Skin, hair and nails Flashcards
Vellus hair
short, fine hair
terminal hair
coarse, thick hair
eccrine sweat gland
evenly distribute sweat glands on skin
apocrine sweat gland
found in axillary and genital regions, stimulated by emotional stress
ABCDE
asymmetry, borders (irregular), color change, diameter (>6mm), elevation
basal cell carinoma
cancer of cells in the basal layer, most common, shiny, translucent, slow growing
scaly red to white-brownish patch
may itch or bleed
squamous cell carcinoma
cancer of cells on upper layer of epidermis, crusty, scaly, red, inflamed or ulcerated. Grows slowly and painlessly, but will grow rapidly after a while can spread (face, back of hands of older, fair skinned adults)
melanoma
cancer of the melanocytes, most lethal b/c it metastasizes easily
mixes of colors
>6mm
melanoma risk factors
having many moles having a few atypical moles red or light hair actinic lentigenes macular or tan spots (freckles) heavy sun exposure light eye or skin color family history
causes of central cyanosis
advanced lung disease
heart disease
abnormal hemoglobins
carotenemia
excess carotene in the blood causes by carrot, sweet potato rich diet
what to look for when examining lesion
- location and distribution
- patterns and shapes
- consistency
- color
- mobility (turgor)
- exudates (what is it draining)
cafe-au-lait spot
more than six may indicate neurofibromatosis, irregular border macule or patch
tinea versicolor
fungal infection of the skin
slightly scaly macules on trunk, neck and upper arms
may be pale (dark skin) or reddish (light skin)
vitiligo
depigmented macules on face, hands, feet where melanocytes are destroyed
hereditary/autoimmune condition
cyanosis
blue coloring (hypoxia) peripheral or central
erythema
red hue, increased blood flow
heliotrope
violaceous eruption over the eyelids
pityriasis rosea
reddish, oval ringworm-like lesions
psoriasis
silvery, scaly lesions mainly on extensor surfaces (elbow, knee)
atopic eczema
reddish
serpiginous
creeping or having a wavy border
annular, arciform
ring shaped
macule
small, flat spot up to 1.0cm (freckles)
patch
flat spot larger than 1.0cm (birthmark)
plaque
elevated lesion 1.0cm or larger (grouping of papules) (psoriasis)
papule
elevated lesion less than 1.0cm (chickenpox)
nodule
marble like lesion larger than 0.5cm that is deeper and firmer than a papule (rheumatoid nodules, dermatofibroma) “boggy” typically painful
wheal
irregular, transient area of localized swelling of the skin-allergic reaction (usually disappears within 24 hours)
vesicle
less than 1.0cm filled with fluid (herpes)
bulla
larger than 1.0cm filled with fluid (herpes)
pustule
filled with pus (indicates infection)
burrow
scabies (raised tunnel in the epidermis) linear
scale
thin flake of exfoliated epidermis
crust (2ndary)
dried residue of skin exudates (serum, pus or blood)
lichenification
palpable thickening of the epidermis
excoriation
scratching
fissure (2ndary)
linear crack (often from dryness) athletes foot
ulcer (2ndary)
deep loss of epidermis, bleeds and scars (bed sore)
lentigo
non-raised patch, caused by sun damage, typically brown
actinic keratosis
small, rough, raised area found on skin that has had long sun exposure (face, scalp, back of hands, chest) precursor to squamous cell carcinoma
seborrheic keratosis
non-cancerous wart-like growths, face, chest, shoulders, back, typically develops after 40 yrs. velvety feel
petechia
small, red spots, bleeding underneath the skin but outside the vessels (does not blanch) on the palate indicates strep pharyngitis
intertriginous
between or under skin folds
primary lesion
directly from an infectious process, palpable or non palpable (acne)
secondary lesion
stems from a primary lesion (scarring from acne)-may be caused by constant contact with primary lesion (repeated itching)
erosion (2ndary)
areas of skin where upper skin layer is lost (ckicken pox)
purpuric lesion
outside vessels (petechia, ecchymosis)
ecchymosis
larger than petechia >3mm, purplish, secondary to bruising, do not blanch, seen with bleeding disorders
telangiectasia
small dilated vessels on skin or mucous membrane. usually on the face, will blanch
spider angioma
usually benign can be up to 2 cm, usually on face, arms and upper trunk
assoc. with pregnancy, liver disease (can’t detox estrogen)
spider vein
usually bluish in color, usually on legs, can accompany varicose vein
dermatomal
covering a band of skin that corresponds to a nerve root (herpes zoster)- must describe which dermatom
things to note on palpation of skin
temperature moisture texture turgor (elasticity) edema
asteatosis
dry skin
flaky, rough, itchy skin
(hypothyroidism)
variations in temperature
warm to cool = normal
warm to hot = fever/infection or hyperthyroidism
cool to cold = hypothyroidism or systemic disease
raynauds
disease of the blood vessels
fingers will be cold
alopecia areata
hair loss from an area of the body, usually scalp
demarcated round patches of hair loss
may be immune-mediated
trichotillomania
hair loss from pulling or plucking
anxiety, OCD
varying lengths of hair
tinea capitis
ringworm (fungal infection)
will see broken hairs
paronychia
infection of nail bed
may spread around nail bed and will be painful
herpetic whitlow
vesicular, contains serous fluid
infection of herpes virus
onycholysis
separation of nail plate from nail bed at distal margin
trauma, psoriasis, fungal infection (onychomycosis)
diabetes, hyperthyroidism
note when examining nails
brittle (hypothyroid)
fine vs coarse
dry vs oily
leukonychia
white spots
usually related to trauma
beau’s lines
deep lines that indicate stopped cell division
related to severe illness
nail grows 1mm every 6-10 days
Mee’s lines
white line that appears like lunula
arsenic poisoning, carbon monoxide
sometimes heart failure,
nail pitting
matrix like nail bed
usually with psoriasis
may also been seen in Reiters, sarcoidosis
clubbing
chronic, persistent hypoxia
nail looks like a club
Terry’s nails
loss of vascularity
assoc with liver disease and CHF, DM and malnutrition
similar in appearance to Mee’s lines, but ground glass appearance
decubitus ulcer
pressure sore or bed sore
cellulitis
infection in the skin, especially dermal