| A | B |
|---|
| epidermis | a thin sheet of squamous (flat) epithelial cells, several layers thick. |
| deepest | Epithelial cells are constantly renewed from the _ layer, growing steadily outward to replace worn-away cells. |
| keratinocytes | Most of the cells of the epidermis are _. |
| keratin | Keratinocytes contain this horny material. |
| toughness | Keratin provides mechanical _ to the outer skin surface. |
| melanin | A few cells in the epidermis are pigment cells that contain _. |
| color | Melanin imparts to the skin its characteristic _, varying according to race, familial characteristics, age, sun exposure, and other factors. |
| pigment | _ distribution is more intense in certain areas, such as around the nipples and in the anogenital region. |
| mucous membrane | At bodily orifices, the epidermis undergoes a transition to _. |
| dermis | A tough layer of connective tissue containing blood vessels, sensory nerves, hair follicles, and sebaceous and sweat glands |
| hair | Protect the body surface and also provides some thermal insulation |
| sebum | Another name for the oil produced by sebaceous glands |
| surface | Sebum is produced by sebaceous glands and discharged on the skin _ |
| protective, moisture-retaining | Sebum exerts _ and _ effects on the dermis. |
| regulation | Sweat, secreted by sweat glands, help in temperature _. |
| primary | Skin lesions resulting from skin disease |
| secondary | Skin lesions resulting from complications of the basic disease, including the effects of scratching and infection |
| bleb | Synonym of bulla |
| bulla | A blister; a thin-walled sac exceeding 1 cm in diameter and containing clear fluid |
| comedones | plural form of comedo |
| comedo | A papule consisting of a dilated sebaceous duct or gland plugged with keratin debris |
| cyst | An ABNL thick-walled structure containing fluid/semisolid material |
| ecchymosis | A broad zone of red/purple discoloration (more than 1 cm in diameter) due to hemorrhage under the epidermis. |
| macule | A clearly defined zone of skin, less than 1 cm in diameter, differing from surrounding skin in color but not in texture/elevation |
| nodule | A firm elevation of the skin surface more than 1 cm in diameter |
| papule | A clearly defined zone of skin, less than 1 cm in diameter, that is raised above surrounding skin, and may differ from it in color or texture |
| petechia | A pinhead-sized, round, red/purple macule due to extravasation of blood under the epidermis |
| plaque | A clearly defined zone of skin, more than 1 cm in diameter, that is raised above surrounding skin, and may differ from it in color/texture, may consist of many confluent papules |
| purpura | A purple zone of hemorrhage in the skin, larger than a petechia, but less than 1 cm in diameter, may be macular (flat) or papular (raised) |
| pustule | a thin-walled sac containing pus |
| telangiectasis | Dilation of 1/more small blood vessels visible thru the skin |
| vesicle | A small, thin-walled sac containing clear fluid |
| wheal | A hive; a small zone of edema in the skin, which may be red/white, are typically multiple & appear and disappear abruptly |
| weal | A synonym of wheal |
| welt | A synonym of wheal |
| cicatrix | A zone of fibrous tissue occurring at the site of a healed injury/inflammatory or destructive lesion extending into the dermis |
| scar | Synonym of cicatrix |
| crust | A hard, friable, irregular layer of dried blood, serum, pus, tissue debris,/any combination of these adherent to the surface of injured/inflamed skin |
| erosion | A surface defect in the epidermis produced by rubbing/scratching |
| eschar | The crust that forms on a burn |
| excoriation | Abrasion of the epidermal surface by scratching |
| fissure | A linear defect/crack in the continuity of the epidermis |
| keloid | A firm, nodular, irregular, often pigmented mass of fibrous tissue representing a hypertrophic scar |
| lichenification | Thickening, coarsening, & pigment change of skin due to chronic irritation, usually scratching |
| pit | A small depression in the skin resulting from local atrophy/scarring after trauma/inflammation |
| scab | synonym of crust |
| scale | A flake of epidermis shed from the skin surface |
| scar | Synonym of cicatrix |
| ulcer | A cutaneous defect extending into the dermis |
| diascopy | Inspection of red/purplish lesions thru a transparent plastic/glass plate, which compresses the skin |
