Derm Intro

Flashcards covering primary and secondary skin lesions, vascular lesions, dermatologic distribution, treatment principles, and diagnostic procedures based on clinical medicine lecture notes.

Macule

A flat, non-palpable skin lesion measuring $< 1\,\text{cm}$.

Patch

A flat skin lesion measuring $\geq 1\,\text{cm}$.

Papule

An elevated or depressed palpable solid lesion measuring $< 1\,\text{cm}$.

Plaque

An elevated or depressed palpable solid lesion measuring $\geq 1\,\text{cm}$

Nodule

A palpable, solid lesion >1cm often with a domed, spherical, or ovoid shape.

Vesicle

A raised, fluid-filled papule (with serum, blood, or lymph) measuring < 1\,\text{cm}.

Bulla

A raised, fluid-filled lesion (with serum, blood, or lymph) measuring $\geq 1\,\text{cm}$.

Pustule

A raised papule < 1\,\text{cm} containing visible pus (white/yellow)

Wheal (Hives/Urticaria)

An irregularly shaped, elevated, edematous lesion with well-demarcated borders that may be erythematous or pale and can move over a period of hours.

Edematous

Swollen

Erythematous

red

Scale

A palpable change in epidermis that may be soft, rough, gritty

crust

dried fluid on skin’s surface that may point to a previous vesicle, bulla, or pustule or excoriations; has two subtypes

Eschar

A subtype of crust that is dry adherent with dark purple/brown/black discoloration and signals necrosis

Fibrin

A subtype of crust that is soft and yellow

Excoriation

Scratching

Lichenification

Thickening and accentuation of skin lines resulting from repeated rubbing or scratching and can be felt (very dry), often found in chronic eczematous processes.

Atrophy

Depressed dermis and shiny epidermis due to skin breaking down (see with aging and cystic acne)

Fissure

A linear loss of continuity of the skin's surface caused by excessive tension or decreased elasticity often seen on palms and soles

Excoriation

A superficial, often linear, skin erosion caused by scratching.

Scar

fibrous tissue that replaces normal dermal or subcutaneous tissue after skin injury

Erosion

A superficial, focal loss of part of the epidermis.

Ulcer

Focal loss of the epidermis extending into the dermis.

Petechiae

Nonblanchable, nonpalpable, pinpoint macules caused by capillary inflammation and RBC extravasation that are typically red

Purpura

Nonblanchable red-purple lesions larger than petechiae resulting from blood extravasation; can be macular or raised/palpable.

extravasation

leakage of fluid

Ecchymosis

collection of blood beneath skin that is a result of extravasation of blood and is a larger version of petechiae/purpura

Telangiectasia

A dilated, superficial blood vessel that blanches under pressure.

Spider Angioma

A central feeding vessel leading to telangiectatic vessels arranged like a spider; blanches with pressure.

cluster

A skin lesion distribution that is limited to one area in a small grouping

grouped

A skin lesion distribution that is more widespread than clusters with typically 2+ clusters

Linear

A skin lesion distribution that makes a straight line

Zosteriform

A skin lesion distribution following a dermatomal pattern.

Coalescing/confluent

A skin lesion distribution that has widespread connection

Serpiginous

A skin lesion distribution that creates a serpent/snake-like pattern

ABCDE Criteria for Melanoma

Asymmetry, Border (irregular), Color (multiple), Diameter (larger than a pencil eraser), and Evolving.

Bathing

A topical treatment method that keeps skin clean and tries to avoid irritation with gentle soaps and soaking to improve topical efficacy

Corticosteroid Potency Rule

Higher lipophilicity typically equals higher potency (ointment>cream>lotion); potency is also increased by occlusion.

Topical Corticosteroid

A therapy for lesions that vary in potency in order to decrease immune system activity

Hydrocortisone acetate

A over the counter topical corticosteroid that has low potency (typ 1% cream/ointment or 2.5% cream)

Triamcinolone acetonide

A prescription topical corticosteroid that has medium potency (0.1% cream/ointment/lotion or 0.025% cream/ointment)

Betamethasone dipropionate and Clobetasol propionate

A prescription topical corticosteroid that has high potency (0.05% cream/ointment/lotion)

Emollients

A type of topical lesion treatment that moisturizes and restores epidermis by promoting keratinocyte differentiation and by producing innate antimicrobial (some also restore skin barrier lipids); most effective on wet skin

Drying agents

A type of topical lesion treatment that is used on weepy skin (from infection/inflammation); Best option is water/wet compress

Antipruritics

A type of topical lesion treatment that helps with itching (typ 0.5% camphor and menthol OR 1% pramoxine hydrochloride)

H1- Blockers

A type of systemic lesion treatment that helps with pruritis due to histamine; often have sedative effects

Systemic Corticosteroids

A type of systemic lesion treatment that can be oral or injected but often have a lot more side effects

Non-steroidal anti-inflammatory agents

A type of topical lesion treatment that helps with atopic dermatitis and exzema

Acne Antibiotics

A type of topical lesion treatment for acne; most commonly have clindamycin or erythromycin

Impetigo Antibiotics

A type of topical lesion treatment for a specific bacterial skin infection in kids

Antifungals

A type of topical lesion treatment for fungal infections

sunscreen

A type of topical preventative therapy that reduces incidence of sunburn, actinic keratoses, and skin cancer

Potassium Hydroxide (KOH) Exam

A cost-effective test using 20% KOH to detect superficial fungal skin infections by identifying spores and hyphae under a microscope.

Tzanck Test

A cost-effective diagnostic test used to detect cutaneous herpes simplex and herpes zoster; often has false positive and negative

Scabies Scraping

A diagnostic test used to confirm the presence of scabies mites, eggs, and/or fecal matter

Wood's Lamp

A diagnostic test that uses a handheld mercury vapor bulb to help diagnose infections and pigment disorders (in dark room, held 10 cm from skin)

T.R.U.E. Test

Thin-layer Rapid Use Epicutaneous Patch Test, A patch test with containing 35 common allergens used to detect allergic contact dermatitis based on the erythema, papules, and/or vesicles that form

Finn chambers

A type of patch test used to detect allergic contact dermatitis with small aluminum discs taped to patients’s back

Dermoscopy

A diagnostic tool that is a handheld microscope with a light source used to magnify the skin; has two types

Polarized Dermoscopy

Dermoscopy that allows us to see into the deep epidermis or superficial epidermis

Nonpolarized Dermoscopy

Dermoscopy that allows us to see into the superficial epidermis

Three-Point Checklist for Dermoscopy

Evaluation for malignancy focusing on Asymmetry, Atypical network, and Blue-white structures; 2/3 = do a biopsy, 1/3 don’t unless its the blue-white structures

Skin biopsy

A diagnostic technique on skin removal that is done on non-excoriated/eroded areas and uses lidocaine with epinephrine typically to anesthetize locally

Shave biopsy

A type of skin biopsy that takes off a superficial sample

punch biopsy

A type of skin biopsy that takes out a deeper portion of skin

Excision and incision/wedge biopsy

A type of skin biopsy that requires surgery

Cryotherapy

An in-office destructive procedure using liquid nitrogen to treat benign and precancerous lesions by spraying until a 2 mm rim of frost develops for 5-30 secs

Curettage and Electrodesiccation

A destructive procedure that is used for seborrheic keratosis, viral warts, pyogenic granulomas, and certain carcinomas; Do NOT use this technique on patients with implantable cardiac devices.