DERM DESCRIPTIONS

atopic dermatitis

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Erythematous papules and plaques with or without scales

nummular dermatitis

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Nummular, scaly, erythematous papules and plaques

Dyshidrotic Eczema

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Intensely pruritic, chronic, recurrent, vesicular ("tapioca-like vesicles")

irritant contact dermatitis

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this is non-immune modulated, has burning, pruritus, and pain, presents as dry, fissured skin, and is LESS distinct

allergic contact dermatitis

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this is type IV mediated hypersensitivity rxn w/ pruritus and has bullae/vesicles w/ DISTINCT angles/lines/borders

Stasis Dermatitis

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this has swelling, color change, itch, weeping and crusts

Seborrheic Dermatitis

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Scattered, yellowish scaly greasy papules and plaques

auspitz sign (psoriasis)

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plaque psoriasis

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this usually presents as 1-10 cm erythematous, sharply, defined, and raised w/ thick, silvery scale

guttate psoriasis

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this is presents as multiple small, drop-like scaly plaques that are usually <1 cm and appear abruptly

inverse psoriasis

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this presents as bright red, waxy-looking, sometimes weeping, w/ minimal scale seen in intertriginous areas

nail psoriasis

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classically presents with pitting and an "oil drop sign"

Generalized Pustular Psoriasis

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Von Zumbusch variant

this a rare subtype of generalized pustular psoriasis

Psoriatic Arthritis

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this may have skin involvement but not all and if nail involvement it is often severe

Dermatitis Herpetiformis

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Chronic recurrent pruritic vesicular eruption on erythematous base in a symmetrical pattern

Pityriasis Rosea

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Papulosquamous eruption with a single, pink, 2-4 cm oval shaped plaque

lichen planus

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Purple (Violaceous), Polygonal, Pruritic, Papule w/ fine white lacy lines

Lichen Simplex Chronicus

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Thick, well- circumscribed plaques that are HIGHLY pruritic (hard to break itch-scratch cycle)

Comedonal acne

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mild acne when sebum blocks cells

Papulopustular/cystic acne

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combination of comedones, red papules, and pustules

mild or severe

Perioral Dermatitis

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Small erythematous papules and pustules w/ erythema and +/- scaling around the mouth

folliculitis

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Purulent material in the epidermis→ presents as erythematous papules and pustules surround hair, or in hair bearing area (can occur from G+ organisms and pseduomas in a hot tub)

carbuncle

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this is a superficial inflammatory mass consisting of several inflamed hair follicles and multiple sites of drainage→ in the epidermis

furuncle/boil

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infection of hair follicles where purulent material extends through the dermis into SubQ tissue forming an abscess

cellulitis

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Skin erythema, edema, and warmth-->Deeper dermis and SubQ fat--> borders are NOT defined

erysipelas

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Skin erythema, edema, and warmth-->Upper dermis and superficial lymphatics-> borders are SHARPLY defined

impetigo

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honeycomb crust with erythematous lesions that rupture, ooze, and crust

Dermatophytosis (aka tinea)

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erythematous annular patch w/ distinct border and central clearing ("Serpiginous border"--> undulating border, snake-like)

Kerion

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Indurated, boggy, nodule with pustules on scalp

Tinea Unguium (aka Onychomycosis)

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Thickened yellow or white nails--> scaling under distal free edge

Candidiasis

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Erythema, +/- pustules in areas of moisture that look like "satelitte" lesions

intertrigo

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Erythematous, moist, macerated skin folds that may be maledorous

Tinea Versicolor

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- Hyperpigmented macules that can hav chronic scaling

Herpes Simplex Virus (HSV)

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Herpetic appearance: vesicles on erythematous base, progresses to tender ulcers that crust and scab over

varicella zoster ("chicken pox")

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- Generalized vesicular rash within 24 hours with classic rash progression w/ macules to papules to vesicles ("dew drop on a rose petal") --> then rupture and crust

herpes zoster (shingles)

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Erythematous, grouped papules in a unilateral dermatomal distribution

Molluscum Contagiosum

these are flesh colored and dome shaped papules with central core/umbilication

verrucae

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Condylomata Acuminata

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Asymptomatic to pruritic, burning, bleeding, tenderness, vaginal d/c, pai

melasma

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Skin hyperpigmentation, seen in women on facial skin (malar region, upper lip, and/or forehead)

vitiligo

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Progressive depigmentation of epidermis Without infiltrate or scaling; Round macules that slowly enlarge to patches

Acanthosis Nigricans

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Velvety, dark thickening (hypertrophic plaques)

