Benign hyperpigmented skin lesions: Clinical (To be retired)
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Benign hyperpigmented skin lesions: Clinical (To be retired)
Subspeciality surgery
Cardiothoracic surgery
Coronary artery disease: Clinical (To be retired)
Valvular heart disease: Clinical (To be retired)
Pericardial disease: Clinical (To be retired)
Aortic aneurysms and dissections: Clinical (To be retired)
Chest trauma: Clinical (To be retired)
Pleural effusion: Clinical (To be retired)
Pneumothorax: Clinical (To be retired)
Lung cancer: Clinical (To be retired)
Anatomy clinical correlates: Thoracic wall
Anatomy clinical correlates: Heart
Anatomy clinical correlates: Pleura and lungs
Anatomy clinical correlates: Mediastinum
Adrenergic antagonists: Beta blockers
ACE inhibitors, ARBs and direct renin inhibitors
cGMP mediated smooth muscle vasodilators
Lipid-lowering medications: Statins
Lipid-lowering medications: Fibrates
Miscellaneous lipid-lowering medications
Antiplatelet medications
Plastic surgery
Benign hyperpigmented skin lesions: Clinical (To be retired)
Skin cancer: Clinical (To be retired)
Blistering skin disorders: Clinical (To be retired)
Bites and stings: Clinical (To be retired)
Burns: Clinical (To be retired)
ENT (Otolaryngology)
Anatomy clinical correlates: Olfactory (CN I) and optic (CN II) nerves
Anatomy clinical correlates: Trigeminal nerve (CN V)
Anatomy clinical correlates: Facial (CN VII) and vestibulocochlear (CN VIII) nerves
Anatomy clinical correlates: Glossopharyngeal (CN IX), vagus (X), spinal accessory (CN XI) and hypoglossal (CN XII) nerves
Anatomy clinical correlates: Skull, face and scalp
Anatomy clinical correlates: Ear
Anatomy clinical correlates: Temporal regions, oral cavity and nose
Anatomy clinical correlates: Bones, fascia and muscles of the neck
Anatomy clinical correlates: Vessels, nerves and lymphatics of the neck
Anatomy clinical correlates: Viscera of the neck
Antihistamines for allergies
Neurosurgery
Stroke: Clinical (To be retired)
Seizures: Clinical (To be retired)
Headaches: Clinical (To be retired)
Traumatic brain injury: Clinical (To be retired)
Neck trauma: Clinical (To be retired)
Brain tumors: Clinical (To be retired)
Lower back pain: Clinical (To be retired)
Anatomy clinical correlates: Olfactory (CN I) and optic (CN II) nerves
Anatomy clinical correlates: Oculomotor (CN III), trochlear (CN IV) and abducens (CN VI) nerves
Anatomy clinical correlates: Trigeminal nerve (CN V)
Anatomy clinical correlates: Facial (CN VII) and vestibulocochlear (CN VIII) nerves
Anatomy clinical correlates: Glossopharyngeal (CN IX), vagus (X), spinal accessory (CN XI) and hypoglossal (CN XII) nerves
Anatomy clinical correlates: Vertebral canal
Anatomy clinical correlates: Spinal cord pathways
Anatomy clinical correlates: Cerebral hemispheres
Anatomy clinical correlates: Anterior blood supply to the brain
Anatomy clinical correlates: Cerebellum and brainstem
Anatomy clinical correlates: Posterior blood supply to the brain
Anticonvulsants and anxiolytics: Barbiturates
Anticonvulsants and anxiolytics: Benzodiazepines
Nonbenzodiazepine anticonvulsants
Migraine medications
Osmotic diuretics
Antiplatelet medications
Thrombolytics
Ophthalmology
Eye conditions: Refractive errors, lens disorders and glaucoma: Pathology review
Eye conditions: Retinal disorders: Pathology review
Eye conditions: Inflammation, infections and trauma: Pathology review
Anatomy clinical correlates: Olfactory (CN I) and optic (CN II) nerves
Anatomy clinical correlates: Oculomotor (CN III), trochlear (CN IV) and abducens (CN VI) nerves
Anatomy clinical correlates: Eye
Orthopedic surgery
Joint pain: Clinical (To be retired)
Lower back pain: Clinical (To be retired)
Anatomy clinical correlates: Clavicle and shoulder
Anatomy clinical correlates: Axilla
Anatomy clinical correlates: Arm, elbow and forearm
Anatomy clinical correlates: Wrist and hand
Anatomy clinical correlates: Median, ulnar and radial nerves
Anatomy clinical correlates: Bones, joints and muscles of the back
