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cicular, begins in center and spreads to periphery (e.g., tinea corporis or ringworm, tinea versicolor, pityriasis rosea |
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lesions run together(urticaria [hives]) |
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distinct, individual lesions that remain separate (e.g. acrochordon or skin tags, acne) |
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twisted, coiled spiral, snakelike |
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clusters of lesions (e.g., vesicles of contact dermatitis) |
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a scratch, streak, line, or stripe |
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resembles iris of eye, concentric rings of color in the lesions (e.g., erythema multiforme) |
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Linear arrangement along a unilateral nercve route (herpes zoster) |
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Annular lesions grow together |
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Solely a color change, flat and circumscribed, of less than 1 cm. Examples: freckles, flat nevi, hypopigmentation,petechiae, measles, scarlet fever |
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Something you can feel (i.e, solid, elevated, circumscribed, less than 1 cm diameter) caused by superficial thickening in the epidermis. Examples: elevated nevus(mole), lichen planus, molluscum, wart (verruca). |
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Macules that are larger than 1 cm. Examples: monogolian spot, vitiligo, cafe au lait spot, chloasma, measles rash. |
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Papules coalesce to form surface elevation wider than 1 cm. A plateau-like, disk-shaped lesion. Examples: Psoriasis, lichen planus |
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Solid, elevated, hard or soft, larger than 1 cm. May extend deeper into dermis than papule. Examples:xanthoma, fibroma, intradermal nevi |
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Superficial, raised, transient, and erythematous; slightly irregular shape due to edema (fluid held diffusely in the tissues). Examples: mosquito bite, allergic reaction, dermographism. |
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Larger than a few centimeters in diametr, firm or soft, deeper into dermis; may be benign or malignant, although "tumor" implies "cancer" to most people. Examples: lipoma, hemangioma |
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Hives: Wheals coalesce to form extensive reaction, intensely pruritic. |
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Elevated cavity containing free fluid, up to 1 cm; a "blister" Clear serum flows if wall is ruptured. Examples: herpes simplex, early varicella, herpes zoster, contact dermatitis |
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Larger than 1 cm diameter; usually single chambered (unilocular); superficial in epidermis; it is thin walled, so it ruptures easily. Examples: friction blister, pemphigus, burns, contact dermatitis |
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Encapsulated fluid-filled cavity in dermis or subcutaneous layer, tensely elevating skin. Examples: sebaceous cyst, wen. |
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Turibd fluid (pus) in the cavity. Circumscribed and elevated. Examples: impetigo, acne |
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the thickened, dried-out exudate left when vesicles/pustules durst or dry up. Color can be red-brown, honey, or yellow, depending on the fluid's ingredients (blood, serum, pus). Examples: impetigo (dry, honey-colored), weeping eczematous dermatitis, scab after abrasion |
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Compact, desiccated flakes of skin, dry or greasy, silver or white, from shedding of dead excess keratin cells. Examples: after scarlet fever or drug reaction (laminated sheets), psoriasis (silver, mica-like), seborrheic dermatitis (yellow, greasy), eczema, ichthyosis (large, adherent, laminated), dry skin |
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Linear crack with abrupt edges, extends into dermis, dry or moist. Examples: cheilosis-at corners of mouth due to excess moisture; athlete's foot |
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Scooped out but shallow depression. Superficial; epidermis lost; moist but no bleeding; heals without scar because erosion does not extend into dermis |
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Deeper depression extending into dermis, irregular shape; may bleed; leaves scar when heals. Examples: stasis ulcer, pressure sore, chancre. |
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Self-inflicted abrasion; superficial; sometimes crusted; scratches from intense itching. Examples: insect bites, scabies, dermatitis, varicella |
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After a skin lesion is repaired, normal tissue is lost and replaced with connective tissue (collagen). This isa permanent fibrotic change. Exmaples: healed are of surgery or injury, acne. |
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The resulting skin level is depressed with loss of tissue; a thinning of the epidermis. Example: straie. |
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Prolonged, intense scratching eventually thickens the skin and produce3s tightly packed sets of papules; loos like surface of moss (or lichen) |
