Unit 7: Chapter 52

Question 1

Macule, Patch

Answer 1

Flat, non palpable skin color changes
May be brown, white, tan, purple or red
Macule < 1 cm
Patch > 1 cm
(Ie) freckles, moles

Question 2

Papule

Answer 2

Elevated, palpable, solid mass with a circumscribed border
Plaque may be coalesced papules with flat top.
Papule: <0.5 cm
Plaque: >0.5 cm

Papules: Elevated nevi, warts, lichen planus
Plaques: Psoriasis, actinic keratos

Question 3

Nodule, Tumor

Answer 3

Elevated, palpable, solid mass that extends deeper into the dermis than does a papule
Nodule: 0.5–2 cm; circumscribed
Tumor: >1–2 cm; tumors do not always have sharp borders

Nodules: Lipoma, squamous cell carcinoma, poorly absorbed injection, dermatofibroma
Tumors: Larger lipoma, carcinoma

Question 4

Vesicle, Bulla

Answer 4

Circumscribed, elevated, palpable mass containing serous fluid
Vesicle: <0.5 cm
Bulla: >0.5 cm

Question 5

Wheal

Answer 5

levated mass with transient borders; often irregular; size and color vary
Caused by movement of serous fluid into the dermis; does not contain free fluid in a cavity (e.g., as a vesicle does)
(Ie) Urticaria (hives), insect bites

Question 6

Cyst

Answer 6

Encapsulated fluid-filled or semisolid mass in the subcutaneous tissue or dermis
(Ie) Sebaceous cyst, epidermoid cysts

Question 7

Fissures

Answer 7

Linear crack in the skin that may extend to dermis
(Ie) Chapped lips or hands, tinea pedis

Question 8

Atrophy

Answer 8

Thin, dry, transparent appearance of the epidermis; loss of surface markings; secondary to loss of collagen and elastin; underlying vessels may be visible
(Ie) Aged skin, arterial insufficiency

Question 9

Lichenification

Answer 9

Thickening and roughening of the skin or accentuated skin markings that may be secondary to repeated rubbing, irritation, scratching
(Ie) Contact dermatitis

Question 10

Vitiligo

Answer 10

Pigmentary problem of concern to darkly pigmented people, one white.
Cause unknown

sudden appearance of white patches on the skin.
The lesion is a depigmented macule with definite smooth borders on the face, axillae, neck, or extremities. vary in size
2 kinds: A or B
A is seen more often, progresses slowly
B occurs early is life and patches are not symmetrical

Question 11

Ringworm (Tinea Corporis)

Answer 11

Caused by any fungi but moist freq is M canis.
Transmission from kittens, puppies and children

most common types of lesions are oval or circular patches on exposed skin surfaces and the trunk, back, or buttocks.
Less common are foot and groin infections.
begins as a red papule and enlarges, often with a central clearing.
Patches have raised red borders consisting of vesicles, papules, or pustules. The borders are sharply defined, but lesions may coalesce
Pruritic is common

Question 12

Herpes Zoster

Answer 12

(shingles) is an acute, localized vesicular eruption distributed over a dermatomal segment of the skin.
Icaused by the same herpesvirus, varicella–zoster, which causes chickenpox.
Iresult of reactivation of a latent varicella–zoster virus infection that was dormant in the sensory dorsal root ganglia since a primary childhood infection.
During an episode, the reactivated virus travels from the ganglia to the skin of the corresponding dermatome. Not as contagious as chickenpox, the reactivated virus can be transmitted to nonimmune contacts.

Question 13

Acne

Answer 13

disorder of the pilosebaceous unit, which comprises a tiny vellus hair, hair follicle, and sebaceous gland.
Either non inflammatory of inflammatory.

Noninflammatory consist of comedones (whiteheads and blackheads).
Blackheads are plugs of material that accumulate in sebaceous glands that open to the skin surface.
The color results from melanin that has moved into the sebaceous glands from adjoining epidermal cells. Whiteheads are pale, slightly elevated papules with no visible orifice.
Inflammatory lesions consist of papules, pustules, nodules, and, in severe cases, cysts

Question 14

Chronic Urticaria

Answer 14

hives, are pale, raised, itchy papules or plaques that occur in the most superficial aspect of the dermis anywhere on the skin.
These small wheals blanch with pressure and vary in size from a few millimeters to centimeters

affects primarily adults and is twice as common in women as in men.
Usually, its cause cannot be determined despite extensive laboratory tests.
It appears to be an autoimmune disorder in a substantial number of people.

