2 derm pattern recognition 1
TRANSCRIPT
CASE STUDIES IN DERMATOLOGIC PATTERN
RECOGNITIONPart 1
PATTERN RECOGNITION IS THE CAPACITY TO DESCRIBE A RASH OR LESION USING A VARIETY OF PHYSICAL CHACTERISTICS IN ORDER
TO LIMIT THE DIFFERENTIAL DIAGNOSIS
PHYSICAL CHARACTERISTICS OF ALL
RASHES AND LESIONS
• 1.BASIC MORPHOLOGY
• 2.SIZE
• 3.SHAPE
• 4.COLOR
• 5.PATTERN
• 6.DISTRIBUTION
EXAMLPES OF BASIC MORPHOLOGY
• 1.MACULE AND PATCH
• 2.PAPULE AND NODULE
• 3.PUSTULE
• 4.WHEAL
• 5.VESICLE AND BULLA
• 6.PLAQUE
MACULES AND PATCHES
MACULES ARE FLAT AND THEREFORE NOT RECOGNIZED
BY TOUCH BUT RATHER A CHANGE IN COLOR FROM YHE SURROUNDING SKIN. PATCHES
ARE LARGER MACULES
MONGOLIAN SPOTS
PAPULES AND NODULES
PAPULES ARE ELEVATED SOLID LESIONS UP TO.5 CM IN
DIAMETER. NODULES ARE LARGER THAN PAPULES
NEUROFIBROMA
PUSTULES
PUSTULES ARE EPIDERMAL OR UPPER DERMAL COLLECTIONS
OF PUS. ABSCESSES ARE DEEPER PUSTULES
BULLOUS IMPETGO
ABSCESSES
WHEALS
WHEALS ARE ROUNDED PALE RED PAPULES OR PLAQUES
CAUSED BY THE EXTRAVASATION OF FLUID
URTICARIA
VESICLES AND BULLAE
VESICLES ARE LESIONS FORMED BY FLUID CREATING A
CLEAVAGE PLANE BENEATH THE STRATUM CORNEUM.
BULLAE ARE LARGER VESICLES
IMPETIGO
PLAQUES
PLAQUES ARE RAISED LESIONS WITH A FLAT TOP. THE RISE IN
ELEVATION IS MUCH LESS THAN YHR WIDTH OF THE
LESION
PSORIASIS
EXAMLPLES OF LESION SHAPE
• 1.ANNULAR.. Like a ring• 2.NUMMULAR… like a coin• 3.LINEAR• 4.OVAL• 5.TARGET• 6.SERPIGENOUS• 7.RETICULATE .. Forming a network• 8.STELLATE …star like
ANNULAR
ANNULAR LESIONS ARE CIRCULAR AND HAVE A
CENTER WITH AN APPEARANCE DIFFERENT FROM THEIR
EDGE OR BORDER
KERATOACANTHOMA
NUMMULAR
NUMMULAR LESIONS TAKE ON THE APPEARANCE OF A FILLED
CIRCLE OR COIN
NUMMULAR ECZEMA
LINEAR
LINEAR LESIONS ARE LONG RELATIVE TO THEIR WIDTH AND GENERALLY STRAIGHT
KELOID
OVAL
THE WORD IS SELF EXPLANATORY
FIXED DRUG ERUPTION
TARGET
TARGET LESIONS ARE MADE UP OF CONCENTRIC CIRCLES OF WHITE AND RED FORMING A
BULLSEYE APPEARANCE
ERYTHEMA MULTIFORME
SERPIGENOUS
LESIONS THAT ARE LONG AND WAVEY WITH A SNAKE-LIKE
APPEARANCE
LARVA MIGRANS
RETICULATE
LESIONS WITH AN INTERCONNECTED OR LACE-
LIKE APPEARANCE
STRETCH MARKS
STELLATE
LESIONS WITH A STAR-LIKE APPEARANCE USUALLY FROM
A RADIAL SPREAD FROM A CENTRAL FOCUS
SUPERFICIAL VARICOSITIES
EXAMPLES OF LESION PATTERN
• 1.GROUPED
• 2.DISSEMINATED
• 3.DERMATOMAL
• 4.SYMMETRIC
• 5.PHOTOSENSITIVE
• 6. CONFLUENT
• 7.INTERTRIGENOUS
GROUPED
MULTIPLE SIMILAR LESIONS ORGANIZED IN CLOSE
PROXIMITY
GENITAL WARTS
DISSEMINATED
LESIONS WHICH ARE SCATTERED RANDOMLY OVER
ALL OR MOST OF THE BODY
GENERALIZED DRUG
REACTION
DERMATOMAL
LESIONS THAT FOLLOW THE PATH OF A PERIPHERAL
SENSORY NERVE
HERPES ZOSTER
SYMMETRIC
LESIONS THAT ARE MIRROR IMAGES OF EACHOTHER FROM ONE SIDE OF THE BODY TO THE
OTHER
ONYCHOMYCOSIS
PHOTOSENSITIVE
LESIONS LIMITED TO THE SUN EXPOSED PARTS OF THE BODY
PHOTOSENSITIVE DRUG ERUPTION
CONFLUENT
THE PROCESS OF SMALLER LESIONS COMING TOGETHER UNTIL THEY FORM A LARGE
LESION BY MERGING
TINEA CORPORIS
INTERTRIGENOUS
LESIONS THAT ARE LOCATED BETWEEN SKIN FOLDS SUCH AS
THE AXILLA, GROIN OR BETWEEN FINGERS OR TOES
LESION SIZE
• USUALLY DESCRIBED IN MILLIMETERS OR CENTIMETERS
EXAMPLES OF LESION OR RASH COLOR
• 1.HYOPIGMENTED• 2.HYPERPIGMENTED• 3.WHITE• 4.BLACK• 5.BLUE• 6.YELLOW• 7.VIOLACEOUS• 8.VARIEGATED
EXAMPLES OF LESION DISTRIBUTION
• 1.HEAD• 2.ORAL• 3.AXILLARY• 4.TRUNCAL• 5.ANOGENITAL• 6.INGUINAL• 7.DEPENDENT• 8.PEDAL