Dermatology
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83 terms
Terms | Definitions |
|---|---|
 Taking skin health history | allergies, family issues, OLDCARTS, sun exposure, skin and hair care, what has been used. |
| Skin includes | skin, hair, and nails as well as mucous membranes |
| dermatology pathology | inflammatory, infectious, immunological, insect bite, exposure |
| questions of patient | appearance, vitals, duration, spread, pain? other contacts? |
| abdominal exam as part of derm exam | to check spleen and liver for enlargement |
| woods lamp | for fungus id |
| widespread increased melanin | can be addisons disease |
| jaundice | always check slcera- not only skin! |
| hypopigmentation/vitilago | check thyroid function |
| primary lesions-macules | - flat, discrete change in color of skin (freckle, etc) |
| primary lesions- patch | - larger than 1cm, flat, discrete lesion (just larger macule) |
| "Christmas tree" distribution | Pityriasis Rosea |
| primary lesions- papules | discrete, raised areas, smaller than 1cm, elevated |
| primary lesions-plaque | slightly raised, flat, associated with scaling, larger than 1cm |
| primary lesions- wheals | flat, lighter color, puritic, less than 24hours (urticaria), central clearing check for sob (risk for angioedema) |
| primary lesion-nodule | discrete palpable lesions of the skin, can be deep |
| primary lesion-tumor | larger than nodule, can be deep, |
| primary lesion- vesicle | smaller than 1cm, fluid filled, raised, usu. clear fluid, |
| primary lesion-bulla | larger than 1cm, fluid filled, usu. clear fluid |
| primary lesion- pustule | pus filled lesion, can be closed or weaping, may have well defined borders |
| primary lesion- cyst | varies in size, semisolid |
| secondary lesions- | evolve from primary lesions through changes |
| secondary lesion- lichenification | thickening of skin, dramatization of skin markings hallmark of eczema |
| secondary lesion- excoriation | usu. from scratching, may be round or linear |
| secondary lesion-fissures | linear cracks in epidermis, common with athlete's foot and corner of mouth (chelitis) |
| secondary lesion- erosion | partial break in epidermis |
| secondary lesion- ulcer | deeper loss of skin surface: stasis, chancre, pressure, small or large, |
| secondary lesion- crust | dried exudate, can be purulent, hemmoragic, or serous |
| cherry angioma | 1-3mm, round, dome shape or flat, no pulsation, may blanch some, trunk, no sig. |
| petechiae- | smaller red/purple lesions, usu. flat, not blanchable, variable distribution (blood outside vessel) |
| purpura- | larger lesions (larger petechiae) |
| spider veins | telangiectasia, radiating legs, will blanch, associated with liver problems, pregnancy, vitamin b def., never below waist, |
| hemangiomas | bright red, usu in infants, goes away by 1yr (usu) |
| basal cell carcinoma | locally invasive, slow, seldom mets, shiny smooth glistening surface, translucent nodule with depressed center, common over 40, usu. face, ears/ sun exposed areas, telangictasia present |
| squamous cell carcinoma | ?immunosupression, regional lymphadenopathy, mets possible, head/ears/lips. Persistent nodule/plaque, ulcer, grows more quickly than basal cell. Sun damaged areas. |
| malignant melanoma | can occur anywhere. Aggressive. ABCDE Asymmetry, border, color, diameter, evolving. |
| acne | consider type/locations in treatment- systemic or localized |
| rosacea | vasomotor instability, sebacous gland instability, telactasias, 30-50yoa, more predominant in females, pustules, papules, |
| seborrhic dermatitis | chronic scaling, flaking, errythematous dermatitis, face, ears, sometimes back and genitals. |
| atopic dermatitis | Eczema. Errythematous papules, scaling, crusts, itching. In flexor surfaces, creases, patches, regional. History of personal/family asthma. Secondary colonization with staph. |
| linear vesicles | from contact with irritant like poison ivy, erosions, leads to crusts, itching. |
| kaposis sarcoma | colored lesions, often in mouth, associated with AIDS but not always, can be macule, papule, nodule |
| leukoplakia | precancerous plaque, elevated flat, needs removed, white |
| dysplastic nevi | has ABCD characteristics but is not melanoma |
| impetigo | gold honey crusted scaling pattern, staph or strep, consider location for treatment, caused by scatching a minor wound, leads to infection. |
| scarlet fever | associated with GABHS, sandpapery redness, flushing, circumoral pallor, fine papular/macular errythema with desquamation, intensified at flexor folds. sometimes rash is not visible, but can be felt. |
