skin moist

11
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what kind of pigmentation does carotene cause?

golden yellow pigment in SC fat; heavy in palms and soles

12
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what kind of pigment does oxyhemoglobin cause?

bright red pigment; predominates in arteries and capillaries

13
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what kind of pigment does deoxyhemoglobin cause?

blueish pigment (cyanosis); predominate in cutaneous blood vessels

14
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what 3 things should you think of with skin exams?

bugs, drugs, and contact

15
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what is tenting / decreased turgor a sign of?

dehydration

16
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what is the mnemonic for describing skin lesions?

SPECL SCAB

  • size

  • pattern (if more than 1)

  • elevation

  • color

  • locaiton

  • shape

  • consistency

  • and

  • borders

17
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what is annular?

ring shaped

18
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what is arcuate?

partial ring shape

19
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what is bizarre mean when describing shape of lesions?

irregular

20
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what does confluent mean?

run together

21
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what does discoid mean?

disc chape- no central clearing

22
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what does iris mean?

circle w/in a circle

23
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what does reticular mean?

marble like

24
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What is the ABCDE mnemonic?

  • asymmetry of shape

  • border irregularity

  • color variation

  • diameter larger than 6 mm

  • elevation or evolving

25
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what is a nevi / mole?

well circumscribed hyperpigmented papule or macule

26
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what is a macule?

flat non palpable lesion < 1 cm

27
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what is a patch?

flat non palpable lesion > 1 cm

28
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what is a papule?

palpable lesion < 0.5 cm

29
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what is a plaque?

palpable lesion > 0.5 cm

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what is a nodule?

solid or cystic lesion < 2 cm

31
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what is a tumor?

solid or cystic lesion > 2 cm

32
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what is a vesicle?

circumscribed papule containing clear/serous or hemorrhagic fluid < 0.5 cm

33
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what is a bullae?

circumscribed papule containing clear/serous or hemorrhagic fluid > 0.5 cm

34
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what is a pustule?

circumscribed papule containing purulent material

35
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what is a furuncle?

infection of the hair follicle; purulent material extends through dermis into SC tissue and small abscess forms

36
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what is a carbuncle?

coalescence of several inflamed follicles into single inflammatory mass w/ pustular drainage from multiple follicles in the epidermis

37
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what is an abscess?

collection of pus w/in the dermis and deeper skin tissues

38
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what is cellulitis?

bacterial infx of skin

<p>bacterial infx of skin</p>
39
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what is lymphangitis?

inflammation or infx of lymphatic channels

<p>inflammation or infx of lymphatic channels</p>
40
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what are verrucae / warts?

  • small tumors of skin caused by HPV 16 and 18 → squamous intraepithelial lesions of anogenital and oral cavity

  • grey to flesh colored nodules raised from skin surface

  • rough, hornlike projections; cauliflower like in texture

<ul><li><p>small tumors of skin caused by <strong>HPV 16 and 18 →</strong> squamous intraepithelial lesions of anogenital and oral cavity</p></li><li><p>grey to flesh colored nodules raised from skin surface</p></li><li><p>rough, hornlike projections; cauliflower like in texture</p></li></ul><p></p>
41
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what is a corn?

conical structure of keratin pointing to dermis; occurs due to pressure on thin skin

<p>conical structure of keratin pointing to dermis; occurs due to pressure on thin skin</p>
42
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what is a callus"?

thickening of epidermal keratin; occurs due to pressure and friction

<p>thickening of epidermal keratin; occurs due to pressure and friction </p>
43
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what is scaling?

exfoliated epidermis

seen in dandruff, psoriasis, etc

<p>exfoliated epidermis</p><p>seen in dandruff, psoriasis, etc</p>
44
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what is crusting?

dried residue of pus, serum, or blood

ex: scabs, impetigo

<p>dried residue of pus, serum, or blood</p><p>ex: scabs, impetigo</p>
45
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what is lichenification?

roughening/thickening of epidermis

ex- atopic derm

<p>roughening/thickening of epidermis</p><p>ex- atopic derm</p>
46
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what is a scar?

replacement of destroyed dermis w fibrous tissue

<p>replacement of destroyed dermis w fibrous tissue</p>
47
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what is a keloid?

elevated scar that grows beyond the wound

<p>elevated scar that grows beyond the wound</p>
48
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what is a burrow?

