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Introduction to Dermatology

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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)  
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Major cell population in Epidermis?   Keratinocytes (80%). Produce keratin, immune function  
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Which cell produces melanin (UV protection)   Melanocytes  
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Antigen presenting cells in the epidermis   Langerhans Cells  
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Where are blood vessels, hair follicles, sebaceous glands, muscles and sweat glands located?   in the dermis  
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Function of the eccrine sweat glands   thermoregulation, whole body  
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Function of the apocrine sweat glands   scent, axilla, genitals, ears, eyelids, mammary  
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_________ synthesize collagen, and is the most abundant protein in mammals   fibroblasts  
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Important hx questions   variation (seasonal, monthly), what have they tried, PMH, FMH, Medications, allergies, Job, hobbies, ETOH, tobacco  
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Descriptive words to specifiy arrangement   discrete, confluent, grouped, linear, annular, arciform, polycyclic, serpiginous, satellite, targetoid, reticulated, nummular  
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Looks like a snake   serpiginous  
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net-like   reticulated  
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filled in circle, like a coin   nummular (vs annular which is empty in the middle)  
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Distribution descriptions   generalized, localized, dermatome, symmetric, bilateral, sun-exposed areas  
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Don't forget to examine   hair, nails and mucous membranes  
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Macule   flat (non-palpable), alteration in color, size is <1cm  
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Patch   macule >1cm  
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Raised/depressed (palpable), size <1cm, color can vary   papule  
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Large papule (>1cm)   Plaque  
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What is the word considered pathognomonic for seborrheic keratosis   waxy  
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Raised and filled with clear fluid; size is <1cm   Vesicle  
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Large vesicle >1cm   Bulla  
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Pustule   raised, circumscribed collection of inflammatory cells and free fluid. variable in size  
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Raised, solid, often round; deeper than a papule, size is <1cm   nodule. Deeper down into the reticular dermis  
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____ is a large nodule   tumor  
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Firm, edematouis papule or plaque. Fluid filled, but fluid is bound. Flat-topped elevations, transient in nature, Type I hypersensitivity rxn   Wheal (hive)  
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Epidermis ready to be sloughed   scale  
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Focal loss of epidermis and dermis, heals with scarring   fissure  
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Thickening of the skin, accentuated skin markings   lichenification  
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nonblanchable blood deposit 1cm or less   petechiae  
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narrow, elevated tunnel = parasite   burrow  
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small, superficial keratin cyst   milia  
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erosions from scratching   excoriation  
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blackheads and whiteheads (acne)   comedo  
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Petechiae >1cm   Purpura  
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Which skin formation is associated with scabies?   burrow  
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Mineral oil prep is used for   scabies  
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KOH prep is good to confirm the presence of   fungus and yeast  
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Diascopy is   putting pressure with a glass slide on a vascular skin lesion.  
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___ is primarily used for herpes infections   Tzanck smear  
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Wood's light is another term for   black light  
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Topical steroid on a fungal infection   Fungus thrives on steroids, so it will get much worse!  
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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  
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central clearing, raised expanding border   fungal infection  
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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)  
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When are patch tests read?   48, and 96 hours  
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A positive rxn (red+/- blister) in a patch test represents   a Type IV delayed hypersensitivity reaction  
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What turns green under Wood's light?   Tinea Capitis.  
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What turns coral red under wood's light?   Erythrasma (seen in webspaces of toes and in groin)  
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Honey colored crust is pathognomonic for   Impetigo  
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Grouped pustules coalescing on an erythematous base   Herpes simplex  
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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  
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Erythematous targetoid papules on the palm of the left hand.   Erythema multiforme  
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Acne is composed of   Acne is composed of comedons, papules and pustules  
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