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A hypertrophic scar. The resulting skin level is elevated by excess scar tissue, which is invasive beyond the site of original injury. May increase long after healing occurs. Looks smooth, rubbery, adn "clawlike" and has a higher incidence among blacks. |
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Port-Wine Stain (Nevus Flammeus) |
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A large, flat, macular patch covering the scalp or face, frequently along the distribution of cranial nerve V. The color is dark red, bluish, or purplish and intensifies with crying, exertion, or exposure to heat or cold. The marking consists of mature capilaries. It is present at birth aqnd usually does not fade. The use of yellow light lasers now makes phtoablation of the lesion possible, with minimal adverse effects. |
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Caused by vascular dilation; permanently enlarged and dilated blood vessels that are visible on the skin surface. |
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A fiery red, star-shapped marking with a solid circular center. Capillary radiations extend from the central arterial body. With pressure, not a sentral pulsating body and blanching of extended legs. Develops on face, neck, or chest; may be associated with pregnany, chronic liver disease, or estrogen therapy, or may be normal |
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A blue-purple dilation of venules adn apillaries in a star-shaped, linear, or flaring pattern. Pressure causes them to empty or disappear. located ont eh legs near varicose veins and also on the face, lips, ears, and chest. |
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Tiny punctate hemorrhages, 1 to 3 mm, round and discrete, dark red, purple or brown in color. |
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A purplish patch resulting from extravasation of blood into the skin, >3mm in diameter |
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Confluent and extensive patch of petechiae and exxhymoses, >3mm flat, red to purple, macular hemorrhage. Seen in generalized disorders such a sthrombocytopenis and scurvy. Also occurs in old age as blood leaks from capillaries in response to minor truama and diffuses through dermis. |
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Primary Contact Dermatitis |
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Local inflammatory reaction to an irritant in the environment or an allergy. Characteristic location of lesions ofter gives clue. Often erythema shows frist, followed by swelling, wheals( or urticaria), or maculopapular vesicles, scales. Frequently accompanied by intense pruritus. |
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Erythematous and symmetric rash, usually generalized. Some drugs produce urticarial rash or vesicles and bullae. History of drug ingestion. |
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Tinea Corporis (Ringworm of the body) |
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Scales-hyperpigmented in whites, depigmented in dark-skinned people-on chest, abdomen, back of arms forming multiple circular lesions with clear centers. |
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Tinea Pedis (ringworm of the foot) |
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"Athletes foot", a fungal infection, first appears as small vesicles between toes, sides of feet, and soles and then grows scaly and hard. Foudn in chronically warm, mosit feet |
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Labial Herpes Simples (cold sores) |
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Herpes simplex virus (HSV) infection has a prodrome of skin tingling and sensitivity. Lesion then erupts with tight vesicles followed by pustules and then rpoduces acute gingivostomatitis with many shallow, painful ulcers. common location is upper lip, also in oral mucosa and tongue. |
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Fine, scaling, round patches of pink, tan, or white that do not tan in sunlight, caused by a superficial fungal infection. Usual distribution is on neck, trunk, and upper arms- a short-sleeved turtleneck sweater area. Most common in otherwise healthy young adults. Responds to oral anti fungal medication. |
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Erythema Migrans of Lyme disease |
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Lyme disease is not fatal but may have serious arthritic, cardiac, or neurologic sequel. It is caused by a spirochete bacterium carried by the black or dark brown deer tick. Deep ticks are common in the Northeast, upper Midwest, and California (with cases occurring in people who spend time outdoors) in May through September. The first stage (early localized LD) has the distinctive bull's eye, red macular or papular rash in 50% of cases. The rash radiates from the site of the tick bite, with some central clearing and is usually located in the axillae, midriff, inguina, or behind knees with regional lymphadenopathy |
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Scaly, erythematous patch, with silvery scales on top. Usually on scalp, outside of elbows and knees, low back, and anogenital areas. |
