Skin Lesions Overview

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Questions and Answers

Which of the following describes a macule?

Crack in the skin

Solid elevation less than 0.5 cm

Flat area of color change without elevation (correct)

Fluid-filled blister

Which lesion is characterized by a solid mass larger than 1 cm?

Papule

Nodule

Tumor (correct)

Plaque

What type of lesion develops from primary lesions and can be caused by external forces such as scratching?

Nodules

Primary lesions

Secondary lesions (correct)

Tumors

Identify the example of a vesicle.

Herpesvirus infection Signup and view all the answers

Which of the following describes scales in skin lesions?

Flakes of skin layer Signup and view all the answers

What is a common sign of oral candidiasis?

Painful, cream-colored patches adhering to the oral mucosa Signup and view all the answers

Which of the following is TRUE regarding treatment for tinea versicolor?

Topical antifungal cream is generally used Signup and view all the answers

What type of louse is spread primarily through sexual contact?

Pubic louse Signup and view all the answers

What is the recommended method for handling linens after contact with someone infested with scabies?

Wash all bedding and clothes in hot water Signup and view all the answers

What symptom is commonly associated with penile candida infections?

Painful red, scaling lesions Signup and view all the answers

Which is a recognized risk factor for developing tinea versicolor?

Immunosuppression Signup and view all the answers

What is a characteristic symptom of scabies?

Wavy lines with severe pruritus Signup and view all the answers

Which statement about treatment for oral candidiasis is accurate?

Medicated mouthwash is a common treatment Signup and view all the answers

In which situation is it advised to continue with massage therapy for vaginal and penile candidiasis?

During active infection without precautions Signup and view all the answers

Which factor does NOT contribute to the spread of lice?

Poor hygiene habits Signup and view all the answers

What is the primary cause of acne vulgaris?

Obstructive inflammation of hair follicles Signup and view all the answers

Which group is most commonly affected by acne vulgaris?

Individuals 12-15 years old Signup and view all the answers

What is a potential psychological side effect of isotretinoin treatment for severe acne?

Depression and psychosis Signup and view all the answers

Which type of bacterial infection involves the deeper layers of skin and is also known as a boil?

Furuncle Signup and view all the answers

What is a common symptom of cellulitis?

Warmth and swelling in the affected area Signup and view all the answers

Which of the following is NOT a common cause of impetigo?

Human papillomavirus Signup and view all the answers

What is a key preventive measure for spreading impetigo?

Covering lesions Signup and view all the answers

What is the characteristic sign of erysipelas?

Orange-peel skin appearance Signup and view all the answers

Which virus is responsible for chickenpox?

Varicella-zoster virus Signup and view all the answers

What best describes the lesions caused by herpes simplex virus?

Fluid-filled blisters surrounded by redness Signup and view all the answers

How is molluscum contagiosum primarily spread?

Contact or indirect contact Signup and view all the answers

Which type of fungal infection is commonly referred to as ringworm?

Tinea corporis Signup and view all the answers

What is a recommended treatment for tinea infections?

Antifungal creams Signup and view all the answers

What is a common risk factor for developing candidiasis?

Immunosuppression Signup and view all the answers

Study Notes

Skin Lesions

A lesion is any variation from normal tissue.
Lesions are classified as either primary or secondary.

Primary Skin Lesions

Changes to the skin directly caused by a disease.
Examples:
- Macule: Flat area of color change (no elevation or depression). Example: Freckles.
- Papule: Solid elevation less than 0.5 cm in diameter.
- Nodule: Solid elevation 0.5 to 1 cm in diameter, extending deeper into the dermis than a papule. Example: Mole.
- Tumor: Solid mass larger than 1 cm. Example: Squamous cell carcinoma.
- Plaque: Flat elevated surface on skin or mucous membrane. Example: Thrush.
- Wheal: Type of plaque, resulting from transient edema (swelling) in the dermis. Example: Intradermal skin test.
- Vesicle: Small blister with fluid within or under the epidermis. Example: Herpesvirus infection.
- Bulla: Large blister greater than 0.5 cm in diameter. Example: Burn.
- Pustule: Vesicle filled with pus. Example: Acne.

Secondary Skin Lesions

Develop from primary lesions or external forces (e.g., scratching).
Examples:
- Scales: Flakes of skin layer. Example: Psoriasis.
- Crust: Dried exudate (discharge) from skin. Example: Impetigo.
- Fissure: Cracks in the skin. Example: Athlete's foot.
- Ulcer: Area of loss extending through the epidermis. Example: Pressure sore.
- Scar: Excess collagen production after injury. Example: Wound healing.
- Atrophy: Loss of some portion of skin. Example: Paralysis.

