Skin, Hair And Nails Flashcards
Thinning of the skin with loss of normal skin furrows?
Atrophy
What is thickening and roughening of the skin?
Lichinification
An abrasion or scratch mark of the epidermis
Excoriation
Replacement of destroyed tissue by fibrous connective tissue
Scar
Blocked sebaceous gland; a common blackhead
Comedo
Dilated small blood vessels
Telangiectasia
Hardening of the skin
Sclerosis
Elevated enlarging scar beyond the boundaries of the wound
Keloid
A bluish discoloration of the mucous membranes and skin caused by reduced or deoxygenated hemoglobin in the small blood vessels
Cyanosis
When the concentration of the arterial blood O2 is low due to poor oxygenation in the lungs or shunts
Imparts a bluish tinge to the tongue and lips
Central cyanosis
A yellow color of the skin and sclera caused by deposition of bilirubin secondary to increased bilirubin levels in the blood
Jaundice
Massive lysis of red blood cells (sickle cell anemia, malaria) producing bilirubin faster than the liver can conjugate it
Hemolytic jaundice
Damage to the liver cells (cirrhosis or hepatitis patients) causing a decrease in both bilirubin uptake and conjugation
Hepatocellular jaundice
Obstruction of the bile ducts (presence of gall stones or a hepatic tumor)
Obstructive jaundice
Too much vitamin A , a yellowing of the skin caused by a diet high in carrots, yellow not in sclera
Carotenemia
Superficial infections caused by dermatophytes
Tinea
The infected area shows scaling, erythema, reddish or grayish patches
Tinea
A common benign acute or chronic skin disease that appears to be based on genetic predisposition , irritation or injury of the normal akin tends to induce lesions
Psoriasis
Koebners phenomenon
Injury or irritation of the normal skin tends to induce lesions pertaining to psoriasis
Red plaques with silvery scales on elbows and knees, with scaliness
Psoriasis
Well demarcated effecting extensor surfaces
Psoriasis
Poorly demarcated plaques in flexural distribution
Atopic dermatitis
Diffuse patchy redness and scaling
Seborrheic dermatitis
Scraping and culture and examination of the hair and nails distinguishes
Psoriasis from candidiasis
A papule or nodule that may have a scab or central erosion- grows very slowly attaining 1-2 cm or more in diameter
Basal cell carcinoma
A waxy, pearly appearance, with telangiectatic vessels easily visible with this condition
Basal cell carcinoma
Occurs on exposed parts in fair skinned individuals who sunburn easily /tan poorly
Squamous cell carcinoma
Small red, conical, hard nodules and occasionally ulcerate
Squamous cell carcinoma
Vary from macules to nodules, varies in color, irregular boarder, grow may be rapid or indolent
Malignant melanoma
Warning signs of malignant melanoma
asymmetry, boarder, color, diameter, elevation, friable
Superficial, flattened papules covered by dry scales, appear on sun exposed skin on older fair skinned patients
Actinic keratosis
Common, benign yellowish to brown raised lesions that feel greasy or velvety , appear on face and trunk
Seborrheic keratosis
Ranges from one or two circular patches of complete hair loss on the scalp or in beard area
Alopecia areata
Usually genetically determined, an autosomal dominant, may begin early in life, temporal recession of hair goes first
Male pattern alopecia
Excessive growth of hair or presence of hair in unusual places
Hirsutism
What are the 5 basic causes of hirutism
- Adrenal virilism 2. Ovarian virilization, 3. Ovarian failure 4. Androgenic drugs
A destructive fungal infection of one or more fingernails or toenails - no symptoms
Onychomycosis
The nails of this condition are luster less, brittle, and may hyper trophy , the substance is friable and pithy
Onychomycosis
Why is onycomycosis difficult to treat?
A long duration of therapy is required and frequency of recurrence
Does topical treatment help onychomycosis?
No, systemic therapy is required, griseofulvin 750 mg QD for 6 months is effective
Horizontal depressions across the nail plate caused by transient arrest in nail growth
Beaus lines
What can cause beaus lines?
Acute stress such as MI, high fever, shock, pulmonary embolism
How long does the nail plate take to grow?
3 to 4 months
A bulbous enlargement of and broadening of the fingertips
Clubbing
The tissue between the nail and underlying bone has a spongy quality that gives a floating sensation when pressed on in what condition?
Clubbing
What causes clubbing?