| wood light | an ultraviolet lamp w/ a filter that selects wavelengths under which certain funguses infecting skin/hair fluoresce brightly |
| Tzanck smear | A stained smear of material from an ulcer/vesicle |
| eczema | Synonym of atopic dermatitis |
| atopic dermatitis | a chronic pruritic condition of the skin |
| seborrheic dermatitis | a scaly dermatitis of parts of the skin richly supplied w/ oil glands |
| contact dermatitis | dermatitis resulting from contact w/ an irritant or allergen |
| impetigo | a spreading bacterial infection of the skin causing itching and crusted sores |
| folliculitis | bacterial infection in hair follicles |
| pyoderma | a general term for any purulent (pus-forming) infection of the skin |
| abscess | a sharply localized bacterial infection, usually due to staphylococci, in which pus forms in a tissue space walled off from surrounding tissues by fibrin, coagulated tissue fluids, & eventually fibrous tissue |
| cellulitis | a type of infection occurring in soft tissues, including skin, whose cardinal features are diffuse & spreading tissue swelling, redness, pain, & fever |
| erysipelas | A severe form of cellulitis, w/ a sharply circumscribed border, bulla formation, & often septicemia |
| tinea corporis (tinea circinata, ringworm of the body) | superficial fungal infection of the skin |
| tinea capitis | ringworm of the scalp |
| kerion | a complication, w/ boggy edema & exudation of pus thru hair follicle openings |
| tinea pedis | athlete's foot |
| tinea cruris | jock itch |
| tinea versicolor | caused by Malassezia furfur, consists of variable numbers of white to tan macules w/ very fine scales |
| onychomycosis | Synonym of tinea ungium |
| tinea ungium | fungal infection of fingernails and tonails |
| candidiasis | infection of skin & mucous membranes w/ the yeastlike fungus Candida albicans |
| Herpes Simplex | local viral infection of skin/mucous membranes, causing vesicular lesions, typically recurrent |
| verrucae | synonym of warts |
| warts | virally induced coarse papules of the skin & mucous membranes |
| cause of warts | HPV |
| HPV stands for | human papillomavirus |
| __ types of HPV have been identified by immunologic means | 80 |
| Most types of warts preferentially affect particular areas. Examples are | plantar warts on soles of feet, genital warts on the external genitalia or uterine cervix |
| Transmission of warts is by | direct contact |
| Genital warts are transmitted | sexually |
| Scratching and picking at warts causes | autoinoculation |
| autoinoculation | implantation of infective viral material at new sites, w/ spread of lesions |
| Wart virus cannot be | cultured |
| Pap smear is _ an adequate screening test for HPV infection | not |
| Suspicious lesions treated with dilute _ acid become chalky grey or white if they are warts | acetic |
| acetowhitening | when warts become chalky grey or white when exposed to acetic acid |
| Cervical lesions that are suspicious for warts are | examined with a colposcope |
| colposcope | a low power microscope w/ light source, adapted for viewing the cervix thru a vaginal speculum |
| HPV infection is chronic and difficult to | eradicate |
| HPV infection may revolve _ after a time, but meanwhile other lesions may have developed, or the condition may have been _ to others. | spontaneously, transmitted |
| _ infection with certain types of _ is now recognized as a leading cause of _ carcinoma, and is probably also associated with genital cancers in men | genital, HPV, cervical |
| Choice of treatment of warts depends on the _ of infection. | site |
| Surgical excision, electrocautery, laser ablation, and _ are currently the most popular methods for treating warts | cryotherapy |
| Other treatments for warts include | Other treatments for warts include |
| scabies | A chronic, pruritic eruption due to borrowing of mites in the skin |
| The cause of scabies is the itch mite, _, a microscopic parasite that burrows under the skin surface and lays eggs | Sarcoptes scabiei |
| Transmission of scabies is from person to person by _ contact, probably also by _ contact such as sharing of toilets. | direct, indirect |
| In scabies, itching is due not to the mere presence of mites but | to a sensitivity reaction to foreign mite protein |
| In scabies, symptoms may not appear for _ after infection | about a month |
| History of scabies: chronic _, more intense at night, associated with formation of reddish papules and linear raised lesions | itching |
| The itching of scabies is more intense at | night |
