Exam 4: Skin Disorders (Lecture 8)

Primary lesions with flat, circumscribed area showing a change in skin color; usually less than 1 cm in diameter:

macule

Primary lesion that is elevated, circumscribed superficial lesion with a diameter greater than 1 cm:

bulla

Primary lesion that is elevated, irregular-shaped area of cutaneous edema; solid, transient with varying diameter:

wheal

Primary lesion that is elevated, firm circumscribed area usually less than 1 cm in diameter:

papule

Primary lesion that is flat, nonpalpable irregular shaped macule usually more than 1 cm in diameter:

patch

Primary lesion that is elevated, firm rough lesion with a flat surface usually more than 1 cm in diameter:

plaque

Primary lesion that is elevated, circumscribed superficial lesion less than 1 cm in diameter:

vesicle

Vesicles are filled with ___________________ fluid, but do not extend into the ___________________

serous

dermis

Primary lesion that is elevated, superficial lesion filled with purulent fluid:

pustule

Primary lesion containing irregular red lines produced by capillary dilation:

telangiectasia

Primary lesion that is elevated, solid lesion that may have clear demarcation; is deeper in dermis and greater than 2 cm in diameter:

tumor

Primary lesion that is elevated, circumscribed encapsulated lesion in dermis or subcutaneous layer; may be filled with fluid or semisolid material:

cyst

Primary lesion that is elevated, firm circumscribed lesion deeper in the dermis than a papule:

nodule

Secondary lesion with rough, thickened epidermis; usually secondary to persistent rubbing, itching, or skin irritation:

lichenification

Secondary lesion with loss of epidermis that is linear, hollowed-out, and crusted:

excoriation

Secondary lesion with heaped up, keratinized, flaky skin cells; irregularly shaped, can be thick/thin and dry/oily:

scale

Secondary lesion with thin to thick fibrous tissue that replaces normal skin after an injury/laceration to the dermis:

scar

Secondary lesion with irregular shape, elevated, progressively enlarging scar; grows beyond the boundaries of the wound and is caused by excessive collagen formation during healing:

keloid

Secondary lesion with linear crack/break from epidermis to dermis that may be moist or dry:

fissure

Secondary lesion with loss of epidermis and dermis that is concave and varying in size:

ulcer

Secondary lesion that is loss of a part of the epidermis following the rupture of a vesicle or bulla; area is depressed, moist, and glistening:

erosion

Secondary lesion that is thinning of the skin surface and loss of markings:

atrophy

Pressure injuries are caused by ___________________ pressure on the skin due to shearing forces, ___________________, and/or moisture that causes damage to the underlying tissue

unrelieved

friction

Capillary blood flow occlusion leads to ___________________ and tissue ___________________. ___________________ injury is the name for pressure injury due to prolonged sitting/lying down

ischemia

necrosis

decubitis

Stage I pressure injury consists of non-blanchable ___________________ of ___________________ skin

erythema

intact

Stage II pressure injury consists of ___________________ thickness skin loss involving the ___________________ or ___________________

partial

epidermis

dermis

Stage III pressure injury consists of ___________________ thickness skin loss involving damage/loss of ___________________ tissue

full

subcutaneous

Stage IV pressure injury consists of ___________________ thickness skin loss with damage to ___________________, ___________________, or supporting structures

full

muscle

bone

Deep tissue pressure injuries are localized areas of deep red, purple, or maroon discolored ___________________ skin or a blood-filled blister caused by damage to underlying ___________________

intact

soft tissue

Unstageable pressure injuries have ___________________ thickness tissue loss with the base of the ulcer covered by ___________________, ___________________ or both in the wound bed. Usually occurs on the ___________________, heels, ___________________, and greater trochanters

full

slough

eschar

sacrum

ischia

The ___________________ scale is used to predict pressure ulcers

braden

___________________ is the medical term for itching one of the most common ___________________ skin disorders

pruritis

primary

Pruritis can be classified into ___________________ or ___________________, as well as ___________________, ___________________, or ___________________

acute

chronic

localized

generalized

migratory

The itch sensation is conveyed by ___________________ nerve fibers, and the response to this is ___________________. The problem is that this causes skin ___________________, ___________________, and scarring. This is modulated by the ___________________

unmyelinated C

scratching

trauma

infection

CNS

___________________ itch is related to any pathologic condition along an ___________________ pathway

neuropathic

afferent

___________________ itch is related to psychological disorders

psychogenic

___________________/___________________ is characterized by pruritic, lesions with distinct ___________________ and epidermal changes. It is the most common ___________________ disorder

dermatitis

eczema

borders

inflammation

Chronic form of dermatitis is thickened, leathery, and ___________________ skin from recurrent irritation and scratching

hyperpigmented

___________________ contact dermatitis is a common form of ___________________-mediated delayed ___________________ type IV

allergic

T cell

hypersensitivity

In allergic contact dermatitis, allergen binds to skin carrier protein to form a ___________________ that is processed by Langerhans cells. It is then carried to ___________________ which become sensitized

stabilizing antigen

T cells

Manifestations of allergic contact dermatitis include erythema, ___________________, pruritis, and ___________________ lesions

swelling

vesicular

___________________ contact dermatitis is non-___________________ inflammation of the skin. It is ___________________ irritation from acids or prolonged exposure to ___________________ substances

