650 Midterm Study Guide (45 multiple choice questions, 5 essay questions

650 Midterm Study Guide (45 multiple choice questions, 5 essay questions Definitions of lesion descriptions (macules, papules, etc)  A macule is a circumscribed flat area of change in color of the skin 1 cm in diameter. o freckles, flat moles, and port-wine stains and the rashes of rickettsial infections, rubella, and measles  A patch is a circumscribed flat area of change in color of the skin 1 cm in diameter.  A papule is a small solid elevation of the skin 1 cm in diameter. o nevi, warts, lichen planus, insect bites, seborrheic keratoses, actinic keratoses, acne, skin cancers  A plaque is a large flatter elevation of the skin, sometimes formed by papules coalescing. o Lesions of psoriasis and granuloma annulare commonly form plaques  A nodule is a solid elevation of the skin 1 cm in diameter that usually extends into the deeper skin layers. o cysts, lipomas, and fibromas  A pustule is a small circumscribed elevation of the epidermis filled with purulent fluid. o bacterial infections and folliculitis.  A vesicle is a small circumscribed elevation of the epidermis containing clear fluid 1 cm in diameter. o herpes infections, acute allergic contact dermatitis, and some autoimmune blistering disorders such as dermatitis herpetiformis.  A bulla is a circumscribed elevation of the epidermis containing clear fluid 1 cm in diameter. o Classic autoimmune bullous diseases include pemphigus vulgaris and bullous pemphigoid  A wheal is a circumscribed, raised lesion consisting of dermal edema and is also known as hives or urticaria. Wheals typically last 24 hours. o Wheals are a common manifestation of hypersensitivity to drugs; stings or bites; autoimmunity; and, less commonly, physical stimuli including temperature, pressure, and sunlight.  Other primary lesions include erosions (loss of epidermal or mucosal epithelium), ulcers (deeper loss of the epidermis and at least the upper dermis), petechiae (nonblanchable punctate foci of hemorrhage), purpura (nonblanchable, raised and palpable), and ecchymoses (nonblanchable, larger areas or purpura). Definitions of shapes/arrangements of lesions (linear, annular, etc)  Configuration: shape of single lesion & arrangement of groups of lesions:  linear or striate (straight line);  annular (ring- like, with central clearing);  nummular or discoid (coin- shaped, no central clearing);  target, bull’s eye, or iris (rings with central duskiness); and  serpiginous or gyrate (having linear, branched, and curving elements). o Examples:  herpes zoster: unilateral, dermatomal vesicles  Herpes simplex: grouped vesicles or pustules on erythematous base  Tinea pedis: annular lesions  Poison ivy w/ allergic contact dermatitis: linear lesions  Shape: Circular, oval, annular, nummular, or polygonal What questions should be included in HPI for skin concerns?  common or concerning symptoms: lesions, rashes and itching (pruritus), hair loss and nail changes  Itching, pain, duration, evolution, periodicity, prior episodes of similar type, dietary items, cosmetics, work chemicals, sunlight, medications, foreign travel  Changes in skin, hair, nails; new growths/ lumps  Skin: Personal and family history of skin cancer, regular skin exams, use of sunscr