patch
primary skin lesion
port wine stain, vitiligo, mongolian spots, cafe au lait spots; flat nonpalpable irregular shape greater than 1cm
nodule
primary skin lesion
erythema nodosum, lipoma; elevated firm, circumscribed lesion; deeper in dermis than a papule 1-2cm in diameter
wheal
primary skin lesion
insect bites, urticaria, allergic reaction; elevated irregular-shaped area of cutaneous edema solid transient, varible diameter
macule
primary skin lesion
freckles, measles, flat moles, petechiae; flat nonpalpable circumscribed lesion less than 1cm in diameter
plaque
primary skin lesion
psoriasis, seborrheic and acitinic keratoses; elevated firm and rough lesion with flat top surface greater than 1cm in diameter
papule
primary skin lesion
wart, elevated moles, lichen planus; an elevated circumscribed area less than 1cm in diameter
vesicle
primary skin lesion
varicella, herpes zoster; elevated, circumscribed superficial, not into dermis, fluid filled less than 1 cm in diameter
tumor
primary skin lesion
neoplasms, bening tumor, lipoma; elevated and solid lesion, may and may not be clearly demarcated, deeper in dermis, greater than 2cm in diamter
bulla
primary skin lesion
blister, pemphigus vulgaris; vesicle greater than 1cm in diameter
pustule
primary skin lesion
imetigo, acne; elevated superficial lesion similar to a vesicle but filled with purulent fluid
Cyst
primary skin lesion
sebaceous cyst, cystic acne; elevated circumscribed encapsulated lesion in dermis or subcutaneous layer filled with liquid or semisolid material
telangiectasia
primary skin lesion
telangienctasia in rosacea, fine, irregular lines produced by capillary dilation
scale
Secondary skin lesion
flaking skin with seborrheic dermatitis or following a drug reaction, dry skin
lichenification
Secondary skin lesion
chronic dermatitis, rough, thickened epidermis secondary to persistent rubbing, itching, or skin irritation, often involves flexor surface of extremity
keloid
Secondary skin lesion
keloid formation following surgery, irregularly shaped progressively enlarging beyond scar, grows beyond the boundaries of the wound, caused by excessive collagen formation during healing
scar
Secondary skin lesion
healed wound or surgical incision; thin to thick fibrous tissue that replaces normal skin following injury or laceration to the dermis
excoriation
Secondary skin lesion
abraision or scratch, scabies; loss of epidermis, linear hollowed out crusted area
fissure
Secondary skin lesion
athlete's foot, cracks at the corner of the mouth; liner crack or break form the epidermis to the dermis, may be moist or dry
erosion
Secondary skin lesion
varicella, variola after rupture; loss of the epidermis, depressed, moist, glistening, follows rupture of a vesicle or bulla
ulcer
Secondary skin lesion
decubti, stasis ulcers; loss of epidermis and dermis, concave, varies in size
crust
Secondary skin lesion
Scab on abrasion, eczema; dried serum, blood, or purlent exudates; slightly elevated, size varies, brown, red, black, tan or straw-colored
atrophy
Secondary skin lesion
striae, aged skin; thinning of skin surface and loss of skin markings, skin translucent and paper-like
milia
An irregular, red, macular rash caused by occlusion of sweat ducts during periods of heat and high himidity.
herpes zoster
An infection caused by the varicella-zoster virus, usually affecting a single dermatome. It causes red swollen plaques or vesicles that become filled with purulent fluid. Pain, itching, or burning of the dermatome usually precedes eruption.
cherry angioma
Tiny, bright ruby red, round papules that may become brown with time. They occur commonly in individuals over the age of 30 and increase numerically with age.
Sebaceous hyperplasia
These are normal findings in the healthy older adult. The tissue appears as yellowish, flattened papules with central depressions.
Tinea corpis
A noncandidal, fungal infection that occurs on a nonhairy part of the body. The lesions may vary in appearance and may be papular, pustular, vesicular, erythematous, or scaling.
herpes simplex
A viral infection that produces tenderness, pain, paresthesia, or mild burning at the infected site before onset of the lesion. Type 1 is usually associated with oral infection.
herpes simplex
A viral infection that produces tenderness, pain, paresthesia, or mild burning at the infected site before onset of the lesion. Type 2 is usually associated with genital infection.
herpes simplex
A viral infection that produces tenderness, pain, paresthesia, or mild burning at the infected site before onset of the lesion. Type 2 is usually associated with genital infection.
basal cell carcinoma
The most common malignant cutaneous neoplasm. Commonly found on the face. Risk factors are fair skin and sun exposure.
squamous cell carcinoma
A malignant tumor arising in the epithelium. It occurs most commonly in sun-exposed areas, lower lip, and ear. The lesions are soft, mobile, elevated masses wth a surface scale.
melanoma
A skin cancer that develops from melanocytes. The lesion should be suspected if there is a history of changes in a preexisting nevus or a new pigmented blue/black lesion that has an irregular border, bleeding, or crusting and is > 6 cm.
kaposi sarcoma
A malignant tumor of the endothelium and epithelial layer of the skin. The lesions are soft, vascular, bluish purple, and painless. It is a common opportunistic infection of individuals who are HIV+.