Hemochromatosis

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Abnormal pigmentation; Slate gray from iron plus brown melanin in skin -> bronze color of skin

Idiopathic livedo reticularis

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netlike pattern disappears after warming

secondary livedo reticularis

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starburst pattern usually confined to buttock and lower extremities

Cutaneous Lupus Erythematosus

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Malar rash --> Bright red, sharply defined, erythema with slight edema and scaling and spares nasolabial folds

erythema nodosum

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Erythematous, painful nodules on bilateral lower legs

Cutaneous T-Cell Lymphoma (CTCL)

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Randomly distributed, scaling & non- scaling erythematous plaques (Plaques start thin, then become thicker over the years)

Pemphigus Vulgaris

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Epidermis sloughs/slips away when rubbed (+ Nikolsy's sign)

Bullous Pemphigoid

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prodrome of pruritic and urticarial papules -> progresses to large tense bullae--> Bullae are tense, hard to rupture (- Nikolsky sign)

Erythema Multiforme

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Starts as erythematous macule-> eventually forms target or iris lesions present

SJS and TEN

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Starts w/ fever, photophobia, mucosal inflammation, sore throat/mouth, painful papules

fixed drug eruption

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Solitary, sharply demarcated, dusky red round/oval patch

Miliaria

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2-4 mm erythematous pruritic non- follicular papules

Morbilliform Drug Eruption

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macular lesions 2-10 mm

Urticaria (hives)

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Intensely pruritic, erythematous plaques

photosensitivity

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severe sunburn with minimal sun exposure

Hidradenitis suppurativa

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Chronic suppurative folliculitis of apocrine sweat bearing skin

lipoma

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Well circumscribed, benign adipose tissue

pilar cyst

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Epidermoid cyst of the scalp, arises from hair follicle

Dermatofibroma

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dome-shaped papules with firm consistency--> Erythematous, violaceous, or hyperpigmented

Xanthoma/Xanthelasma

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Yellow papules & plaques caused by cholesterol deposits in and around eyelid skin

Venous Ulcers

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Irregular shape, moderate/heavy drainage, pain w/ ambulation, edema, stasis dermatitis with hemosiderosis (pigment)

arterial ulcer

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"punched out look", round, well defined border

neuropathic ulcer

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Bottom of foot, diabetic; "punched out" deep ulcer

Pressure Ulcer

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Partial or full skin breakdown due to prolonged pressure

Pyoderma Gangrenosum

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Inflammatory papule or pustule that progresses to a painful ulcer

scabies

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Intensely pruritic eruption (3-4 weeks post primary infection)

spider bite

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Can cause a significant reaction: infarct of skin

bedbug bite

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Bites occur in a line or cluster-->"breakfast, lunch, and dinner" sign

chiggers

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Intense itching around sock line or pant waist

Not a widespread rash

basal cell carcinoma (BCC)

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malignant epithelial tumor arising from the bottom layer of the epidermis

Cutaneous Squamous Cell Carcinoma (SCC)

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Sharply demarcated scaling or hyperkeratotic papule or plaque

Actinic Keratosis (AKA Solar Keratosis)

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Single or multiple, discrete, dry, rough adherent scaly lesions

melanoma

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Classically black or brown appearance; Irregular border with outward spreading of pigment

Seborrheic Keratosis (SK)

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"waxy, stuck on" lesions

nevi

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symmetric, tan/brown/pink, papules or macules

Ephelides

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lentigo

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"sun spots"

cherry angioma

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Typically <3 mm in diameter; Bright red, discrete, round papules, non- blanching

Telangiectasia

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Dilated or broken blood vessels visible on surfaces of skin

Alopecia Areata

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Non-scarring discrete patches--> Smooth, circular discrete areas of complete hair loss ("exclamation point hairs")

Androgenic Alopecia (males)

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hair thinning on the crown and/or recession in temples

Androgenic Alopecia (females)

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hair thinning across crown (frontal hairline preserved) part wider anteriorly

Telogen effluvium

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hair comes out in clumps in shower/brush

Trichotillomania

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Irregular patterns of hair loss, can be on head, eyebrows, and lashes

Scarring-Alopecia (AKA Cicatricial Alopecia)

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Inflammation destroys hair follicles, leading to scarring of the follicle and permanent hair loss

Paronychia

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Inflammation/infection of lateral and/or posterior nail folds

felon

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Think pad of finger; Pain, erythema, edema

superficial burn

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involves epidermis only

partial thickness burn

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involves of epidermal + dermal involvement

full thickness burn

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