Skin, Hair and Nails Flashcards
What are 5 questions to ask about previous skin disease?
- Any previous skin disease
- How was it treated
- Any family history of allergies or allergic skin problems
- Any known allergies to drugs, plants or animals
- Any birthmarks or tattoos
Why would you ask if person has any previous skin diseases or family history of? What are some common ones
- To see if it is caused by genetics
- Allergies
- Hayfever
- Psoriasis
- Atopic dermatitis (eczema)
- Acne
Why would you ask if they have any allergies?
To identify offending allergins
Why would you ask if there are any birthmarks/ tattoos
There is a risk of Hepatitis C, which is increased by the use of non sterile equipment when applying tattoos
Define hypo/hyper pigmentation
Hypopigmentation: loss of pigmentation
Hyperpigmentation: increase in colour
Why would you ask if skin colour change is all over or localized? Give 3 examples
Generalized: suggestive to systemic illness
- pallor, jaundice, cyanosis
What would be concerning about a change in mole size, pigmentation
Possible neoplasm in pigmented nevus
What is oily and dry skin called
Oily: seborrhea
Xerosis: dry
What are some common skin problems?
Dry skin, aging, drug reactions, allergies, obstructive jaundice, uraemia and lice infestation
What are 3 questions you would ask regarding moles?
- any change in colour, size, shape
- Any sudden tenderness, bleeding or itching
- Any sores that do not heal
What are 3 questions you would ask in regards to excessive dryness or moisture?
- Any change in skin temperature, moisture or texture
- Any excess dryness and is it seasonal or constant
What are 4 questions to ask about pruritus?
- Any skin itching (mild or intense)
- Does it awaken you from your sleep?
- Where is the itching and when did it start?
- Any other skin pain or soreness? Where?
What could skin pain come from in regards to pruritus?
Excoriation of primary lesion caused by scratching
What are some questions to ask about bruising?
- Any excess bruising
- Where
- How did it happen
- How long have you had it
What would signal signs of abuse?
Multiple cuts/bruises, bruises in various stages of healing, above knee and elbows, and illogical explanation
What would be signs of frequent falling? What would be the cause?
- Bruises
- Dizziness of neurological or cardiovascular origin
What would be signs and cause of frequent minor trauma
- Excessive bruising
- Can be caused by alcoholism and other drug abuse
Why is a thorough history important for rashes/lesions
May be an accurate predictor of the type and cause of lesion
Why is the location important for lesions/rashes?
Can be a clue to the cause, and can determine migration pattern/evolution
Why is the spreading pattern of a rash important
Can give a clue to the cause of the rash
What questions would you ask about setting regarding rashes/lesions?
- does anyone at work or home have similar rash
- Have you been camping, acquired a new pet, try new food or taken new drugs
- Does it come with stress
What would be the significance of asking patient what they think the rash or lesions mean
- Fear of cancer
- Illnesses borne by ticks
- STI
Why are coping strategies (if the rash has affected self-care, hygiene and ability to function) important to ask about
- Chronic skin disease may increase risk of low self-esteem, social isolation and anxiety
What can new stress in life do to skin?
Can cause chronic skin illness
Why would you ask about medications when inspecting skin, nail and hair?
Drugs can produce allergic skin eruptions, can increase sunlight sensitivity and can cause hyper pigmentation
What are some drugs that can cause allergic reactions?
- Aspirin
- Antibiotics
- Barbiturates (sleeping pills)
- Some tonics
What drugs would produce burn responses?
- Sulphonamides
- Thiazide Diuretics
- Oral Hypoglyemic agents
- Tetracycline
What drugs can cause hyper pigmentation?
- Antimalarials
- Antineoplastic Agents
- Hormones
- Metals
- Tetracycline
Why would you ask how long the patient has been taking the medication?
Sensitivity can develop even after being on the drug for a long time
What is alopecia?
Significant loss of hair
What is hirsutism?
Shaggy or excessive hair
What 5 questions would you ask about hair loss?
- Gradual or sudden onset
- Symmetrical
- Associated with fever, illness, increased stress?
- Unusual hair growth?
- Any recent changes in texture or appearance
Why is it important to ask about hair loss?
Because hair loss is associate with vitality usually, therefore sometimes people can seek trivial solutions which can cause greater problems
What can change in nails indicate?
- Nutritional deficits
- Bacterial and Viral infections
- Trauma
What would you ask that would determine those who are risk for environmental/occupational hazards
Exposed to occupational hazards like dyes, toxic chemicals or radiation
Hobbies, household or furniture repair work
Why would we ask if they get sun exposure from outdoor work, leisure, tanning beds, etc?
Unprotected sun exposure can lead to accelerated aging and produces lesions
Would bug bites affect skin?
Yes, it can product lesions or contact dermatitis
What would you tell people who have chronic reoccurring urticaria (hives) to do?
Keep a journal of meals and environment they were exposed to
Why is it important to assess patients self care (i.e. cosmetics/soaps used, sunscreen)
Because of the pressure of beauty norms, many over-the-counter remedies are costly and can increase skin problems
In older adults, why do we ask about skin changes in the last few years?
Can affect self concept and can cause distress
Why is pruritus common in older adults?
Can be a side effect of medicine or systemic disease
What is senile pruritus? What is a common cause in older adults
Usually results from dry skin, itching skin.
Caused by too frequent bathing/use of soap
The reason for asking about any other skin pain in older adults is because…?
Some diseases (shingles), produce more intense sensations of pain and itching Other diseases (diabetes), may reduce sensation in extremities
Why is it important to ask about foot changes in older adults?
Some older adults cannot reach down to perform foot care
Why do we ask older adults if they have a history of diabetes or peripheral vascular disease in regards to skin?
Can be a risk for lesions in feet to ankles
Why can skin care in older adults be a concern for skin care?
Dermatitis can be caused from certain cosmetics, creams, ointments and dyes applied to achieve a youthful appearance
What is different about skin inflammatory response in older adults
It is delayed
