lesions Flashcards
What are ephelides?
Freckles- small, flat, brown pigmented macules in sun exposed areas of skin.
What is a nevus? Junctional? Compound?
Mole- proliferation of melanocytes. Tan-brown in color. Flat or raised. Should be symmetrical, smooth border with single, uniform pigmentation.
Junctional Nevus- children and only macular (flat).
Compound Nevus- Junctional progress to compound in adults and can be macular or papular (raised).
ABCDE
Warning Signs:
Asymmetry (not regularly round or oval, two halves of lesion do not look the same)
Border irregularity (notching, scalloping, ragged edges, poorly defined margins)
Color variation (areas of brown, tan, black, blue, red, white, or combination)
Diameter greater than 6mm (i.e., the size of a pencil eraser), although early melanomas may be diagnosed at a smaller size
Elevation or Enlargement
Additional symptoms: rapidly changing lesion, a new pigmented lesion, and development of itching, burning, or bleeding in a mole. Any of these signs should raise suspicion of malignant melanoma and warrant referral.
If a lesion is present, what characteristics should nurse note?
1) Color
2) Elevation
3) Pattern or shape
4) Size in cm using ruler
5) Location
6) Any exudate
Primary Lesions vs. Secondary Lesions
*Lesions are traumatic or pathologic changes in previously normal structures. They can be primary or secondary
Primary: Develop on previously unaltered skin (macules, papules, nodules, tumor, cyst, etc.)
Secondary: a lesion that changes over time or lesion is due to an infection or scratching (Crust, fissure, ulcer, scar, scale, etc.)
Macule
a color/pigmentation change, pigmented, flat circumscribed, and less than 1 cm- freckles, measles
Papule
solid, elevated, circumscribed, less than 1 cm. Due to thickened epidermis- wart, nevus (mole)
Patch
Macule larger than 1 cm (mongolian, vitiligo)
Plaque
papules that have coalesced to form surface elevation wider than 1 cm
Nodule
solid, elevated, hard of soft, larger than 1 cm (Fibroma)
Tumor
Firm or soft. Larger than a few cm in diameter, benign or malignant
Wheal
superficial, raised, erythematous (mosquito bite, allergic reaction)
Urticana
Hives, coalesce to form extensive reaction, very pruritic (itchy)
Vesicle
elevated cavity containing free fluid, up to 1 cm. (chicken pox, herpes)
Bulla
larger than 1 cm, rupture easy (blister, burn)
Cyst
encapsulated, fluid filled. (sebaceous cyst)
Pustule
Turbid fluid (pus) in cavity. (impetigo, acne)
Crust
dried out exudate left when vescile or pustle bursts or dries up. Red-brown, honey, or yellow. Ex-weeping eczematous dermatitis, scab after an abrasion
Scale
flakes of skin from shedding dead excess keratin cells. (psoriasis or eczema)
Fissure
linear crack that extends into dermis. Dry or moist. Ex- cheilosis at corners of mouth due to moisture, athletes foot
Erosion
Scooped out shallow depression involving only epidermis
Ulcer
Deeper depression extending into dermis, may bleed, and scars when it heals. Ex- stasis ulcer, pressure sore
Excoriation
Self-inflicted abrasion, scratches from intense itching. Ex- insect bites, varicella (chicken pox)
Scar
Collagen replaces normal tissue after lesion is repaired
Atrophic scar
thinning in epidermis (striae)
Lichenification
intense scratching eventually thickens the skin, looks like surface of moss or lichen
Keliod
hypertrophic scar
Annular Shape/Config.
Circular. begins in center and spreads to periphery (tinea corporis, ringworm)
Confluent Shape/Config.
lesions run together (hives)
Zosteriform Shape/Config.
Linear arrangement along nerve route (herpes zoster)
Discrete Shape/Config.
Distinct, individual lesions (molluscum)