| The itching of scabies is associated with formation of reddish _ and linear _ lesions. | papules, raised |
| The papules and burrows of scabies is found most often on the finger webs, wrists, elbows, nipples, _, and genitalia. | buttocks |
| The papules and burrows of scabies are never found on the | face or scalp |
| In scabies, there may be evidence of _, _, or _. | excoriation, lichenification, secondary infection |
| An older name for scabies is | "seven year itch" |
| In scabies, secondary infection may cause _ in debilitated persons, especially children | extensive weeping and crusting |
| In scabies, topical treatment with _ is generally curative. | permethrin, lindane, or crotamiton |
| In scabies, itching may be treated with oral or topical | antipruritics |
| phthiriasis | a synonym of pediculosis |
| pediculosis | human cutaneous infestation w/ lice |
| Pediculosis corporis | the body louse |
| Pediculosis capitis | the head louse |
| Pediculosis pubis | the pubic louse |
| visible | Lice are _ to the naked eye |
| surface | Lice live and breathe on the body _ |
| blood | Lice derive nourishment from the host's _ |
| skin | Lice obtain the host's blood by piercing the _ |
| hairs | Lice remain in position by grasping body or scalp _ |
| nits | _: lice eggs |
| attach | Lice _ their nits to hairs |
| weeks | Lice eggs hatch in about two _ and females become sexually mature in another two _ |
| month | A single pregnant female louse can grow to a substantial colony in about a _ |
| person to person | Lice transmission is from _ |
| sexually | Pubic louse infestation is a _ transmitted disease |
| indirect | _ transmission can occur in lice infestation |
| feces | In pubic lice infestation, the minute dark spots that may be noted on underwear are deposits of louse _ |
| blue | In lice infestation, fine _ patches may be noted on skin in sites where lice have fed |
| orifices | Lice do not burrow under the skin or penetrate body _ |
| transmit | the Pthirus lose does not _ disease |
| typhus, plague | the Pediculus louse is a vector of _ and _ in parts of the world where these diseases are endemic |
| pyrethrin, lindane | Treatment of lice is with topical _ or _, left on the skin long enough to kill both adult lice and eggs |
| curative | Treatment of lice infestation withpyrethrin or lindane is _ |
| acne vulgaris | a chronic eruption of comedones, papules, pustules, and cysts occurring primarily in adolescence |
| unknown | The ultimate cause of acne vulgaris is _ |
| genetic | In acne vulgaris, there may be a _ predisposition |
| males | acne vulgaris tends to be worse in _ |
| castrated males | acne vulgaris does not occur in _ |
| acne, acneform | _ or _ lesions develop in Cushing syndrome |
| chloracne | _ is acne vulgaris due to industrial exposure to chlorine |
| iodide, iodism | medicinal administration of _ can bring the comedones of _ |
| emotional stress | Acne typically worsens during times of _ |
| sebaceous | Acne lesions develop in oil (_) glands. |
| sebum | Acne develops apparently as a result of heightened _ production that leads to retention of _ and plugging of gland ducts |
| comedones | The plugged, enlarged glands of acne are called _ |
| chemical | In acne, sebum plugs darken as a result of _ changes |
| cysts | very large comedones form _ |
| fatty acids | retained sebum is broken down by bacteria or spontaneous chemical changes to form _,which cause local inflammation&induce a foreign body reaction |
| aggravated | symptoms of acne vulgaris are _ by application of greasy or oily cosmetics&by repetitive picking&squeezing of lesions |
| protracted | healing of acne vulgaris pustules may be _,& may leave pits/scars |
| blackheads, whiteheads, papules, pustules, cysts | appearance of lesions of acne vulgaris vary in type (_), number of distribution,& severity |
| face, upper back,& chest, rarely elsewhere | acne vulgaris usually appears in these places |
| isotretinoin | In acne vulgaris, _ taken by mouth for 4-6 months induces lengthy, usually permanent resolution of acne |
| severe | isotretinoin is reserved for _ cases because of side effects |
| rosacea (acne rosacea) | a reddish facial eruption occurring in the middle-aged and elderly |
| unknown | the cause of rosacea is _ |
| migraine headaches | rosacea occurs more commonly in persons w/ _ |
| antibiotic treatment | rosacea responds to _ |
| topical adrenocorticosteroids | prolonged application of potent _ to the face can induce a reaction similar to rosacea |