slightly raised tunnel in epidermis; ex- scabies

<p>slightly raised tunnel in epidermis; ex- scabies</p>
49
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what is a fissure?

linear crack from epidermis to dermis; ex- cheilitis, athletes foot

<p>linear crack from epidermis to dermis; ex- cheilitis, athletes foot</p>
50
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what is excoriation?

superficial linear traumatized area; ex- abrasion or scratch

<p>superficial linear traumatized area; ex- abrasion or scratch</p>
51
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what is petechia?

reddish/purple macules < 2mm; do NOT blanch w/ pressure

<p>reddish/purple macules &lt; 2mm; <strong>do NOT blanch w/ pressure</strong></p>
52
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what is purpura?

reddish/purple macules > 2mm; does NOT blanch w/ pressure

<p>reddish/purple macules &gt; 2mm; <strong>does NOT blanch w/ pressure</strong></p>
53
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what is ecchymosis?

flat, non palpable, SC accumulation of extravasated blood; color evolves over time: purple/blue → red/brown → green/yellow

<p>flat, non palpable, SC accumulation of extravasated blood; color evolves over time: purple/blue → red/brown → green/yellow</p>
54
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what is a hematoma?

palpable, SC accumulation of extravasated blood; color evolves over time: purple/blue → red/brown → green/yellow

<p>palpable, SC accumulation of extravasated blood; color evolves over time: purple/blue → red/brown → green/yellow</p>
55
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what is a telangiectasia?

fine, irregular blood vessel

<p>fine, irregular blood vessel</p>
56
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what is a spider angioma?

central red macule w/ radiating spider like arms

<p>central red macule w/ radiating spider like arms</p>
57
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what is a cherry angioma?

small red papule

<p>small red papule</p>
58
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what is an erosion?

superficial, focal loss of part of epidermis

<p>superficial, focal loss of part of epidermis</p>
59
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what is an ulceration?

focal loss of epidermis extending into dermis

<p>focal loss of epidermis extending into dermis</p>
60
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what is stage 1 pressure ulcer

  • alteration of intact skin

  • redness or purple stage to skin

  • inc warmth or coolness

<ul><li><p>alteration of intact skin</p></li><li><p>redness or purple stage to skin</p></li><li><p>inc warmth or coolness</p></li></ul><p></p>
61
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what is a stage II pressure ulcer?

partial thickness skin loss involving epidermis and/or dermis

<p>partial thickness skin loss involving epidermis and/or dermis</p>
62
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what is a stage III pressure ulcer?

  • full thickness skin loss does not extend through fascia

  • doesnt involve muscle or bone

  • necrosis of SC tissue

<ul><li><p>full thickness skin loss does not extend through fascia</p></li><li><p>doesnt involve muscle or bone</p></li><li><p>necrosis of SC tissue</p></li></ul><p></p>
63
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what is a stage IV pressure ulcer?

  • full thickness skin loss

  • destruction of tissue, muscle, and/or bone

  • sinus tracts (tunneling wounds) are common

<ul><li><p>full thickness skin loss</p></li><li><p>destruction of tissue, muscle, and/or bone</p></li><li><p>sinus tracts (tunneling wounds) are common</p></li></ul><p></p>
64
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what is atrophy?

depression of skin caused by thinning of epidermis or dermis

<p>depression of skin caused by thinning of epidermis or dermis</p>
65
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what is a patch test?

confirms substances that produce allergic contact dermatitis

66
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what is auspitz sign?

bleeding after scales scraped off

67
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what is nikolsky phenomenon?

shearing of blisters upon pressure to skin

68
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what is darier sign?

scrape skin → red, swollen and possible wheal → urticaria pigmentosa

<p>scrape skin → red, swollen and possible wheal → urticaria pigmentosa</p>
69
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what is koebner phenomenon?

appearance of new skin lesions on previously unaffected skin secondary to trauma

<p>appearance of new skin lesions on previously unaffected skin secondary to trauma</p>
70
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when should you biopsy?