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Usually starts as a skin-colored papule (may be deeply pigmented) with a pearly translucent top and overlying telangioectasia (broken blood vessel). Then develops rounded, pearly borders with central red ulcer, or looks like large open pore with central yellowing. Most common form of skin cancer; slow but inexorable growth. Basal cell cancers occur on unexposed areas |
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Squamous cell cancers arise from actinic keratoses or de novo. Erythematous scaly patch with sharp margins, 1 cm or more. Develops central ulcer and surrounding erythema. Usually on hands or head, areas exposed to UV radiation; above, on habitually sun-exposed bald scalp. Less common than basal cell carcinoma but grows rapidly. |
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Half of these lessons arise from preexisting nevi. Usually brown; can be tan, black, pink-red, purple, or mixed pigmentation. Often irregular or notched borders. May have scaling, flaking, oozing texture. Common locations are on the trunk and back in men an women, on the legs in women, and on the palms, soles of feet, and nails in Blacks. |
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Kaposi Sarcome: Patch Stage |
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Kaposi carcome is a vascular tumor and is the most common tumor in HIV-infected persons. Considered an AIDS-defining illness, KS can occur at any stage of HIV infection. Here, multiple patch-stage early lesions are faint pink on the temple and beard area. They easily could be mistaken for bruises or nevi and be ignored. |
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Patchy, asymmetric balding that accompanies severe illness or use of chemotherapy where growing hairs are lost and resting hairs are spared. Regrowth occurs after illness or discontinuation of toxin. |
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Tinea Capitis (Scalp Ringworm) |
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Rounded, patchy hair loss on scalp, leaving broken-off hairs, pustules, and scales on skin. Caused by fungal infection; lesions may fluoresce blue-green under Wood's light. Usually seen in children and farmers; highly contagious, may be transmitted by another person, by domestic animals, or from soil. |
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Sudden appearance of a sharply circumscribed, round or oval balding patch, usually with smooth, soft, hairless skin underneath. Unknown cause; when limited to a few patches, person usually has complete regrowth. |
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Traumatic Alopecia: traction Alopecia |
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Linear or oval patch of hair loss along hair line, a part, or scattered distribution; caused by trauma from hair rollers, tight braiding, tight ponytail, barrettes. |
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Superficial infection of hair follicles. Multiple pustules, "whiteheads," with hair visible at center and erythematous base. usually on arms, legs, face, and buttocks. |
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Traumatic self-induced hair loss usually the result of compulsive twisting or plucking. Forms irregularly shaped patch, with broken-off, stub like hairs of varying lengths; person is never completely bald. |
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Red, swollen, hard, tender, pus-flled lesion caused by acute, localized bacterial (usually staphylococcal) infection; usually on back of neck, buttocks, occasionally on wrists or ankles. Furuncles are due to infected hair follicles, whereas abscesses are due to traumatic introduction of bacteria into the skin. Abscess are usually larger and deeper than furuncles. |
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An intensely pruritic contagion caused by the scabies mite. Mites form a linear or curved elevated burrow on fingers, web spaces of hands, and wrists. Other family members are usually infected. The patient cannot stop scratching. |
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Red, swollen, tender inflammation of the nail folds. Acute paronychia is usually a bacterial infection; chronic paronychia is most often a fungal infection from a break in the cuticle in these who perform "wet" work |
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Transverse furrow or groove. A depression across the nail that extends down to the nail bed. Occurs with any trauma that temporarily impairs nail formation, such as acute illness, toxic reaction, or local trauma. Dent appears first at the cuticle and moves forward as nail grows. |
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Red-brown linear street, embolic lesions, occur with subacute bacterial endocarditis; also may occur with minor trauma (on nails) |
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This is a slow, persistent fungal infection of fingernails and, more often, toenails, common in older adults. Fungus causes change in color (green where nail plate separated from bed), texture, thickness, with nail crumbling or breaking, and loosing of the nail plate, usually beginning at the distal edge and progressing proximally. |
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Sharply defined pitting and crumbling of nails with distal detachment often occurs with psoriasis. |
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Depression down middle of nail or multiple horizontal ridges, caused by continuous picking of cuticle by another finger of same hand, which causes injury to nail base and nail matrix. |
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