module 6 hx and skin exam Flashcards
7 key questions related to skin lesions
when? onset where? site of onset Itch/hurt? how has it spread? Individual lesion changes? color, shape aggravating factors? - heat, cold, sun, exercise, travel hx, drug ingestion, pregnancy, season Previous tx? topical/systemic
Past medical hx
previous skin problems tolerance to sunlight - previous severe sunburn sensitivity to sensory stimuli Allergies Medications: present and past Atopic hx: asthma, hay fever, eczema
past medical hx systemic illness
cardiac respiratory liver endocrine or other - example: lupus
Family hx
psoriasis
atopy melanoma
xanthomas
personal and social hx
Skin care habits, sun exposure, chemical exposure, drug use, cosmetics
Recent physical or emotional stress
-> worsening skin issues
Use of tobacco, alcohol, recreational drugs
Hobbies, exposures, travel
skin risk factors
over 50 male fair, freckled, ruddy complexion light-colored hair or eyes tendency to burn easily frost, wind, UV radiation near equator family hx of skin cancer radiation exposure (x-rays) repeated trauma/skin irritation precancerous dermatoses
adequate skin exam should include
oral mucosa scalp palms soles nails of hands and feet
inspection
color - general pigmentation - widespread color change: pallor, jaundice Hygiene Thickness Vascularity or Bruising Skin lesions
Palpation
temperature: dorsal hand
texture: smooth, even?
moisture: perspiration, oil
turgor
mobility
describing skin lesions
shape: reg/irreg size color: solid/variation texture: smooth/rough Evavation/depression pedunculation(hanging): skin tag exudate: odor, color, amount, consistency
configuration
annular grouped linear arciform diffues
location
region of body
distribution
generalized/localized
patterns
discrete / confluent
annular
round lesions, central clearing
confluent
lesions that run together
discrete
well demarcated
gyrate
star-shaped
raised erythemous boarder
target
pick macule with purple center or center papule
linear
interlocking/ straight line
polycyclic
coalescing circles
- combine together -> one large area
zosteriform
follows dermatome
basal cell carcinoma
most common skin cancer often on exposed parts of body Pt complains of - persistent sore that doesn't heal - possible crusting, itching - shiney/pearly
squamous cell carcinoma
2nd most common often on exposed skin Pt presents with - sore that wont heal - crusting possible - possible itching - central depression possible
Melanoma/moles
mostly deadly form of cancer
- most develop as new lesions
contributing factors to melanoma
heredity
UV light
hormones
ABCDE of melanoma
Asymmetry Boarder: irregular, ragged, notched, blurred? Color Diameter: >6mm "larger and larger" Elevated/evolution