  • question for malignancy

  • failure to heal

  • inc in size

  • bleed easily

  • ulcerate spontaneously

  • tumor or growth of uncertain nature

  • inflammatory condition

71
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what is moh’s surgery?

high specialized method of excision that allows for histologically confirmed removal of tumor w/ smallest surgical margins and defect; guided by frozen section mapping in 3 dimensions

72
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what is cryosurgery?

used for small, superficial non malignant lesions (warts)

NOT recommended for thick areas (palms/soles) or anatomically confined areas (nails) bc of severe pain

73
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what is dermoscopy?

inspection of deeper layers of epidermis and papillary dermis w/ hand lens w/ built in lighting and magnification of 10-30x

distinguishes bt benign and malignant growth patterns in pigmented lesions

74
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what is hirsutism?

inc hair growth; can be due to hormonal changes and increased androgen

ex: females w/ PCOS

75
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what conditions are associated w/ decreased hair growth?

androgenic alopecia, alopecia areata, trichotillomania, hypothyroidism (queen Anne’s sign- loss of lateral eyebrow), tinea capitis, venous stasis

76
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what is tinea capitis?

fungal infection of hair/scalp

77
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what is koilonychia?

spooning of nails; nail plate thins and becomes inverted due to poor perfusion to nails

ex: iron deficiency anemia

<p>spooning of nails; nail plate thins and becomes inverted due to poor perfusion to nails</p><p>ex: iron deficiency anemia</p>
78
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what is nail pitting?

dystrophy of nail plate; areas of small depression or “pits”

ex: autoimmune, psoriasis, FHx

<p>dystrophy of nail plate; areas of small depression or “pits”</p><p>ex: autoimmune, psoriasis, FHx</p>
79
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what are splinter hemorrhages?

bleeding from capillaries

ex: trauma, endocarditis

<p>bleeding from capillaries</p><p>ex: trauma, endocarditis</p>
80
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what is a subungual hematoma?

hemorrhage to nail plate

ex: trauma

<p>hemorrhage to nail plate</p><p>ex: trauma</p>
81
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what are beau’s lines?

traverse depression of nail plate, usually bilateral; sign that systemic illness or injury disrupted nail growth

<p>traverse depression of nail plate, usually bilateral; sign that systemic illness or injury disrupted nail growth</p>
82
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what are mee’s lines?

curving transverse white bands on nails

ex: arsenic poisoning, HF, Hodgkins, CO poisoning

<p>curving transverse white bands on nails</p><p>ex: arsenic poisoning, HF, Hodgkins, CO poisoning</p>
83
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what is oncyholysis?

separation of nail plate from bed; starts distally

ex: trauma, excess manicuring, psoriasis, diabetes, drug reaction

<p>separation of nail plate from bed; starts distally</p><p>ex: trauma, excess manicuring, psoriasis, diabetes, drug reaction</p>
84
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what are Lindsay’s nails?

half white / half brown/red/pink; suggests chronic renal failure

<p>half white / half brown/red/pink; suggests chronic renal failure</p>
85
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what are terry’s nails?

white nails; sign of HF

86
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what do blue-green nails suggest?

pseudomonas infx

87
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What drug causes brown-yellow discoloration of nails?

phenindion (anticoagulants)

88
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what does brown/black nail discoloration suggest?

onychomycosis / paronychia

89
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what is melanonychia?

line through nail; can be benign or malignant

<p>line through nail; can be benign or malignant</p>
90
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what is clubbing?

angle bt nail base and finger is > 180 degrees (lovibond’s sign); end of finger becomes rounded and bulbous

ex: chronic hypoxia

<p>angle bt nail base and finger is &gt; 180 degrees (lovibond’s sign); end of finger becomes rounded and bulbous</p><p>ex: chronic hypoxia</p>
91
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what is felon?

acute infx of fingertip pulp space

<p>acute infx of fingertip pulp space</p>
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what is paronychia?

acute infx of nail fold

<p>acute infx of nail fold</p>
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what is herpetic whitlow?

herpes infx of finger pad

<p>herpes infx of finger pad</p>
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what is onychia?

fluctuant swelling beneath entire nail plate

<p>fluctuant swelling beneath entire nail plate</p>
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what do white or pale nail beds indicate?

anemia

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what do white nail plates indicate?

severe liver disease

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what does koilonychia indicate?

iron deficiency state or erythrocytosis

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what should you think w/ a splinter hemorrhage that starts in germinal matrix and grows outward w/o any normal bed bt proximal end and germinal matrix?

malignant melanoma

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what does nail biting increase risk of?

eponychium

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splinter hemorrhages are usually caused by trauma, but may indicate _____

endocarditis