Dermatology Flashcards
When inspecting and palpating the skin, what does this include assessment of?
- skin colour; look for changes in pigmentation, redness, pallor, cyanosis and yellowing of the skin.
-moisture
-texture. - mobility and turgor.
- characteristics of skin lesions
- finger nails and toenails.
what is pallor?
- pallor is seen on the fingernails, lips and mucous membranes particularly of the mouth and palpebral conjunctiva. in darker individuals checking the skin of the palms and soles may be useful.
what is central cyanosis?
- central cyanosis is best identified in the lips, oral mucosa and tongue. be aware darker individuals have melanin in their lips that may simulate cyanosis.
can cyanosis of the nails, hands and feet be central and peripheral in origin?
- yes.
what is jaundice?
- yellowing of the skin that can be observed in the sclera( white outer layer of the eyeball). palpebral conjunctiva, lips, hard palate, undersurface of the tongue, tympanic membrane and skin.
what to inspect when looking at moisture of skin?
- look for dryness, sweating and oiliness.
what to assess when looking at temperature?
- use the back of your hands to access the temperature of the arms and legs. not temp of red areas.
what to assess when looking at texture?
- palpate the skin for any roughness or smoothness.
what is mobility and turgor?
- lift a fold of skin on the dorsum of the hand, subclavicular fossa or anterior thigh for 3 seconds so that it is tented and then release. evaluate the ability to change shape and return to normal.
- skin with decreased turgor remains elevated after being pulled up and released.
what was abnormal subclavicular and anterior thigh turgor associated with?
Hypernatremia; a common electrolyte problem that is defined as a rise in serum sodium concentration to a value exceeding 145 mmol/L
what is a macule?
- a flat, nonpalpable circumscribed area (up to 1cm) of colour that’s brown, red, white or tan.
what is a patch?
- a flat non-palpable lesion with changes in skin colour, 1 cm or larger.
what is a papule?
a elevated palpable, firm circumscribed lesion up to 1 cm.
what is a plaque?
A elevated, flat-topped, firm, circumscribed lesion up to 1 cm.
what is a nodule?
- an elevated, firm, circumscribed, palpable area larger than 0.5 cm–> its typically deeper and firmer than a papule.
what is a cyst?
- a nodule filled with an expressible liquid of semisolid material
what is a vesicle?
- a palpable elevated, circumscribed, superficial, fluid-filled blister up to 1 cm.
what is a bulla?
- a vesicle 1cm of larger filled with serous fluid.
What is a pustule?
- which is elevated and superficial similar to a vesicle but is filled with pus.
what is a wheal?
- a relatively transient, elevated, irregularly shaped area of localized skin edema. most a red, pale pink or white.
What is a scale?
- a thin flake of dead exfoliated epidermis.
what is a crust?
- the dried residue of skin exudates such as serum, pus, or blood.
what is a lichenification?
- visible and palpable thickening of the epidermis and roughening of the skin with increased visibility of the normal skin furrows (often from chronic rubbing).
what is excoriation?
- linear or punctuate loss of epidermis usually due to scratching.
what to consider when assessing skin lesions?
- anatomic location; where on the skin–> if it is a flexor or extensor region.
- consider the distribution; single or multiple lesions, symmetrical or asymmetrical distribution? herpes zoster (shingles presents in a characteristic dermatomal distribution, or candida infections occur in intertriginous areas (skin folds).
- consider the morphology (linear, clustere, annular (in a ring), arciform (in an arc), geographic, or serpiginous (serpent or worm like).
- note the types of skin lesions ( macules, papules, vesicles).
- note their, size, shape, colour, regularity or irregularity and borders.
- consider the ABCD(E) method to screen melanoma in describing moles.
What is the ABCD(E) method?
A= asymmetry.
B= border- irregular.
C= colour variation.
D= diameter greater or = to 6 mm.
(E)= evolution/change- as part of your history/examination.
what are additional things to note?
- areas of inflammation.
-itching, bleeding.
what are additional things to note when palpating?
- tenderness, warmth, thickness, consistency (hard, soft, firm, fluctuant).
- whether firm pressure leads to blanching.
- scaling.
- inflamed regional lymph nodes; for infectious or malignant lesions.
What to inspect when looking at the hair?
- inspect and palpate the hair; on the scalp as well as other regions of the skin; note its quantity distribution and texture.
what to look for when inspecting nails?
- inspect and palpate the toenails and finger nails. note their colour, shape and if there are any leisons.
true/false; longitudinal bands of pigment may be seen in the nails of unhealthy darker skinned individuals?
False; can be seen in healthy, darker skinned individuals.
What are beaus lines in nails?
-Beau’s lines are indentations that run across the nails. The indentations can appear when growth at the area under the cuticle is interrupted by injury or severe illness.
What is Onycholysis?
Onycholysis is when your nail separates from its nail bed. It often appears after an injury to your nail, but it may have other causes, including fungi.
What is Onychorrhexis?