irritant

immunologic

chemical

irritating

Manifestations of irritant contact dermatitis are similar to ___________________

allergic contact dermatitis

Atopic dermatitis/atopic eczema are common in ___________________ and infants and can last into ___________________

children

adulhood

___________________ dermatitis occurs in the legs as a result of venous ___________________, edema, phlebitis, varicosities, and vascular ___________________

stasis

stasis

trauma

Stasis dermatitis progression: edema --> ___________________ --> pruritus --> scaling --> ___________________ --> hyperpigmentation --> ___________________

erythema

petechiae

ulcerations

Seborrheic dermatitis is ___________________ skin inflammation involving the scalp, eyebrows, ___________________, nasolabial folds, ear canals, ___________________, chest, and back

chronic

eyelids

axillae

Seborrheic dermatitis involves periods of ___________________ and ___________________. It is called ___________________ in infants. Manifestations include greasy, ___________________, white or yellowish ___________________

remission

exacerbation

craddle cap

scaly

plaques

Psoriasis is a ___________________ disorder involving chronic, ___________________, proliferative, inflammatory autoimmune skin disorder mediated by ___________________

papulosquamous

relapsing

T cells

Manifestations of psoriasis involve scaly, ___________________, silvery, elevated lesions usually on the scalp, face, trunk, ___________________, or ___________________

thick

elbows

knees

Psoriasis involves thickening of the epidermis and dermis caused by increased ___________________ (cells do not have time to ___________________ or ___________________)

epidermal turnover

mature

keratinize

Systemic complications of psoriasis include arthritis, ___________________ disease, and ___________________ disease

nail

cardiovascular

Most common type of psoriasis:

plaque psoriasis

Most rare type of psoriasis:

inverse psoriasis

Type of psoriasis most common in children:

Guttate psoriasis

Type of psoriasis that develops pus:

pustular

Type of psoriasis that is exfoliative dermatitis characterized by widespread red, scaling lesions:

erythrodermic psoriasis

Pityriasis rosea is benign, ___________________ inflammatory disorder associated with a ___________________ virus. Forms ___________________ patches that are circular, demarcated, and salmon-pink

self-limiting

herpes-like

Herald

Lichen planus is a benign, ___________________ disorder of the skin and ___________________ membranes. It has an unknown origin with ___________________ involvement, adhesion molecules, inflammatory ___________________, perforin, and antigen-presenting cells

autoinflammatory

mucous

T cell

cytokines

Lichen planus lesions are non-scaling, purple ___________________ with pruritis on wrists, ankles, lower ___________________, and genitalia

colored

legs

Acne vulgaris is inflammatory disease of the ___________________ follicles. Common in ___________________

pilosebaceous

adolescence

Hidradenitis suppurativa is inflammation of the pilosebaceous ducts of ___________________ and sweat glands. It is aggravated by ___________________, tight clothing, ___________________, perspiration, obesity, and ___________________

hair follicles

smoking

heat

stress

Acne rosacea is skin inflammation in ___________________ adults. Lesions are erythematotelangiectatic, ___________________, phymatous, and ___________________

middle-aged

papulopustular

ocular

Treatment of acne rosacea includes ___________________protection, ___________________ and oral drugs, ___________________ to treat rhinophyma, and ___________________ lasers

photo

topical

surgical exclusion

pulsed

Lupus erythematosus is inflammatory, ___________________, systemic disease with ___________________ manifestations

autoimmune

cutaneous

2 types of lupus erythematosus:

discoid

systemic

Cutaneous lupus is acute, subacute, or chronic, and is restricted to the ___________________.

skin

Cutaneous lupus involves a ___________________ pattern over the nose and cheeks. It can lead to ___________________ lupus

butterfly

systemic

Cutaneous lupus involves development of ___________________-reactive T and B cells. Decreased number of ___________________, increased proinflammatory ___________________. Tissue damage caused by ___________________ and immune complexes

self

regulatory T cells

cytokines

autoantibodies

Vesiculobullous disorders are diseases with different ___________________ and clinical courses that share common characteristic of vesicle or blister ___________________

causes

formation

Pemphigus is a ___________________, autoimmune, chronic ___________________-forming disease of skin and ___________________ mucous membranes. ___________________ form in deep and superficial layers of the ___________________

rare

blister

oral

blisters

epidermis

Pemphigus is caused by circulating ___________________ autoantibodies that are directed against ___________________ (cell surface adhesion molecule) in the epidermis. Tissue ___________________ demonstrate autoantibody presence

IgG

desmoglein

biopsies

Bullous pemphigoid is a more ___________________ disease than pemphigus ___________________. It is bound ___________________ mediated

benign

vulgaris

IgG/IgE

Bullous pemphigoid causes ___________________ blistering. It is distinguished from pemphigus by presence of ___________________

subepidermal

eosinophils

___________________ is an acute, recurring disorder of skin and mucous membranes. Associated with ___________________ or ___________________ to drugs/microorganisms

erythema multiforme

allergic

toxic

Erythema multiforme is caused when autoimmune complexes formed and deposited around dermal ___________________, keratinocytes, and basement membranes

blood vessels

Hallmark of erythema multiforme is ___________________ or target lesions. These are erythematous regions surrounded by rings of alternating ___________________ and inflammation. Erosions and crusts form when the lesions ___________________

Bull's eye

edema

rupture

___________________ and ___________________ are the same disease. They are caused by ___________________ reactions

Stevens-Johnson syndrome

Toxic epidermal necrolysis

drug