Question 15

Psoriasis

Answer 15

common, chronic inflammatory skin disease characterized by circumscribed, red, thickened plaques with an overlying silvery-white scale.
Characterized by increaed cell turnover marked by epidermal thickening called hyperkeratosis
occurs worldwide, although the incidence is lower in warmer, sunnier climates.

Question 16

PlaqueType Psoriasis

Answer 16

which is the most common type, is a chronic stationary form of psoriasis.
The lesions may occur anywhere on the skin, but most often involve the elbows, knees, and scalp
The primary lesions are sharply demarcated, thick, red plaques with a silvery scale that vary in size and shape.

Question 17

Guttate Psoriasis

Answer 17

occurs in children and young adults and is characterized by teardrop-shaped, pink to salmon, scaly lesions. Its lesions are usually limited to the upper trunk and extremities.
This form of psoriasis usually is brought on by a streptococcal infection.
It generally responds to treatments such as UVB phototherapy, only to return with recurrent streptococcal infections

Question 18

Pustular Psoriasis

Answer 18

characterized by papules or plaques studded with pustules
Localized pustular psoriasis usually is limited to the palms of the hands and soles of the feet.
Generalized pustular psoriasis is characterized by more general involvement and may be associated with systemic symptoms such as fever, malaise, and diarrhea.
The person may or may not have had preexisting psoriasis.

Question 19

Erythrodermic Psoriasis

Answer 19

rare form of psoriasis affecting all body surfaces, including the hands, feet, nails, trunk, and extremities.
It is characterized by a process in which the lesions scale and become confluent, leaving much of the body surface bright red, with continuous skin shedding. Severe itching and pain often accompany it.

Question 20

Methotrexate

Answer 20

Treatment for psoriasis
which is used for cancer treatment, is an antimetabolite that inhibits DNA synthesis and prevents cell mitosis.

Question 21

Pityriasis Rosea

Answer 21

a rash that primarily affects children and young adults. The origin, unknown but is hypothesized to be triggered by a viral infection.
some support for human herpes virus 6 (HHV-6) or 7 (HHV-7).
The incidence is highest in spring and fall.
Cases occur in clusters and among people who live or work closely together, indicating an infectious spread. no data to support communicability.
It may be an immune response to any number of agents.
The characteristic lesion is an oval macule or papule with surrounding erythema. Solitary lesion is the herald patch.

Question 22

Scabies

Answer 22

A mite, Sarcoptes scabiei, which burrows into the epidermis. Lesion may BNP red or brown.
After a female mite is impregnated, she burrows into the skin and lays two to three eggs each day for 4 or 5 weeks.
The eggs hatch after 3 to 4 days, and the larvae migrate to the skin surface.
At this point, they burrow into the skin only for food or protection.
Transmitted person to person.
Areas: between fingers, surface of wrist, inner elbow, axilla, nipple, penis, belt line and gluteal crease
Pruritus is common

Question 23

Pediculosis (Lice)

Answer 23

Lice are gray, gray-brown, or red-brown, oval, wingless insects that live off the blood of humans and animals. Lice are host specific; lice that live on animals do not transfer to humans and vice versa.
Lice also are host dependent; they cannot live apart from the host beyond a few hours

Question 24

Classification of Burns

Answer 24

classified according to the depth of involvement as first-, second-, and third-degree burns. The depth of a burn is largely influenced by the duration of exposure to the heat source and the temperature of the heating agent.

Question 25

First Degree

Answer 25

superficial partial-thickness burns) involve only the outer layers of the epidermis. They are red or pink, dry, and painful. There usually is no blister formation. (IE) mild sunburn . The skin maintains its ability to function as a water vapor and bacterial barrier and heals in 3 to 10 days. require only palliative treatment, such as pain relief measures and adequate fluid intake.

