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CM Derm Intro
Introduction to Dermatology
| Question | Answer |
|---|---|
| How many layers comprise the epidermis? | Stratum corneum (flat dead cells without nuclei/organelles, dense, 8-15 layers thick)Stratum granulosum (transitional layer)Stratum spinosum (differentiation)Stratum basale (mitosis) |
| Major cell population in Epidermis? | Keratinocytes (80%). Produce keratin, immune function |
| Which cell produces melanin (UV protection) | Melanocytes |
| Antigen presenting cells in the epidermis | Langerhans Cells |
| Where are blood vessels, hair follicles, sebaceous glands, muscles and sweat glands located? | in the dermis |
| Function of the eccrine sweat glands | thermoregulation, whole body |
| Function of the apocrine sweat glands | scent, axilla, genitals, ears, eyelids, mammary |
| _________ synthesize collagen, and is the most abundant protein in mammals | fibroblasts |
| Important hx questions | variation (seasonal, monthly), what have they tried, PMH, FMH, Medications, allergies, Job, hobbies, ETOH, tobacco |
| Descriptive words to specifiy arrangement | discrete, confluent, grouped, linear, annular, arciform, polycyclic, serpiginous, satellite, targetoid, reticulated, nummular |
| Looks like a snake | serpiginous |
| net-like | reticulated |
| filled in circle, like a coin | nummular (vs annular which is empty in the middle) |
| Distribution descriptions | generalized, localized, dermatome, symmetric, bilateral, sun-exposed areas |
| Don't forget to examine | hair, nails and mucous membranes |
| Macule | flat (non-palpable), alteration in color, size is <1cm |
| Patch | macule >1cm |
| Raised/depressed (palpable), size <1cm, color can vary | papule |
| Large papule (>1cm) | Plaque |
| What is the word considered pathognomonic for seborrheic keratosis | waxy |
| Raised and filled with clear fluid; size is <1cm | Vesicle |
| Large vesicle >1cm | Bulla |
| Pustule | raised, circumscribed collection of inflammatory cells and free fluid. variable in size |
| Raised, solid, often round; deeper than a papule, size is <1cm | nodule. Deeper down into the reticular dermis |
| ____ is a large nodule | tumor |
| Firm, edematouis papule or plaque. Fluid filled, but fluid is bound. Flat-topped elevations, transient in nature, Type I hypersensitivity rxn | Wheal (hive) |
| Epidermis ready to be sloughed | scale |
| Focal loss of epidermis and dermis, heals with scarring | fissure |
| Thickening of the skin, accentuated skin markings | lichenification |
| nonblanchable blood deposit 1cm or less | petechiae |
| narrow, elevated tunnel = parasite | burrow |
| small, superficial keratin cyst | milia |
| erosions from scratching | excoriation |
| blackheads and whiteheads (acne) | comedo |
| Petechiae >1cm | Purpura |
| Which skin formation is associated with scabies? | burrow |
| Mineral oil prep is used for | scabies |
| KOH prep is good to confirm the presence of | fungus and yeast |
| Diascopy is | putting pressure with a glass slide on a vascular skin lesion. |
| ___ is primarily used for herpes infections | Tzanck smear |
| Wood's light is another term for | black light |
| Topical steroid on a fungal infection | Fungus thrives on steroids, so it will get much worse! |
| MOA of KOH | dissolves the keratin from the skin scrapings allowing a better picture. Heat speeds this rxn, but avoid boiling the specimen. Always scrape the border of the lesion, that is where the active infection is |
| central clearing, raised expanding border | fungal infection |
| What is the name of this procedure? Place on slide, air dry, fix with methanol, stain with Wright’s or Giemsa. | Tzanck smear. Looking for multinucleated giant cells. Looking for herpes (murky presentation in immunocompromised patients) |
| When are patch tests read? | 48, and 96 hours |
| A positive rxn (red+/- blister) in a patch test represents | a Type IV delayed hypersensitivity reaction |
| What turns green under Wood's light? | Tinea Capitis. |
| What turns coral red under wood's light? | Erythrasma (seen in webspaces of toes and in groin) |
| Honey colored crust is pathognomonic for | Impetigo |
| Grouped pustules coalescing on an erythematous base | Herpes simplex |
| Erythematous papules and vesicles on the palm of the hand and sole of the feet. Some are dried up. With sores in mouth | Hand foot and mouth dz. Coxsackie virus |
| Erythematous targetoid papules on the palm of the left hand. | Erythema multiforme |
| Acne is composed of | Acne is composed of comedons, papules and pustules |
Created by:
ltm12