Skin Flashcards
Three layers
Epidermis
Dermis
Subcutaneous tissue
Carotene
yellow pigment
Vellus hair
short, fine, less pigmentation
Terminal hair
coarser, pigmented (scalp/eyebrows)
SEBACEOUS GLANDS
present all surfaces except palms/soles; produce a fatty substance secreted onto skin surface through hair follicles
SWEAT GLANDS
Eccrine glands and Apocrine glands
Eccrine glands
sweat glands. widely distributed, open directly onto skin surface, help control body temperature
Apocrine glands
sweat glands. found in axilla and groin, stimulated by emotional stress
Skin cancers are
most common cancers in the U.S.
Most prevalent on hands, neck, and head
types of skin cancers
Basal cell carcinoma
Squamous cell carcinoma
Melanoma
BASAL CELL CARCINOMA (BCC)
Comprises 80% of skin cancers
Shiny and translucent, they grow slowly and rarely metastasize
most common type of skin cancer
basal cell carcinoma
Basal cell carcinoma: the most ___ type of skin cancer
common
Basal cell carcinoma: it is typically seen in
older adults
Basal cell carcinoma: has no known
precursor lesion
Basal cell carcinoma: Approximately 80% of BCCs occur on the
head and neck
Basal cell carcinoma: rarely
metastasize and grow slowly for years prior to developing a more rapid growth rate
Basal cell carcinoma: once the growth speeds up, they grow relentlessly and,
if left untreated, can cause extensive local destruction and disfigurement.
Basal cell carcinoma: typically begins as a
small, translucent or pink, pearly papule with small telangiectasias on the surface.
SQUAMOUS CELL CARCINOMA: over all description
Crusted, scaly, and ulcerated, they can metastasize
Squamous cell carcinoma: possesses the potential to
metastasize, the risk of which depends on various factors.
Squamous cell carcinoma: The most common first site of metastasis is the
regional lymph nodes
Squamous cell carcinoma: prognosis
poor with 10-year survival rates of less than 20% for patients with advanced regional lymph node involvement.
Squamous cell carcinoma: precursor lesion
a precursor “premalignant” lesion termed actinic keratosis (AK). AKs are extremely common in fair-skinned older Caucasian individuals who have had significant chronic sun exposure.
Squamous cell carcinoma: actinic keratosis (AK)
occur as well-demarcated, scaly, rough patches or plaques on chronic sun-exposed skin surfaces. Their color can vary from skin-colored, erythematous, pink, or to brown, and they are often more easily palpated than seen.
Melanoma overview
Comprises 4% of skin cancers
Rapidly increasing in frequency, they spread
> 6 mm
HARMM: risk factors for melanoma
History of previous melanoma Age over 50 Regular dermatologist absent Mole changing Male gender
ADITIONAL RISK FOR MELANOMA (besides HARMM)
≥50 common moles
≥1-4 atypical or unusual moles (especially if dysplastic)
Red or light hair
Solar lentigines, macular brown or tan spots (usually on sun exposed areas)
Heavy sun exposure (especially severe childhood sunburns)
Light eye or skin color (especially freckles/burns easily)
Family history of melanoma
ABCDE:
Screening Moles for Possible Melanoma
A for asymmetry
B for irregular borders, especially ragged, notched, or blurred
C for variation or change in color, especially blue or black
D for diameter ≥6 mm or different from other moles, especially changing, itching, or bleeding
E for evolution or change in size, symptoms, or
morphology
Red color of oxyhemoglobin best assessed at
fingertips, lips, and mucous membranes
In dark-skinned people, palms and soles
For central cyanosis, look in
lips, oral mucosa, and tongue
Look for jaundice in
sclera
Mobility and turgor
Lift fold of skin
Note ease with which it lifts up (mobility) and speed with which it returns to place (turgor)
things you look for when checking skin (categories)
Moisture
Temp
Texture
Mobility and turgor
NAILS: Longitudinal bands of pigment may be
a normal finding in people with darker skin
Onychomycosis is a
fungal infection of the nails that causes discoloration, thickening, and separation from the nail bed
Paronychia
a skin infection around the fingernails or toenails. It usually affects the skin at the base (cuticle) or up the sides of the nail
primary vs secondary lesions
primary are flat, secondary have loss of the skin surface
secondary lesions: Erosion:
loss of superficial epidermis, surface moist but does not bleed
secondary lesions: Ulcer:
a deeper loss of epidermis and dermis, bleed and scar
secondary lesions: Fissure:
a liner crack in the skin
secondary lesions: Materials on the skin surface
Crust: the dried residue of serum, pus, or blood
Scale: a thin flake of exfoliated epidermis
Miscellaneous Lesions
Lichenification: Thickening and roughening of the skin
Atrophy: Thinning of the skin with loss of the normal skin furrows
Pressure sores result when
sustained compression obliterates arteriolar and capillary blood flow to the skin
Pressure sores: Assess these patients by carefully inspecting the skin that overlies the
sacrum, buttocks, greater trochanters, knees, and heels
P. 182-183 Describing skin findings
Table 6-1 to Table 6-8 (p. 191-205)
Table 6-10 (p. 207-208): Focus on DM, SLE, Thyroid disease
Study skin lesions in Blackboard: Pityriasis rosea, Tinea Versicolor, Psoriasis, Atopic Eczema
time permitting (use conversation table)
what are the 4 stages of pressure ulcers
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