| burning&flushing of the face, w/ patches or diffuse rosy tint, papules, and sometimes pustules or excessive sebum production | history of rosacea |
| papules,pustules,telangiectases,oiliness | In rosacea _ are usually present to some degree |
| telangiectases | visible patches of dilated skin vessels |
| cornea | inflammation of the eyelids & even the _ may occur in rosacea |
| hyperplasia | in some patients with rosacea, marked _ of the tissues of the nose eventually develops |
| rhinophyma | marked hyperplasia of the nose |
| chronic | rosacea is highly _, but treatment provides a fair degree of control |
| metronidazole | topical _ or other antibiotics provide improvement of symptoms in rosacea |
| antibiotics, corticosteroids | oral _ and topical _ may be required in rosacea |
| obliterate | lasers can _ telangiectases in rosacea |
| required | For severe rhinophyma in rosacea, plastic surgery is _ |
| hives | an acute, often transitory eruption of intensely itchy papules/wheals |
| urticaria | synonym of hives |
| histamine | urticaria is caused by a release of _ from mast cells in the dermis |
| local edema, capillary dilatation, and stimulation of nerve endings | when histamine is released from mast cells in urticaria, the results is _ |
| factors | several _ can induce urticaria |
| cholinergic urticaria | when urticaria occurs due to heat, it's called |
| dermographism | when urticaria occurs due to simple stroking of the skin, it's called |
| sudden onset of localized/generalized eruption of intensely itchy wheals/papules, which may be transitory | history of urticaria |
| physical examination of urticaria | wheals (raised white or red papules) surrounded by erythema |
| wheals may be _ or _ and _ | round, scalloped, confluent |
| scratching | signs of _ may be present in urticaria |
| cause | blood studies and allergic screening may indicate the underlying _, but usually do not |
| one or two weeks | urticaria often occurs in attacks at intervals of a few hours, but typically resolves within _ unless continued exposure to the causitive agent occurs |
| occult infection or malignancy | urticaria persisting beyond 1 month may point to _ |
| epinephrine | severe urticaria responds to intramuscular _ |
| antihistamines such as diphenhydramine or hydroxyzine | _ may be given orally or by injection to control an acute attack of urticaria |
| the nonsedating antihistamines terfenadine and astemizole | _ may be useful prophylactically in urticaria even though they are ineffective in other forms of pruritus |
| doxepin, a tricyclic antidepressant | _ is effective in urticaria either orally or topically |
| topical and systemic corticosteroids | in severe cases of urticaria, _ may be used |
| vitiligo | patches of depigmentation widely distributed over the skin |
| vitiligo is due to | destruction of pigment cells |
| 1% | vitiligo is found in about _ of the population |
| diabetes mellitus, hyperthyroidism, hypothyroidism, hypoadrenocorticism (Addison disease),& gastric carcinoma | vitiligo occurs w/ increased frequency in person w/ _ |
| PUVA treatment, using topical methoxsalen and ultraviolet light | _ may provide some improvement of vitiligo |
| psoralen + ultraviolet A | PUVA stands for |
| cosmetics | the best method of management of vitiligo is often judicioius usse of _ |
| psoriasis | a chronic skin disorder characterized by scaly plaques |
| increased proliferation of epidermal cells | cause of psoriasis |
| evidently an autoimmune disorder | psoriasis is _, to which some persons are genetically predisposed |
| history of psoriasis | plaques of scaly thickening of the skin, particularly the scalp, knees, and elbows,w/ moderate itching. Nails and joints may be affected |
| reddish-purple thickened plaques of skin covered w/ silvery, firmly adherent scales | in psoriasis, _ is part of the physical examination |
| pitting/strippling, inflammation | _ of nails and _ of joints, particularly the distal interphalangeal joints, may be noted in psoriasis |
| guttate psoriasis | in _ the plaques are small and numerous |
| Koebner phenomenon | _: (formation of lesions at sites of trauma) may be noted in guttate psoriasis |
| in psoriasis, skin biopsy (_) shows characteristic changes in the epidermis | usually unnecessary |
| treatment of psoriasis | topical steroids, calcipotriene, tar ointments; tar shampoos of the scalp. UVB; PUVA. Oral methotrexate, etretinate, cyclosporine |
