Physical Exam. of the skin, hair and nails Flashcards
What is the overall skin inspection? (6)
a. Color
b. Uniform Appearance
c. Thickness
d. Symmetry
e. Hygiene
f. Presence of any leasion
What scale is used as a reference for skin pigmentation?
Fitzpatrick Scale ( I-VI)
What are the things when looking at lesions?(9)
a. Lesions itself
b. Size ( L x W, mm and cm)
c. Shape and configuration
d. Lesion Color
e. Elevation/depression
f. Demarcation (Boarders)
g. Border/margins
h. Presence of exudate
I. location and distribution
Annular
ring-shaped with clear center
Round(nummular)
Coin-shaped; solid circle or oval
Arcuate Lesion
(arc-shaped) often a result in incomplete formation of annular leasion
Multiform Lesion
Multiple different shapes located together
Polycyclic Lesion
formed from coalescing circles, rings or incomplete rings
Targetoid Lesion
Target like, center darker then the periphery
Punctae Lesion
Dot-like, typically around 1 cm
Umbilicated Lesion
central depression also known as “delled”
Liner Lesion
Straight Line
Serpiginous Lesion
Snake-like
What kind of exudate is mild, yellow, and cloudy discharge associated with mild infections?
Seropurulent
What exudate that is thick, yellow to green discharge is typically associated with infection?
Purulent
What exudate is thin, clear discharge associated with and expected in the inflammation stage of wound healing?
Serous
What is dried crust exudate?
Serum
What primary skin lesion is a Flat, a circumscribed area of color change less than 1 cm in diameter?
Macule
What primary skin lesion a flat, non-palpable, irregularly shaped macule greater than 1 cm in diameter?
Patch
What primary skin lesion is an elevated, firm circumscribed area less than 1 cm in diameter?
Palpule
What primary skin lesion is an elevated firm, rough, lesion, with a flat top greater than 1 cm in diameter?
Plaque
What primary skin lesion is elevated, circumscribed, superficial-filled(clear/serous), less than 1 cm?
Vesicle
What primary skin lesion is an elevated, superficial lesion, similar to a vesicle but filled with purulent fluid?
Pustule
What primary skin lesions an elevated, superficial lesions, similar to a vesicle but filled with purulent fluid greater than 1cm?
Bulla
What primary skin lesions are elevated, irregularly-shaped areas of cutaneous edema, solid, transient and. variable?
Wheal (Hive)
What primary skin lesions are elevated, firm, circumscribed lesions, deeper in the dermis than a papule, and 1-2 cm in diameter?
Nodule
What primary skin lesions are elevated and solid lesions, that may not be clearly demarcated, deep in the dermis, grater than 2 cm?
Tumor (mass)
What primary skin lesions are encapsulated lesions in the dermis or hypodermis filled with liquid or semi-solid material?
Cyst
What primary skin lesions are fine, irregular, red lines produced by capillary dilation?
Telangiectasica
What are the three categories of secondary skin lesions?
a. Accumulation of material
b. Change in the sin integrity or thickness
c. Loss of layers or skin breakdown
What are loose or adherent flakes composed of stratum corneum cells?
Scales
Examples: Psoriasis, Seborrheic Dermatitis
What are rough and thickened epidermis secondary to persistent rubbing, itching, or irritation?
Lichenification
Ex: Chronic Dermatitis, Atopic Dermatitis
What are dried serum, blood, or purulent exudates; slightly elevated?
Crust
ex: Scabs, Impetigo
What is a thick and fibrous tissue that replaces normal skin after injury to the dermis?
Scar
What is a overgrowth of scar tissue that remains confined to the site of initial injury, maybe raised or flat?
Hypertrophic scar
What is irregularly shaped, elevated scar that grows beyond the boundaries of the initial injury or wound and common in skin types IV-VI?
Keloid
What is thinning of the skin and loss of skin marking, skin can translucent and paper like?
Atrophy
With loss of skin layers loss of part of epidermis, doesn’t bleed, heals without scarring follows rupture of a vesicle or bulla?
Erosion
With loss of skin layers loss of epidermis and dermis, concave, may bleed, heals with scaring?
Ulcer
With loss of skin loss of epidermis, linear, hollowed-out crusted area, due to mechanical trauma (scratching)?
Excoriation
With loss of skin layers has linear crack in skin continuity from epidermis to dermis, can be moist or dry?
Fissure
What kind of hair loss has variable patchy and round hair loss on scalp?
Alopecia Areata
What kind of hair loss secondary to excessive/constant traction?
Traction Alopecia
What kind of hair loss secondary to scar formation and follicle loss?
Scarring Alopecia
What type of hair loss is loss of all scalp hair?
Alopecia Totalis
What type of hair loss is loss of all body hair?
Alopecia Universalis
What type of skin issue comes from HPV that occur on the soles of the feet, appear to have black dots and disrupt normal skin lines?
Plantar Warts
What skin like issue has accumulation of melanocytes/nevus cells in dermis, symmetric brown macule or papule with smooth, regular borders, typically have colors beige, pink, or brown, usually < 6 mm?
Nevus (Moles)
What are the three categories of abnormalities of the nail?
a. Injury
b. infectious
c. Systemic Disease
Subungal Hematoma
Bleeding from nail bed secondary trauma
Onychosis
Nail separated from distal nail bed, secondary to trauma, hematoma, fungus
Onychocyptosis
ingrowing of nail, secondary to improper trimming technique, shoe compression
Onychomycosis
- yellow, crumbling nail plate.
- Hyperkeratotic debris beneath
- Onychosis
Paronychia
- infection around nail
a. Bacteria
