SKIN Flashcards
arises from free nerve endings (nonmyelinated
- Itching - Pruritus
Severe Itching
Pruritus
o Like itching, may be localized or generalized acute or chronic, and caused by an obvious dermatologic problem or an underlying systemic problem.
RASHES
Temperature fluctuations
Cold Urticaria
Air humidity
o Warm Weather Skin Rash
Exposure to contaminants
Cutaneous Anthrax
The most common types are caused by vascular disease or pressure or by diabetes.
Non - healing sore or chronic ulceration
▪ Decrease in color of the skin caused by lack of oxygen in the body. Best observed around fingernails, lips, palpebral conjunctiva, and oral mucosa; likewise, on the palms of hands and soles of feet
PALLOR
▪ Bluish discoloration of the skin due to lack of oxygen or poor tissue perfusion ▪ best observed on the lips and nail beds
Cyanosis
Cause by diseases of heart and lungs. Bluish discoloration of tongue and linings of the mouth.
CENTRAL CYANOSIS
Results from decreased peripheral circulation. Seen at the arms and legs.
PERIPHERAL CYANOSIS
Also known as icterus; a yellowish appearance of the skin, sclera, mucous membranes, and excretions related to hepatobiliary disorders or hemolytic diseases.
Jaundice
Redness of the skin due to congestion of the capillaries
Erythema
BIRTHMARKS
Hyperpigmentation
Destruction of melanocytes in the area.
Hypopigmentation
VITILIGO
Complete or partial lack of melanin.
Hypopigmentation
ALBINISM
Odors from excessive sweating
(hyperhydrosis)
Possible thyrotoxicosis
excess thyroid hormone)
Odors from night sweats
Possible tuberculosis
Urine odor
Incontinence problem
▪ Initial alteration in the skin
▪ abscess, ulcer, tumor, and open wound
Primary skin lesions
▪ Arises from a change in a primary lesion
▪ crusts, kelloids, scars
Secondary skin lesions
The ABCDE of Lesions
▪ Assymetry
▪ Border Irregularity
▪ Color Variations
▪ Diameter
▪ Elevation
Small, flat, nonpalpable skin color change (skin color may be brown, white, tan, purple, red).
Macule and Patch
- The collection of small blood vessels
Cherry Angioma (Macule)
small brown patches on the skin typically on elderly people
Lentigines (Macule)
- tiny circular bleeding under the skin
▪ Petechiae (Macule)
bright red rash that covers most of the body, bacterial illness that develops in people with strep throat
Scarlet fever (Macule)
- mask of pregnancy
Chloasma (PATCH)
- congenital dermal melanocytosis. flat and blue-gray
- typically appear on the buttocks or lower back, but may also be found on the arms or legs
Mongolian spot (PATCH)
- discoloration of the human skin caused by a vascular anomaly
- a capillary malformation in the skin
Port-wine stain (PATCH)
*A long-term skin condition characterized by patches of the skin losing their pigment
▪ Vitiligo (PATCH)
▪ Elevated Nevi
▪ benign (noncancerous) moles, also known as dysplastic nevi
▪ Warts
▪ growths on skin caused by an infection with humanpapilloma virus, or HPV
Papules
▪ Actinic Keratosis
▪ crusty, scaly growth caused by damage from exposure to ultraviolet (UV) radiation
▪ Psoriasis
Plaque
o Elevated mass with transient borders that is often irregular. Size and color vary. Collection of edema fluid into the dermis. Raised, superficial, and temporary.
Wheal
- outbreak of swollen, pale red bumps or plaques on the skin that appear suddenly
- either as a result of the body’s reaction to certain allergens, or for unknown reasons
HIVES (wheals)
- lump of fatty tissue between your skin and the underlying muscle
- it feels rubbery, and you may be able to move it around a bit
- usually painless, harmless, and not cancerous
Lipoma (NODULES)
- the second most common form of skin cancer
- usually found on areas of the body damaged by UV rays from the sun or tanning beds
Squamous cell carcinoma (NODULES)
- superficial benign fibrous histiocytoma
- a common cutaneous nodule of unknown etiology that occurs more often in women
- frequently develops on the extremities (mostly the lower legs) and is usually asymptomatic, although pruritus and tenderness can be present
Dermatofibroma (NODULES)
o Encapsulated fluid-filled or semisolid mass that is located in the subcutaneous tissue or dermis o 1 cm or larger elevated o Palpable, solid with depth into dermis
Cyst
o Palpable, fluid filled
o Palpable, fluid filled
- set of viruses that produce viral infections in the majority of humans
- can be spread when an infected person begins shedding the virus
Herpes simplex (VESICLES)
- also called chickenpox
- a very contagious viral disease
- usually mild, but it can be serious in infants under 12 months of age, adolescents, adults, pregnant women, and people with weakened immune systems
Varicella (VESICLES)
- caused by an allergic reaction to an oily resin called urushiol (u-ROOshe-ol)
- this oil is in the leaves, stems and roots of poison ivy, poison oak and poison sumac
Poison ivy rash (VESICLES)
- partial thickness burns
- affect the epidermis and the dermis (lower layer of skin)
Second-degree burns (VESICLES)
