Assessment of the skin Flashcards
What are two categories of abnormality for the skin?
- specific conditions to the skin
- non-specific - signs and symptoms of systemic illness, injury, nutrition, hydration and circulation displayed on teh skin
What are some functions of the skin?
- Protection
- Thermoregulation
- Infection prevention (integrity and pH 5-5.5 and acidic)
- Vitamin D regulation
- Waterproofing
Briefly state some features of the skin
- Epidermis – dermis - subcutaneous tissue
- Collagen and connective tissue
- Muscle
- Sensory nerve ending
- Hair
- Blood vessels
- Protein rish croneocyets – keratin and filaggrin
- Lipid rich matrix – epidermis produced liquid to - replace lost desquamation
- Lipids derive from keratinocytes
- Ceramides, free fatty acids and cholesterol
What are some factors that cause skin changes?
- UV
- Biological aging
- Skin disease eg, atopic eczema, psoriasis, inherited ichthyosaurs asteatotic eczema
- Hormones eg. Menopause
- Illness eg. Malignancy
- Over washing
- Poor self-care and nursing care
- Therapeutic treatments eg. Nineties, radiotherapy, corticosteroids and light therapy
- Environment (heating, low humidity and sunlight)
- Poor nutrition and hydration
What does peters (2012) say is needed to prepare for a skin assessment?
- Touch
- Sensitivity or embarrassment
- Adequate lighting and privacy
- Magnifying glass
- Full examination
- Skin type (fitzpatrick scale types 1-6)
- Documentation (diagrams and photos)
- Referral and escalation pathways
What sections are involved in a physical examination of skin conditions?
- General overview – affected area compared to unaffected area
- Nails eg. Clubbed
- Mucous membranes
- Hair
- Lymph node (eg. Raised nodes)
- Other systems effected that need examining
How can you recognise an emergent situation in skin conditions?
- Difficulty breathing, swallowing or signs of oedema
- Also panting systemic illness and fever
- Sever sudden rash following viral symptoms
- Any tracking
State thee chronic skin conditions
- Oedema
- Ezecma
- Seriosis
During a skin assessment what should be documented and reported?
- Location – generalised, localised and record with a diagram or picture
- Number and distribution – single, multiple, symmetrical or asymmetrical
- Shape (outline) – well defined, poor defined, irregular border, linear.
What are the two types of lesions?
Primary – present at/ part of initial onset of disease
Secondary – result of manipulation (scratching, rubbing and picking), injury and changes over time caused by the disease
What is a macule?
Flat discolouration less than 1cm
What is a patch?
Flat discolouration more than 1cm
What is a papules?
Solid, raised, dis stick borders then than 1cm
What is a plaques?
Solid, raised, distinct borders, flat-topped epidermal change more than 1cm
What is a vesicle?
Raised lesion filled with clear fluid less than 1 cm
What is a pustule?
Raised lesion filled with fluid exudate giving a yellow appearance
What is a bulla?
Raised lesion filled with clear fluid greater than 1cm
What is a nodule?
raised and in distinct borders
Deep palpable portion
If skin moves over it – subcutaneous
If skin moves with then intradermal
What is a tumour?
Nodule larger than 1 cm
What is a weal>
Tense oedema in upper dermis
Flat topped and slightly raised
Pale red or white in centre
What is a cyst?
Raised lesion with palpable sac spilled with liquid or semisolid material
What is crusting?
Secondary
Blister roof combined with dried plasma exudate
What is erosion and oozing?
Vesicle base with roof removed
Moist, slightly depressed area which heals without scaring
What is an ulcer?
Loss of whole thickness of epidermis and dermis
Results in a scar
What is excoriation?
Fingernail removal of epidermis and upper dermis
What is a fissure?
Linear, wedge shaped cracks extending down the dermis
What is lichenification?
Thickened epidermis
What is a scar?
Dermal damage
Keloid is excessive scarring
What is scaling?
Whitish plates on skin surface
What is desquamation?
Peeling of sheets of skin
What is atrophy?
Depressed skin from thinning