Bacterial Infections

Acne Vulgaris:
- Common, inflammatory condition of pilosebaceous units (oil glands).
- Overproduction of sebum forms a keratin plug, infected by bacteria.
- Forms comedones (pimples).
- Common in younger individuals (12-15), triggered by puberty-related androgen surge.
- Equally affects males and females, though males tend to have more severe cases.
- Follicular keratinization blocks follicle.
- Androgens cause increased sebum production.
- Bacteria (e.g., Propionibacterium acnes) colonizes.
- Genetics are involved.
- Triggers: Hormonal changes, oily products, certain drugs, sweating, excessive skin contact.
- Progression: Comedones → papules → pustules → cysts/nodules.
- Treatment: Limit triggers, OTC/Rx medications, cleansers, topical/oral antibiotics, oral contraceptives, isotretinoin (severe cases).
Folliculitis, Furuncle, Carbuncle: Infections of hair follicles.
- Folliculitis: Inflammation of hair follicle.
- Furuncle: Deeper inflammation of follicle, forming an abscess (boil).
- Carbuncle: Group of furuncles.
- Cause: Bacteria (mostly Staphylococcus aureus), viruses/fungi, irritation, occlusion.
- Treatment: Topical cleansers, antibiotics. If furuncle/carbuncle, drainage required.
Pseudofolliculitis Barbae: Ingrown beard hair, common in Black men.
- Irritation from shaving causing hair to curl into skin.
- Itchy, red papules/pustules.
- Often chronic, firm papules (unlike the acute, pustular folliculitis barbae).
- Treatment: Warm compresses, antibiotics if infection present.
Impetigo: Superficial bacterial skin infection (deeper = ecthyma).
- Commonly caused by Streptococcus or Staphylococcus.
- Spread by contact/contaminated objects.
- Vesicles/pustules, oozing, honey-colored crust.
- Treatment: Antibiotics (topical/oral).
Cellulitis: Bacterial infection of dermis & subcutaneous tissues.
- Often follows skin wounds/boils.
- Commonly caused by Staphylococcus aureus or group A Streptococcus.
- Redness, warmth, tenderness, swelling, possible fever, chills, lymphadenopathy. Spreading red streaks possible (lymphangitis).
- Serious if untreated; can spread to bloodstream (sepsis).
- Treatment: Oral antibiotics (based on suspected organism).
Erysipelas: Superficial form of cellulitis.
- Commonly caused by various Streptococcus species.
- Erythematous lesions with sharply demarcated, raised border (orange-peel skin).
- Warm, swollen, painful/tender area. Lymphadenopathy and possible lymphedema.
- Systemic symptoms possible (fever, chills, etc.).
- Treatment: Prompt antibiotic treatment crucial to avoid sepsis or complications.

Viral Infections

Warts, Varicella, Herpes Zoster, Herpes Simplex, Molluscum Contagiosum (see individual entries below)

Fungal Infections

Tinea (ringworm), Candidiasis, Tinea Versicolor (see individual entries below)

Parasitic Infections

Scabies & Pediculosis (see individual entries below)
(Note: The following are the subtopics of the viral, fungal, and parasitic infections listed above that are not fully outlined)*

Several types (common, plantar, flat, genital).
Genital warts are highly contagious.
Treatment varies by type; most resolve spontaneously; topical treatments are usual.
Warts may be painful or painless, isolated or clustered.
Can be a risk for cancer development.

Varicella Zoster (Chickenpox)

Highly contagious viral infection, often in children.
Spread via respiratory droplets/direct contact.
Blisters that crust over.
Possible complications: pneumonia, encephalitis.
Treatment is supportive; antivirals could be suggested.
Vaccination is available.

Herpes Zoster (Shingles)

Reactivation of dormant Varicella-Zoster Virus (VZV).
Often in older individuals.
Painful vesicles in dermatomal patterns.
Can cause post-herpetic neuralgia (PHN).
Treatment is supportive; antivirals are used for early treatment.
Vaccination exists.

Herpes Simplex Virus (HSV)

Highly contagious; oral or genital herpes depending on the strain.
Painful vesicles/pustules, crusting, recurrent/latent phases, common triggers.
No cure; treatment focuses on reducing symptoms and transmission periods.
HSV-1 and 2 can each infect the body's other portions (e.g., HSV-1 can infect the genitals).

Molluscum Contagiosum (MC)

Highly contagious viral skin infection, often in children.
Small, raised lesions with a central dimple.
Treatment is often supportive; removal techniques could be suggested instead of letting it resolve naturally.
Some types of warts of molluscum (or types of warts) are more common in HIV patients, other types may be more spreadable, etc.

Tinea (Ringworm)

Fungal infection, classified by location (e.g., Tinea pedis - foot, Tinea unguium - nail, Tinea corporis - body).
Circular rash, scaling or crumbling nails, etc.
Treatment: Antifungal creams/powders, possibly corticosteroids (for pain/itching).

Candidiasis

Fungal infection of skin/mucous membranes; commonly in groin, mouth, and between digits.
May be caused by Candida albicans.
Risk factors: immunosuppression, hyperhidrosis, incontinence, certain medications.
Symptoms vary by location (e.g., vaginal discharge, oral patches).
Treatment: Antifungal creams/medicated mouthwash, keeping the skin dry.

Tinea Versicolor

Fungal infection causing discolored skin patches.
Often in warm/humid climates.
Hypo- or hyperpigmented patches, possibly scaling; not always painful or itchy.
Treatment: Topical antifungal creams, oral antifungals (if needed).

Scabies

Mite infestation.
Severe itching, tiny red bumps/rash, especially in skin creases or folds (especially at night after a bath).
Highly contagious – direct contact.
Treatment: Topical creams, wash bedding/clothes.

Pediculosis (Lice)

Several types of lice (head, body, pubic).
Severe itching, visible lice/eggs.
Highly contagious – direct contact/sharing items.
Treatment: Topical creams/shampoos, re-applying after 10 days, daily combing, disinfection/vacuuming to remove fomites (infected items).

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Description

This quiz covers the classification of skin lesions, focusing on primary lesions caused directly by diseases. You'll explore various types of lesions, including macules, papules, and nodules, with examples to enhance your understanding. Test your knowledge and familiarize yourself with dermatological terminology.