Tinea ungunium
Fungal infection of the nail. The fungus grows in the nail plate, causing it to crumble.
strawberry hemangioma
These irregular reddened areas may occur on the nape of the neck, eyelids, forehead, and upper lip. They suggest a rich capillary bed. Many times they disappear by the time the child reaches 1 year of age.
acitinic keratosis
These slightly raised erythematous lesions are commonly seen on the dorsal surface of the hands, neck, and face. Solar keratosis occurs secondary to chronic sun damage and has a malignant potential.
Actinic keratosis, a red, scaly plaque occurring in sun-
Intertriginous surfaces
Intertriginous surfaces are areas where skin surfaces meet, such as the groin and under pendulous breasts
injuries consistent with abuse
-Human bite marks
-Injuries covered by clothing
-Bruising with fingertip grab marks
- Burns consistent with immersion of buttocks
*Bruises that occur with accident falls are more commonly found over bony prominences. Accidental burns are likely to have a
Faun tail nevus
tuft of hair over the spinal column at birth
-can be associated with spina bifida
epidermal verrucous nevi
warty lesions in a linear or whorled pattern that may be pigmented or skin colored- present at birth and early childhood
-associated with skeletal central nervous system and ocular abnormalities
cafe au lait macules
present at birth or shortly thereafter
-can be associated with neurofibromatosis or things like pulmonary stenosis, temporal lobe dysrhythmia and tuberous sclerosis
freckling in the axiallary or inguinal area also associated with this
Ash leaf macule
White macules present at birth associated with tuberous slcerosis...on the trunk mainly but can be on the face and limbs
Facial port wine stain
When it involves the opthalmic division of the trigeminal nerve, may be associated with ocular defects like glaucoma
-may be accompanied by angiomatous formation of the meninges(Sturge-Kalishcer-Weber syndrome) that results in calcification of the adjacen
Hair collar sign
ring of long dark, coarse hair surrounding the midline scalp nodule in infants is usually an isolated cutaneous anomaly that may indicate neural tube closure defects of the scalp
supernumerary nipples
congenital accessory nipples with or without glandular tissue located along the mammary ridge.
-may be associated with renal abnormalities especially in the presence of other minor anomalies particularly in whites
congenital lymphedema with or without transient hemagniomas
may be associted with gonadal dysgenesis caused by absence of an X chromosome, producing an XO karotype (Turner syndrome0
unexpected palmar crease
down's syndrome
lentigo
brown macule that appears in sun exposed areas
senile lentigo= liver spots
furnucle
boil- deap seated infection of the pilosebaceous unit- staph aureus is the most common cause..initially it is a small abcess that spreads to surrounding tissue
cellulitis
Streptococcus pyogenes or Staph aureus...diffuse acute infection of skin and surroudning tissue
folliculitis
inflammation and infection of the hair follicle and surrounding dermis
eczematous dermatitis
most common inflammatory skin disorder, several forms including irritant contact dermatitis, allergic contact dermatitis and atopic dermatitis
pitryiasis rosea
self-limiting inflammation of unknown cause
rosacea
chronic inflammatory skin disorder
Acanthosis Nigricans
nonspecific reaction pattern with obesity, certain endocrine systems or malignancies or as an inherited disorder
cutaneous anthrax
caused by spore forming bacterium up to 12 days after deposition of organism into skin
small pox
Variola virus- direct transmission via infected saliva droplets- most infectious during first week of illness
Basal cell carcinoma
most common form of skin cancer. may have itching, crusting and may not heal- face, ears, neck, scalp, shoulders
squamous cell carcinoma
second most common form of skin cancer. persistent nonhealing sore-may have crusting or bleeding- most common on scalp, back of hands, lower lip, ear and rim of ear
Onychomycosis
fungal infection of the nail- nail bed starts to crumble because fungus grows into nail bed
Onycholysis
loosening of the nail plate with separation from the nail bed that begins at the distal groove- can come from psoriasis, medications, allergic contact dermatitis, hyperthyroidism, candida or pseydomonas infection
Koilonychia
spoon nails from deficiency anemia, syphilis, fungal dermatoses and hypothyroidism
Beau lines
coronary occlusion, hypercalcemia, skin disease
Terry nails
cirrhosis, chronic CHF, adult onset DM, age
psoriasis
chronic and recurrent disease of kerating synthesis
digital mucous cysts
measles
trichotillomania
physical manipulation of hair causes loss