Onychorrhexis causes ridges and splitting in your nails. Your nails may have several splits that cause triangle tears on the edges. Onychorrhexis involves the nail matrix, which is responsible for making your nail grow.
What is Onychomadesis?
Onychomadesis is a periodic idiopathic shedding of the nails beginning at the proximal end, possibly caused by the temporary arrest of the function of the nail matrix. One cause in children is hand, foot, and mouth disease.
What is Onychoschizia?
Onychoschizia is a type of nail fragility and is a condition that causes lamellar (horizontal) splitting of the nail plate;3,4 it is a common problem seen by dermatologists and occurs at least twice as often in women than men.
What is trachyonychia?
trachyonychia is a disorder of the nail unit that most commonly presents with rough, longitudinally ridged nails (opaque trachyonychia) or less frequently, uniform, opalescent nails with pits (shiny trachyonychia). The term trachyonychia refers to ‘rough nails.
What is pitting is psoriasis?
Pitting is well known nail deformity in psoriasis and probably the most frequent. The pits are usually quite small, about the size of a pin-head (under 1 mm in diameter), but much larger depressions, and even isolated punch-out areas, are seen occasionally.
What is pitting in alopecia areata?
Patients with alopecia areata sometimes have nail pitting. Chronic paronychia is a painful inflammation of the periungual area caused by an infection. It occurs in occupations in which the fingers are kept moist, such as fishmongers, aquarists, and hair stylists.
What is lichen planus?
Lichen planus is a benign, chronic, mucocutaneous disorder that affects the skin, mucosae, and nails. The occurrence of nail lichen planus has been reported to be about 10% to 15%. 1,2 Nail lichen planus is more common in adults than in children, and it mostly affects the fingernails rather than the toenails.
What is darier disease?
Darier disease (DD) or Darier–White disease, also known as keratosis follicularis, is an autosomal dominantly inherited genodermatosis characterized by greasy hyperkeratotic papules in seborrheic regions, nail abnormalities and mucous membrane changes.[1]
What is leukonychia?
Leukonychia, or white nails, is usually not an alarming sign, but it can sometimes unmask severe systemic disorders or congenital conditions. The white color can be due to nail plate or nail bed abnormalities.
what is true leukonychia?
True leukonychia is whitening of the nail plate itself and is further separated into total and subtotal, or partial, the latter occurring as punctate, transverse, and longitudinal.
What is apparent leukonychia?
Apparent leukonychia is characterized by a white appearance of the nail due to abnormal vasculature of the nail bed.
what is nail clubbing?
Nail clubbing occurs when the tips of the fingers enlarge and the nails curve around the fingertips, usually over the course of years. Nail clubbing is sometimes the result of low oxygen in the blood and could be a sign of various types of lung disease.
What is Brachyonychia?
brachyonychia (or racquet nails) is a clinical term defining nail units in which the width of the nail plates and nail beds is greater than the length
What is Onychogryphosis?
Onychogryphosis is a disorder of nail plate growth that is characterized by an opaque, yellow-brown thickening of the nail plate with associated gross hyperkeratosis, elongation, and increased curvature. It is often described as a “ram’s horn nail” or being “oyster-like” in appearance.
What is Dorsal pterygium?
Dorsal pterygium is an irreversible nail deformity known to be associated most commonly with trauma, though also with dermatoses affecting the nail matrix like lichen planus, graft versus host disease, or autoimmune bullous disorders
What is ventral pterygium?
Pterygium inversum unguis (PIU), also known as ventral pterygium, is a rare abnormality characterized by adherence of the distal nail bed to the ventral surface of the nail plate, resulting in obliteration of the distal groove.
What is nail splinters?
Splinter hemorrhages look like thin, red to reddish-brown lines of blood under the nails. They run in the direction of nail growth. They are named splinter hemorrhages because they look like a splinter under the fingernail. The hemorrhages may be caused by tiny clots that damage the small capillaries under the nails.
What is a pincer nail?
Pincer nail is a condition characterized by excessive transverse nail curvature, progressively pinching the nail bed distally.
what is yellow nail?
Yellow nail syndrome is an extremely rare disorder characterized by malformations affecting the fingernails and toenails, abnormalities affecting the lungs and the airways (respiratory tract), and swelling or puffiness in different parts of the body because of the accumulation of protein-rich fluid (lymph) in the soft …
What is Pachyonychia congenita?
Pachyonychia congenita (PC) is a very rare genetic disorder that affects the skin and nails. The symptoms usually begin at birth or early in life, and the condition affects people of both sexes and all racial and ethnic groups.
What is koilonychia?
Spoon nails (koilonychia) are soft nails that look scooped out. The depression usually is large enough to hold a drop of liquid. Often, spoon nails are a sign of iron deficiency anemia or a liver condition known as hemochromatosis, in which your body absorbs too much iron from the food you eat.
What is Onychauxis?
Onychauxis is the medical term for an overgrowth or thickening of the nail which can become discoloured turning white, yellow, red or black. Red or blackened nails are often a result of dried blood underneath the nail plate, however, it is important to check it out as it can be melanoma.
