Derm 1- Skin exam and morphology

Question 1

What are the 6 indications for a full body skin exam?

Answer 1

1. PMHx of skin cancer
2. Increased risk for melanoma (2 first degree relatives with melanoma, 100+ nevi)
3. Pt with concerning or changing growth
4. New rash on body
5. New pt with undiagnosed skin condition
6. Follow up pts with extensive skin conditions (ex: psoriasis)

Question 2

What are the ABCDEs of melanoma?

Answer 2

Asymmetry

Border Irregularity

Color variation

Diameter >6mm

Evolution

Question 3

What is the MC melanoma site for men? for women?

Answer 3

Men= Back

Women= Legs and then back

Question 4

Which of the following is an indication for a total body skin exam?

A. new pt w/ acne on forehead

B. New pt w/ sister who has melanoma

C. New pt w/ a mold on his chin that he has had since childhood w/o change

D. New pt. w/ a paternal aunt w/ history of melanoma

E. New pt w/ a wart on her right index finger

Answer 4

B. New pt w/ sister who has melanoma

Question 5

What is a macule and a patch and how are they different?

Answer 5

They are both flat (nonpalpable) and have color change only

Macules: <1cm

Patch: >1cm

(“Pat doesn’t have a flat stomach b/c he eats too much Mac and cheese”)

Question 6

What is a papule and a plaque and how are they different?

Answer 6

• Both are solid, raised lesions
• Papule- <5mm
• Plaque- Raised, flat topped lesion >10mm

Question 7

What is the difference b/w a vesicle and a bullae?

Answer 7

both are serous fluid filled space in epidermis

vesicle is small, bulla is >1cm

“blister”

Question 8

What is a wheal?

Answer 8

• an edematous papule
• typicall transient
• circumscribed
• erythematous borders w/ pale centers

Question 9

WHat is the difference b/w a nodule and a tumor? (hint: size)

Answer 9

both are raised lesions deeper in the skin

nodule is >1cm

tumor is >2cm

(“1 nod 2 the tumor”)

Question 10

What is an erosion and an ulcer? what is the difference between the two?

Answer 10

• Erosions and ulcercarions are secondary lesions described as a breakdown or loss of the superficial epidermis or dermis
• Erosion= no scar, not deep
• Ulcer= scar, shallow or deep

Question 11

What is a “scale”?

Answer 11

Flakes of “dead skin”/fragments of stratum corneum

Question 12

What is petechiae/purpura/ecchymoses?

Answer 12

Nonblanchable, bleeding into the skin that is either pinpoint, centimeter sized or larger than 1cm

Question 13

What are nummular/discoid/round lesions?

Answer 13

all coin shaped lesions

Question 14

What is an annular lesion?

Answer 14

ring shaped lesion

Question 15

What is an arcuate lesion?

Answer 15

shaped like an arc

Question 16

What is a figurate/polycyclic lesion?

Answer 16

• lots of different ring shapes
• rings within rings

Question 17

What is a retiform/reticulate lesion?

Answer 17

Web or net like, following vascularture

Question 18

What is a “mammillated” lesion?

Answer 18

‘nipple like’

bumpy, like a cobblestone road