Question 26

Second Degree Burns: Partial Thickness

Answer 26

involve both the epidermis and dermis. partial-thickness burns involve the epidermis and various degrees of the dermis. They are painful, moist, red, and blistered. Underneath the blisters is weeping, bright pink or red skin that is sensitive to temperature changes, air exposure, and touch. The blisters prevent the loss of body water and superficial dermal cells. Excluding excision of large burn areas, it is important to maintain intact blisters after injury because they serve as a good bandage and may promote wound healing. These burns heal in approximately 1 to 2 weeks.

Question 27

Second Degree Burns: Full Thickness

Answer 27

involve the entire epidermis and dermis. Structures that originate in the subcutaneous layer, such as hair follicles and sweat glands, remain intact. These burns can be very painful because the pain sensors remain intact. Tactile sensation may be absent or greatly diminished in the areas of deepest destruction. These burns appear as mottled pink, red, or waxy white areas with blisters and edema. resemble flat, dry tissue paper,

Question 28

Third Degree Burns

Answer 28

full-thickness burns extend into the subcutaneous tissue and may involve muscle and bone. Thrombosed vessels can be seen under the burned skin, indicating that the underlying vasculature is involved. Vary in color from waxy white or yellow to tan, brown, deep red, or black. Are hard, dry, and leathery. Edema is extensive in the burn area and surrounding tissues. There is no pain because the nerve sensors have been destroyed.

Question 29

Burns: Rule of 9

Answer 29

counts anatomic body parts as multiples of 9% the head is 9%, each arm 9%, each leg 18% anterior trunk 18%, posterior trunk 18% with the perineum 1%

Question 30

Pressure Ulcers

Answer 30

are ischemic lesions of the skin and underlying structures caused by unrelieved pressure that impairs the flow of blood and lymph. Often are referred to as decubitus ulcers or bedsores. Most likely to develop over a bony prominence, but they may occur on any part of the body that is subjected to external pressure, friction, or shearing forces.

Question 31

Ulcer: Staging

Answer 31

Stage I: characterized by a defined area of persistent redness in lightly pigmented skin or an area of persistent redness with blue or purple hues in darker skin. Stage II: partial-thickness loss of skin involving the epidermis or dermis or both. superficial and presents clinically as an abrasion, a blister, or a shallow crater. Stage III: full-thickness skin loss involving damage and necrosis of subcutaneous tissue that may extend down to but not through underlying fascia. Manifests as a deep crater with or without undermining of adjacent tissue. Stage IV: full-thickness skin loss and necrosis with extensive destruction or damage to the underlying subcutaneous tissues that may extend to involve

Question 32

Skin Cancers

Answer 32

The melanocytes, which protect against sunburn through increased production of melanin and sun tanning, are particularly vulnerable to the adverse effects of unprotected exposure to ultraviolet light

Question 33

Malignant Melanoma

Answer 33

which is a malignant tumor of melanocytes, is a rapidly progressive and metastatic form of skin cancer. Slightly raised black or brown. Borders are irregular and surface are uneven May be surrounding erythema, inflammation and tenderness.

Question 35

Basal Cell Carcinoma

Answer 35

Neoplasma of the noon keratinizing cells of the basal layers of the epidermis Most common skin cancer is light people

Question 36

Squamous Cell Carcinoma

Answer 36

Second most common malignant tumors of the outer epidermis Increaed risk for metastasis a red-scaling, keratotic, slightly elevated lesion with an irregular border, usually with a shallow chronic ulcer. The lesions usually lack the pearly rolled border and superficial telangiectases found on BCCs. Later, lesions grow outward, show large ulcerations, and have persistent crusts and raised, erythematous borders. Lesions occur on sun-exposed areas of the skin, particularly the nose, forehead, helix of the ear, lower lip, and back of the hand.

Question 37

Rubeola

Answer 37

measles, hard measles, and 7-day measles) is an acute, highly communicable viral disease caused by a morbillivirus. characteristic rash is macular and blotchy; sometimes the macules become confluent. rash usually begins on the face and spreads to the appendages. symptoms: a fever of 100°F or greater, Koplik spots (i.e., small, irregular red spots with a bluish-white speck in the center) on the buccal mucosa, and mild to severe photosensitivity Other: cold like symptoms, general malaise, and myalgia. In severe cases, the macules may hemorrhage into the skin tissue or onto the outer body surface