- rare group of blistering autoimmune diseases that affect the skin and mucus membranes
Pemphigus (BULLA)
- red, itchy rash caused by direct contact with a substance or an allergic reaction to it, not contagious but very uncomfortable
Contact dermatitis (BULLA)
caused by burns
▪ Large burn blisters (BULLA)
caused by bacterial infection
Bullous impetigo (BULLA)
o Thickening and scaling with increased skin markings,
- Lichenification
Eczema
- Lichenification
o Shedding of dead skin cells
o Can be either dry or oily
o Flaking of the skin surface
o Maybe adherent or loose o Variable in color
Scales
Psoriasis
Scales
o Dried exudates, dried serum, blood or pus on the surface of the skin,
Crust
Impetigo
Crust
o Skin mark left after healing of wound or lesion that represents replacement by connective tissue of the injured tissue o Young scars are red or purple, whereas mature scars are white or glistening
Scar
o Hypertrophic scarring because of excess collagen formation
Keloid
o Raised and irregular
Keloid
o Abrasion or other loss that does not extend beyond the superficial epidermis o Loss of outer skin layers from scratching or rubbing
Excoriations
o Ex. Scabies
Excoriations
o Loss of superficial epidermis that does not extend to the dermis
Erosions
o Ex. Dermatophyte
Erosions
o Skin loss extending past epidermis, with necrotic tissue loss.
o Bleeding and scarring are possible
Ulcers
o Ex. Stasis ulcer
Ulcers
o Thinning of skin with transparent appearance
Atrophy
o Ex.Thinning of skin due to aging
Atrophy
Lesions are associated with bleeding, aging, circulatory conditions, diabetes, pregnancy, and hepatic disease, among other problems
Vascular Lesions
▪ Round or irregular macular lesion that is larger than petechial lesion
▪ The color varies and changes: black, yellow, and green hues
▪ It is secondary to blood extravasation and associated with trauma, injury and bleeding tendencies
Ecchymosis
▪ Secondary to blood extravasation
▪ Caused by steroids, vasculitis, systemic diseases
▪ Associated with bleeding tendencies or emboli to skin ▪ Round red or purple macule that is 1–2 mm in size
Petechia
▪ Papular and round, red or purple lesion found on the trunk or extremities
▪ It may blanch with pressure
▪ It is a normal age – related skin alteration and usually not clinically significant
Cherry Angioma
▪ Red arteriole lesion with a central body with radiating branches
▪ Associated with liver disease, pregnancy, and vitamin B deficiency
▪ Usually noted on the face, neck, arms, and trunk, rare below the waist
▪ Compression of the center of the arteriole completely blanches the lesion
Spider Angioma
▪ It does not blanch when pressure is applied
▪ It is secondary to superficial dilation of venous vessels and capillaries
▪ Associated with increased venous pressure states (varicosities)
▪ Bluish or red lesion with varying shape
Telangiectasis
▪ A localized collection of blood creating an elevated ecchymosis
▪ It is associated with trauma
Hematoma
▪ Red color
▪ Irregular-shaped macular patch
▪ Strawberry marks
Capillary Hemangioma
Red color
▪ Seen with dilation of dermal capillaries
o Port - wine stain
o Caused by sebaceous gland overactivity with plugging of hair follicles and retention of sebum, resulting in papules, and pustules
o Onset is typically at puberty, but acne may last into advanced age
o Greater incidence in males
o Caused by Propioni Bacterium Acne
o Most common on face, back, and shoulders
o Lesions may be sore and painfulo Aggravated by emotional distress, greasy topical applications (cosmetics), and certain medications (oral contraceptives, isoniazide, rifampin, lithium, phenobarbital)
Acne Vulgaris
o Causes reddish, irregular, slightly raised lesions that have a rough, gritty surface
o Sign of sun-damaged skin
o Precancerous lesion, may progress to squamous cell cancer o Typically less than 1 cm in diameter
o Generally on sun-exposed areas of face, head, neck, and hands
Actinic Keratosis
o Localized skin irritation, inflammation, and pruritus from contact with an irritating substance
o Can occur as an additive effect of multiple irritants (soaps, detergents, or chemicals) or allergy to a specific agent (topical to a specific agent, topical medication, plant oils, or metals)
o Secondary infections may occur at the site
o Edema may occur, with development of vesicles and bullae
o Vesicles or bullae may rupture, causing crusting
o Edema may be very significant, particularly when face or genitalia are involved
Contact Dermatitis
o Causes redness, pruritus, scratching, and skin lesions in a person with a predisposition to skin irritations
o Red to red-brown, slightly scaly lesions
o Lichenification with increased skin markings common
o Exudative
o Common sites include face, neck, upper trunk, wrists, hands, and flexor surfaces (folds) of knees and elbows
o Lesions on face, neck, and upper trunk are called monk’s cowl o Itching can be quite severe
o Sites may develop secondary infection
