Skin exam

Question 1

What are the 5 things to look for when palpated the skin?

Answer 1

Moisture
Minimal perspiration or oiliness should be present.

Temperature
Use the dorsal surface of your hands or fingers.

Texture
Smooth, soft, and even

Turgor
Altered if the patient is substantially dehydrated or if edema is present

Mobility
Move easily when pinched, and return to place immediately when released

Question 2

What are the 4 thing to look for when inspecting and palpating the hair?

Answer 2

Color
Texture
Distribution
Lesions

Question 3

What are the 4 things to look for when inspecting and palpating the nails?

Answer 3

Shape and Contour
Consistency
Color
Capillary Refill

Question 4

What are some abnormal findings of the skin color?

Answer 4

Pallor - paleness
Vitiligo - patches
Depigmentation - loss of color
Hyperpigmentation - darker color
Acrocyanosis - blueness of the hands or feet in infants
Cyanosis - blue
Erythema - red
Jaundice - yellow

Question 5

What are the two types of skin lesions?

Answer 5

Primary―those that occur as initial spontaneous manifestations of a pathologic process
Secondary―those that result from later evolution of or external trauma to a primary lesion

Question 6

What are the characteristics of skin lesions?

Answer 6

Size (measure all dimensions)
Shape
Color
Texture
Elevation or depression
Attachment at base
- Pedunculated―having a stalk
- Sessile―without a stalk
Exudates
-Color
-Odor
-Amount
-Consistency
-Configuration
  Annular (rings)
  Grouped
  Linear
  Arciform (bow-shaped
Location and distribution
-Generalized or localized
-Region of the body 
-Patterns 
-Discrete or confluent

Question 7

Describe a macule.

Answer 7

flat circumscribed area that is a change in the color of the skin; less than 1 cm in diameter.
examples - freckles, flat moles, measles, petechiae

Question 8

Describe a papule.

Answer 8

an elevated, firm, circumscribed area; less than 1 cm in diameter
example - wart (verruca), elevated, moles, lichen planus

Question 9

Describe a patch.

Answer 9

a flat, nonpalpable, irregularly shaped macule greater than 1 cm in diameter.
example - vitiligo, port-wine stains, mongolian spots

Question 10

Describe a plaque.

Answer 10

Elevated, firm, and rough lesion with flat top surface greater than 1 cm in diameter.
example - psoriasis, seborrheic, and actinic keratoses

Question 11

Describe a wheal.

Answer 11

Elevated, irregular shaped are of cutaneous edema; solid, transient, variable diameter
example - insect bites, allergic reactions

Question 12

Describe a nodule

Answer 12

elevated, firm, circumscribed lesion; deeper in dermis than a papule; 1-2 cm in diameter
example - lipoma, erythema nodosum

Question 13

Describe a tumor

Answer 13

elevated and solid lesion, may or may not be clearly demarcated; deeper is dermis; greater than 2 cm in diameter

Question 14

Describe a vesicle

Answer 14

elevated, circumscribed, superficial, not into dermis; filled with serous fluid; less than 1 cm in diameter.
ex. - varicella, herpes zoster

Question 15

Describe a bulla.

Answer 15

vesicle greater than 1 cm in diameter

ex. - blister, pemphigus, vulgaris

Question 16

Describe a pustule.

Answer 16

elevated, superficial lesion; similar to a vesicle but filled with purulent fluid
ex. - impetigo, acne

Question 17

Describe a cyst.

Answer 17

elevated, circumscribed, encapsulated lesion; in dermis or subcutaneous layer; filled with liquid or semisolid material.
ex. - sebaceous cyst, cystic acne

Question 18

Describe a telangiectasia.

Answer 18

fine, irregular, red lines produced by capillary dilation.

ex. - telangiectasia in rosacea

Question 19

Secondary skin lesions

Answer 19

A

Question 20

Describe a scale.

Answer 20

heaped- up, keratinized cells; flaky skin; irregular; thick or thin; dry or oily; variation in size.
ex. - flaking of skin with seborrheic dermatitis or following a drug reaction

Question 21

Describe a lichenification.

Answer 21

rough thickened epidermis secondary to persistent rubbing, itching, or skin irritation,; often involves flexor surface of extremity.
ex. - chronic dermatitis.

Question 22

Describe a keloid

Answer 22

irregularly shaped, elevated progressively enlarging scar; grows beyond the boundaries of the wound; caused by excessive collagen formation during healing.
ex. - keloid

Question 23

Describe a scar.

Answer 23

thin to thick fibrous tissue that replaces normal skin following injury or laceration to the dermis.
ex. - healed wounds

Question 24

Describe a excoriation.

Answer 24

Loss of the epidermis; linear hollowed-out, crusted area

ex. - abrasion or scratch, scabies

Question 25

Describe a fissure

Answer 25

linear crack or break from the epidermis to the dermis; may be moist or dry
ex. - athletes foot

Question 26

Describe an erosion.

Answer 26

loss of part of the epidermis; depressed, moist, glistening; follows rupture of a vesicle or bulla.
ex. - varicella, variola after rupture

Question 27

Describe an ulcer

Answer 27

loss of epidermis and dermis; concave; varies in size

ex. - decubiti, stasis ulcers

Question 28

Describe a crust

Answer 28

dried serum, blood, or purulent exudates; slightly elevated; size varies; brown, red, black, tan, or straw-colored
ex. - scab on abrasion, eczema

Question 29

Describe a atrophy

Answer 29

thinning of the skin surface and loss of skin markings; skin translucent and paper-like
ex. - striae, aged skin

Question 30

Pregnant women must be inspected for…

Answer 30

Striae gravidarum (stretch marks)
Telangiectasias/hemangiomas
Cutaneous tags 
Increased pigmentation 
Palmar erythema
Itching
Altered hair growth

Question 31

What is trichotillomania?

Answer 31

hair pulling