| pastias lines | rash that is linear, often at elbow or flexor folds. |
| strawberry tongue | associated with scarlet fever |
| cellulitis | deep skin infection. Usually staph/strep. |
| erysipelas | Group a strep, warm to touch, headache, fever, vomitting, located in the "triangle of death" eye area. |
| folliculitis | superficial pustular infection of hair follicle, localized, is bacterial, anywhere where hair is present, razor is common culpret, can be from hot tub (psuedomonis). Can do culture. |
| furuncle | boil. Bacterical infection of skin. Can follow folliculitis. |
| carbuncle | furuncles that come together. Folliculitis spreads to furuncle, to carbuncle. Often staph. |
| staphylococcal infection | "scaled skin". bacterial infection. Ill defined borders. |
| pseudomonas | awful smell. Puncture wounds, bedsores. |
| meningococcemia | associated with meningitis, systemic infection, over two nuchal rigidity, "toxic", petichiae and purpura (won't blanch), febrile, sore throat, |
| fungal infections | scrape skin scaling, place on slide with KOH, wait a few minutes, examine under scope, "spaghetti and meatballs" |
| candidiasis | yeast like fungus, common diaper rash, skin folds, errythemetous, macular/papular, well demarcated, some satilite legions, mild/moderate pruritis |
| tinea versicolor | flat eruption, hypo/hyperpigmented, "lifeguard suntan", will not tan or burn. May take years for repigmentation to occur if it will. |
| tinea capitis | broken hair shafts, may drain, treat early to prevent perm. baldness |
| tinea corporis | ringworm, on skin, area of central clearing, some itching |
| tinea cruris | jock itch, well defined, errythematous, flat or raised, |
| scabies | intense itching, at night, not on face, finger webbing, under axilla, groin, toe webbing. Close contact. +burrows. |
| head lice | often only see nits, shake hair shaft- will not fall off, do follow up treatment in 10-14 days to kill eggs. Hard for patients to do all the cleaning, treatment necessary. |
| rickettsial rocky montain spotted fever | 3-10 days post tick bite, fever, pain, rash, photophobia, n/v, starts on wrist, ankles and spreads inward, petichael rash, will get on palms/soles of feet. |
| lyme disease | tick bite. errythematous lesion with central clearing, "bull's eye", red papular lesions, will migrate, trunk, axilla, groin. Flu like symptoms. Early- ha, weakness. Intermediate- arthralgia, Late- meningitis, ms changes. |
| HSV | cold sore, vesicle lesions, can get anywhere on body, have to break vesicle and culture at base of lesion. |
| herpes zoster | must have chicken pox first. Vesicles that follow dermatome on one side of body. Immunize over age 60. |
| molluscum contagiosum | umbilicated papule. Viral, spread through direct contact, very contagous. Usually same color as skin. |
| fifth's disease | erythma infectiosum. Viral, sudden onset, macular red rash on checks, face, then 2-3days later on extremities, parovirus, circumoral pallor, stay away from pregnant women |
| pityriasis rosea | viral? herald patch on trunk, flat patch with central clearing and scaling border, common in spring, fall and in teens, then papular discrete oval rashes on trunk, Christmas tree distribution |
| roseola | hhv-6 viral infection. 2-3 days fever in irritable infant, 104-105 fever, not "that sick" looking, then rash- pink, fades within 12-24 hours. Fever goes away with rash. |
| rubella | viral xantham. Starts on face, then caudilly, lymphadenopathy, postauricular nodes, not very sick, cannot be around pregnant women. |
| forchheimer spots | In mouth, present in rubella. Indicative of rubella. |
| rubeola | measles. Cough, runny eyes, congestion. Photophobia, fever. Self-limiting. Sicker than rubella. |
| koplik spots | in bucal mucosa, white spots, indicative of rubeola. |
| varicella | chicken pox, flat macule, to papule, to vesicle, then scabs over. Contagious until last vesicle is scabbed over! |
| psoriasis | can be tender or pruritic, well demarcated, scaling, elbows, knees, hands, fingernails, scalp, hard for patients to deal with it, chronic autoimmune, plaques, papules. |
| lichen planus | inflammatory process, skin and mucous membranes, itching papules, flat-topped, white webbingin buccal mucosa, papule, purple, planar, pruritic, polyangular. |
| milia | white cystic lesions in babies, will go away |
| beau's lines | associated with stress or illness, transverse lines in nails |
| terry nails | brown ring distal ring, luna not always visible, CHF, liver, DM |
| paronychia | inflammation of nail folds, red, swollen, acute or chronic, |
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