| ultraviolet B | UVB stands for |
| pityriasis rosea | a mild,benign,self-limited scaly eruption |
| viral | the cause of pityriasis rosea is possibly _ |
| spring and fall | pityriasis rosea is more common in |
| 2:3 | the male:female attack rate of pityriasis rosea is |
| demonstrated | in pityriasis rosea,person-to-person transmission has not been _ |
| history of pityriasis | appearance of a solitary scaly patch on the skin,followed in 1-2 weeks by a generalized eruption of similar but smaller lesions |
| mild or absent | in pityriasis, itching is _ |
| physical examination of pityriasis rosea | a widespread eruption of oval fawn-colored macules w/ fine scales on the trunk&proximal extremities |
| spared | In pityriasis rosea, the hands, face, and feet are typically _ |
| trunk, segmental, Christmas treetree | In pityriasis rosea, _ lesions follow a _ distribution, especially on the back, giving a "_" appearance |
| secondary syphilis,serologic, syphilis | because pityriasis simulates _, a _ test for _ is often done to rule out that possibility |
| 6 weeks | in pityriasis rosea, lesions disappear spontaneously in about _ |
| ultraviolet treatments and topical or oral steroids | _ may abolish Sx's, but treatment is seldom needed since itching is mild |
| basal cell carcinoma, sunlight, face | a slowly growing, waxy or pearly papules w/ telangiectatic vessels, appearing on parts of the body exposed to _, particularly the _ |
| middle-aged, elderly | basal cell carcinoma mostly appears in the _ or _ |
| ulceration & widespread erosion | in basal cell carcinoma, _ may occur if treatment is delayed |
| metastasis, rare | in basal cell carcinoma, _ is _ |
| surgical excision, chemosurgery, cryotherapy | treatment of basal cell carcinoma is by _, including Mohs _ & _ |
| squamous cell carcinoma | a hard red nodule appearing on sun-exposed skin, usually in a middle-aged or elderly peson |
| actinic keratosis | in squamous cell carcinoma, the lesion may develop in a pre-existing _ & may rapidly ulcerate |
| uncommon | in squamous cell carcinoma, metastasis is _ |
| excision | treatment of squamous cell carcinoma is by _ |
| malignant melanoma | a pigmented malignancy of the skin that develops in persons of all ages,progresses rapidly,metastasizes widely,&is fatal w/o treatment |
| ninth | among malignancies,melanoma ranks _ in incidence,& incidence is increasing |
| sun exposure | at least some cases of melanoma are due to |
| benign | melanoma can develop anew or in a previously _ nevus |
| nevus | pigmented spot |
| irregularity of shape/border, uneven distribution of pigment,pink,blue,/black color,bleeding/ulceration,& rapid enlargement | features of a pigmented lesion that suggest melanoma are |
| treatment | _ of melanoma is by excision |
| thickness of the tumor, depth of invasion | in melanoma, prognosis depends on the _ or the _ |
| Breslow classification | in melanoma, the thickness of the tumor |
| Clark classification | in melanoma, the depth of invasion |
| radiation & chemotherapy | in metastatic melanoma, _ may prolong survival |
| not living tissue | the visible part of the scalp & body hair is _, but hair follicles are subject to a number of disorders |
| alopecia | medical term for baldness |
| baldness | hair loss leading to temporary/permanent,patchy/diffuse zones of _ can result from scarring after trauma or after severe bacterial/fungal infection |
| systemic lupus erythematosus, iron deficiency, pituitary deficiency | baldness can be a symptom of these systemic diseases |
| brow & vertex | male pattern baldness affects the _ |
| genetically | male pattern baldness is _ determined |
| elevated blood levels of androgens from any cause | male pattern baldness may affect genetically predisposed women with _ |
| minoxidil | baldness often responds to topical _ in persons of both sexes |
| cycles | each hair follicle normally passes thru _ b/n anagen & telogen |
| telogen effluvium | a transitory generalized thinning of scalp hair due to a systemic condition that puts the growth of a large number of hairs into the telogen phase at the same time,w/resultant shedding of hair |
| pregnancy,oral contraceptives,excessive dieting,high fever,& any severe physical/emotional stress | causes of baldness include |
| 2 to 4 months | hair thinning becomes noticeable after a latent period of _,& typically resolves spontaneously w/in a few months |
| hirsutism | excessive/cosmetically objectionable hairiness |