Hyperplasia of the fibrovascular tissue between the nail matrix and the bony phalanx
Clubbed fingers are indicative of what
Cardiac disease, pulmonary disease, or GI disease
Spoon nails caused by softening and thinning of the nail plate resulting in concave or spoon shaped nails
Koilonychia
Patients with iron deficiency or Plummer-Vinson syndrome can develop what
Koilonychia
Hemochromatosis, raynauds syndrome and an autosomal dominant disorder can lead to this
Koilonychia
The distal separation of the nail palate from the nail bed caused by excessive exposure to water, soaps and detergents
Onycholysis
Psoriasis and hypo hyperthyroidism can cause this
Onycholysis
Inflammation of the proximal and lateral nail folds
Paronychia
What do you not when you inspect and palpate the skin ?
Color, vascularity, moisture, texture, temperature, mobility and turgor
How do you observe any lesions of the skin?
Anatomical location/distribution, grouping/arrangement, color, type
What do you look for when inspecting and palpating the fingernails and toenails?
Color, shape, lesions
What do you look for when inspecting the mucous membranes?
Moisture, pigmentation, cyanosis, pallor, jaundice and lesions
What do you inspect and palpate in the head exam?
Skull, scalp, face, hair, skin
Psoriasis has what kind of lesion?
Plaque
Erythema nodosum is what kind of skin lesion?
Nodule
Herpes simplex, impetigo, chicken pox and scabies are what kind of lesions ?
Vesicles
Skin that has a purulent exudate that may be white, yellow or greenish yellow
Pustule
Acne and pustular psoriasis are what lesions
Pustule
What is an ulcer
A deeper loss of skin surface, may bleed and scar
What is fissure
A linear crack in the skin, groove or deep furrow, may be seen with eczema
What is seen with eczema, impetigo and tinea?
Crust
Psoriasis, seborrhea, pityriasis rosea and tinea have what in common?
Scales
Peripheral cyanosis can be caused by what?
Exposure to cold, congestive heart failure, and peripheral vascular disease
Where should you look for jaundice?
Sclera, lips, hard palate, undersurface of the tongue and the skin
Malaria and sickle cell anemia patients can have what?
Hemolytic jaundice
Hepatocellular jaundice can be seen in what patients?
Cirrhosis and hepatitis
What patients have obstructive jaundice?
Gallstones or hepatic tumor
Where should you look for pallor in patients?
fingernails, lips and mucus membranes (especially those of the mouth and palpebral conjunctiva)
What is a cafe au lait spot?
Slightly but uniformly pigmented Macule or patch with somewhat irregular boarders
When does neurofibromatosis occur?
Six or more spots of cafe au lait with a diameter that’s greater than 1.5 cm
A bright red faintly pulsatile lesion containing a central arteriole
Spider angioma
A massive number of spider angioma may indicate a disease T or F
True
Spider angioma is seen in what patients?
Hepatic cirrhosis
What is cherry angioma?
Bright or ruby red Macule or papule 1-3 mm in size
Petechia vs purpura
A deep red or reddish purple fading away over time but petechia is less than .5cm whereas purpura is greater than .5
Eccymosis
Blood outside the vessels , seen in bleeding disorders
Over 2/3 of these patients have a personal or family history of allergic rhinitis, hay fever or asthma
Atopic dermatitis
The itch that rashes condition
Atopic dermatitis
Acute, poorly defined erythematous patches, papules and plaques
Atopic dermatitis
What is treatment for atopic dermatitis ?
They are sensitive to low humidity and gets worse in winter.
Tell patient to avoid bathing more than once a day, use no drying soaps , use emollients , corticosteroids, avoid dairy products and wheat
Seborrheic dermatitis
Very common chronic dermatosis characterized by redness and scaling
Occurs in regions where sebaceous glands are most active like face and scalp
Seborrheic dermatitis
Simple dandruff
Presence of mild scaling without erythema
Thrush
Oral candidiasis - usually painful and looks like creamy white curd like patches overlying erythematous mucosa
Oral candidiasis is seen in what patients?
Denture wearers, diabetics, anemia , chemotherapy, receiving corticosteroids or broad spectrum antibiotics
What are the risk factors of Vulvovaginal candidiasis?
Pregnancy, uncontrolled diabetes, broad spectrum antibiotics, corticosteroid use and aids
What is the diagnosis for tinea?
Scrapings of the lesions, by direct microscopic examination of a potassium hydroxide preparation or by culture
What is treatment for tinea?
Topical anti fungal preparations and possible systemic treatment
Tinea corporis
Ringworm of the body
Tinea pedis
Feet
Tinea unguium
Nails
Tinea capitis
Scalp
Tinea cruris
Jock itch
Tinea Barbae
Bearded areas
What is diagnostic for basal cell carcinoma ?
The translucent or pearly quality