o May be triggered by changes in temperature, emotional stress, or food allergies
Eczema / Atomic Dermatitis
o A contagious disease caused by the herpes simplex virus (HSV1 & HSV2)
o Recurrent clusters of small vesicles on erythematous base
o Sites burn and sting
o Neuralgia often occurs
Herpes Simplex
o A superficial dermatitis in the skinfolds
o Caused by heat, moisture, and friction, and is most common in obese people
o Pink to reddened skin in body folds (between and beneath buttocks, beneath fatty abdominal pad, or beneath pendulous breasts)
o Areas in folds develop erythema, fissures, and denudationo Lesions may itch, burn, or sting
Intertrigo
o A common, mild, acute inflammatory skin disease
o Often described as “Christmas tree” rash because of shape
o Rash may last 4 to 8 weeks
o Can be intensely pruritic
o Believed to be caused by viral infection
Pityriasis Rosea
o A common dermatitis that has genetic causes and may begin at any age
o Silvery scales on bright red papules
o Scales generally thick
o Area beneath bleeds if scale is removed
o Usually occurs on extensor surfaces of knees, elbows, and scalp
o Itching may be mild or severe
o A genetic predisposition is suggested by family history
Psoriasis
o A chronic disorder of unknown cause that occurs mainly on the face
o Acne component with papules, pustules, and seborrhea
o May be aggravated by alcohol, caffeine, chocolate, heat, and spicy foods, as well as by situations that promote flushing
Rosacea
o A disorder of the sebaceous glands that causes an increase in the amount of sebaceous secretion
o Typical sites include scalp, face (between brows, along sides of nose, at mustache / beard areas) and on presternal, interscapular, and umbilical regions
o Itching may be present o Fissuring is possible with secondary infections
o “Super dandruff” is common term because it occurs along sites with greater hair distribution
Seborrhea
o A benign skin lesion that may be pigmented
o Sharply demarcated lesions o Brown to black pigmentation
o Rough, dry surface
o Elevation o Surrounding skin generally normal
o Incidence increases with age
o Generally found on trunk, although potentially can occur anywhere
Seborrheic Keratosis
o Eczema of the legs with pigmentation, edema and chronic inflammation resulting from venous insufficiency
o Stasis ulcer is associated with stasis dermatitis and develops from venous insufficiency
o Red, scaly patch often initial sign
o Site develops vesicles and crusts o Ulcer may develop as a result of trauma, edema, or infection
o Caused by poor circulation, which can be related to peripheral vascular diseases, obesity, or poor nutrition
Stasis Dermatitis
o A fungal infection of the scalp
o Well-demarcated, reddened area
o Scaling, itching
o Dry, brittle hair
Tinea Capitis
o a fungal skin disease occurring anywhere on the body
o Ringworm
o Ring-shaped erythematous lesions on body
o Advancing border with small vesicles
o Pruritic
o Most often on exposed surfaces
Tinea Corporis
o a fungal skin disease occurring in the genital and anal areas in males
o Sharply demarcated, reddened areas
o Severe pruritus
Tinea Cruris
o a fungal skin disease occurring in the genital and anal areas in males
o Sharply demarcated, reddened areas
o Severe pruritus
Tinea Cruris
o A fungal skin disease occurring in the foot
o Athlete’s foot
o Exfoliating, fissuring, macerated area of erythema
o Sites itch, burn, and / or sting
Tinea Pedis
o An invasive, cancerous skin tumor with strong potential for metastasis to both regional and distant sites and organs
o Commonly presents as a black or purple nodule
o Other color variations include pink, tan, brown, red, or even “normal” tones
o May also be flat or pedunculated
o Erythema may surround lesion
o May ulcerate or become friable o May be found on any location, including sun- exposed areas, palms, or soles
Melanoma
o A form of skin cancer occurring mainly in the squamous cellso Pink, scaly, elevated lesions
o Base of lesions may be inflamed
o Typically on sun-exposed surfaces, including scalp, hands, lips, and ears
Squamous cell carcinoma
o An epidermoid cancer, one of the most common malignant skin diseases
o Rarely metastatic
o Typically has pearly, flesh-colored or transparent “rolled” border
o Usually occurs on sun-exposed surfaces, especially the face
Basal cell carcinoma
remains elevated after being pulled up (PINCHED) and released
Skin Turgor
o Full-thickness loss with extensive involvement of muscle, bone, or supporting structures
o This deep ulcer may involve undermining and sinus tracts of adjacent tissues
Grade 4 ULCER
o Full-thickness loss involving subcutaneous tissue
o Ulcer may extend to but not through fascia
o A deep crater that may undermine adjacent tissues
Grade 3 ULCER
o Partial-thickness loss involving both epidermis and dermis
o Ulcer is still superficial and appears as a blister, abrasion or very shallow crater
Grade 2 ULCER
o Nonblanchable erythema of intact skin
o Indicates potential for ulceration
Grade 1 ULCER