Anatomy clinical correlates: Hip, gluteal region and thigh
Anatomy clinical correlates: Knee
Anatomy clinical correlates: Leg and ankle
Anatomy clinical correlates: Foot
Trauma surgery
Traumatic brain injury: Clinical (To be retired)
Neck trauma: Clinical (To be retired)
Chest trauma: Clinical (To be retired)
Abdominal trauma: Clinical (To be retired)
Urology
Penile conditions: Pathology review
Prostate disorders and cancer: Pathology review
Testicular tumors: Pathology review
Kidney stones: Clinical (To be retired)
Renal cysts and cancer: Clinical (To be retired)
Urinary incontinence: Pathology review
Testicular and scrotal conditions: Pathology review
Anatomy clinical correlates: Male pelvis and perineum
Anatomy clinical correlates: Female pelvis and perineum
Anatomy clinical correlates: Other abdominal organs
Anatomy clinical correlates: Inguinal region
Androgens and antiandrogens
PDE5 inhibitors
Adrenergic antagonists: Alpha blockers
Vascular surgery
Peripheral vascular disease: Clinical (To be retired)
Leg ulcers: Clinical (To be retired)
Aortic aneurysms and dissections: Clinical (To be retired)
Anatomy clinical correlates: Anterior and posterior abdominal wall
Adrenergic antagonists: Beta blockers
Lipid-lowering medications: Statins
Lipid-lowering medications: Fibrates
Miscellaneous lipid-lowering medications
Antiplatelet medications
Thrombolytics
Assessments
Benign hyperpigmented skin lesions: Clinical (To be retired)
USMLE® Step 2 questions
0 / 8 complete
Questions
USMLE® Step 2 style questions USMLE
of complete
Retrieved from: Wikipedia
Which of the following is the most appropriate response by the doctor at this time?
Memory Anchors and Partner Content
Transcript
Content Reviewers
Rishi Desai, MD, MPHHyperpigmentation is the darkening or increase in the natural color of the skin, most often due to hypermelanosis, which is an increased deposition of melanin in the epidermis or dermis.
This can be associated with a multitude of clinical conditions, ranging from normal variations of skin color to acquired and inherited syndromes.
Diagnosis of hyperpigmentation includes physical examination and a detailed history.
A complete skin examination should be performed under visible light to observe important clinical parameters, including the extent of the pigmentary abnormality, distribution, pattern, color hue and morphology of individual lesions.
Under natural light, epidermal hypermelanosis appears light brown to dark brown in color, while dermal hypermelanosis has a bluish or ashen gray hue with margins less defined than epidermal hypermelanosis.
Complete skin examination should include observing these general features with the naked eye, and then further examine them through dermoscopy.
Next, hyperpigmented skin lesions may be examined under a Wood's lamp, which emits low wave ultraviolet.
A light that allows a better visualization of variations in skin pigmentation.
This is done in a darkened room with the Wood's lamp held at 4 to 5 inches from the skin, to observe any subsequent fluorescence.
Under a Wood's lamp, epidermal hypermelanosis shows enhanced pigmentation, while dermal hypermelanosis doesn’t.
Finally, a skin biopsy for histopathologic evaluation is not routinely performed for the diagnosis of all hyperpigmented lesions, but it may be necessary when the clinical diagnosis is uncertain or suggests malignancy.
The most frequent benign hyperpigmented skin lesions are melanocytic nevi, most commonly known as moles.
These are benign proliferations of a type of melanocyte called nevus cells, which cluster as nests within the lower epidermis and dermis.
Melanocytic nevi must be differentiated from malignant melanoma using the mnemonic ABCDE to spot any worrisome signs, where lesions are asymmetrically shaped, borders are irregular or notched, coloration varies within the same lesion, the diameter is larger than 6 millimeters, and the lesion rapidly evolves over time, quickly increasing in size, and can cause skin elevation.
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