Skin, Hair, and Nails Flashcards
What is the ROS question for skin, hair, and nails?
Any changes with your skin, hair, or nails? Any discolorations, lumps, or rashes?
What’s one important thing when looking comprehensively at the skin?
Blisters
What do we look for on inspection of the skin?
Color and patterns of color changes
What do we assess a red color for?
Oxyhemoglobin and the pallor in its absence
What does pallor result from?
Decreased redness in anemia and decreased blood flow seen in fainting or arterial occlusion
Where is central cyanosis best assessed?
Lips, oral mucosa, and tongue
What can cause central cyanosis?
- Advanced lung disease
- Congenital heart disease
- Hemoglobinopathies
What is cyanosis of the nails, hands, and feet cause by?
Peripheral in origin
What simple thing could cause peripheral cyanosis?
Anxiety or a cold examining room
What is the cyanosis of HF usually?
Peripheral, reflecting deoxygenation with impaired circulation
What should we look for in the sclera?
Yellow color of jaundice
What does jaundice suggest?
Liver disease or excessive hemolysis
What does NOT affect the sclera?
Yellow color that accompanies high levels of carotene (palms, soles, and face)
What are changes in pigmentation caused by?
Widespread increase in melanin by Addison’s disease
What is Addison’s?
Hypofunction of the adrenal cortex
What does Cafe-Au-Lait Spot suggest?
Neurofibromatosis
What is Tinea Versicolor common in?
Common superficial fungai infection of the skin
What is Vitiligo?
Depigmented macules appear on the face, hands, feet, and other regions
What is cyanosis?
Bluish color that is visible on toenails and toes
What is Carotenemia?
Yellowish with pink palm but does NOT affect sclera (jaundice does)
What is Erythema?
Red hue, increased blood flow
Waht is hellotrope?
Violaceous patches over the eyelids in the collaten vascular disease dermatomyositis
Define Lesions
Any of various pathological or traumatic changes in bodily organ or tissue, including tumors, ulcers, sores, and wounds
What are the 3 basic lesion descriptions?
- Flat
- Solid
- Fluid filled
What is a scale?
A thin flake of dead exfoliated epidermis
What is crust?
The dried residue of skin exudates such as serum, pus, or blood
What is Lichenification?
Visible and palpable thickening of epidermis and roughening of the skin
What are scars?
Increased connective tissue that arises from injury or disease
What are keloids?
Hypertrophic scarring that extends beyong the borders of the initiating injury
What are 3 secondary depressed skin lesions?
- Erosion
- Excoriation
- Fissure
Erosion
Nonscarring loss of the superficial epidermis, surface is moist but does not bleed
Excoriation
Linear or punctate errosions caused by scratching
Fissue
A linear crack in the skin often resulting from dryness
Ulcer
Deeper loss of epidermis and dermis, may bleed or scar
Difference between Petechia and Ecchymosis
Ecchymosis more purple
What is specific about Basal Cell Carcinoma?
Grows slowing and almost never metastasizes
When does Squamos Cell Carcinoma usually appear?
Sun-exposed skin of fair skinned adults older than 60
How do we palpate the skin for temp?
Backs of fingers
Where do we have generalized warmth in fever?
Hyperthyroidism (coolness in hypo)
What do we note when looking at the hair?
Quantity, distribution, and texture
Define Alopecia
Hair loss (diffuse, patchy, or total)
What happens to the hair in hypothyroidism?
Sparse hair
What happens to the hair in hyperthyroidism?
Fine, silky hair
What is mobility of the skin?
How easily you can lift it
What is turor of the skin?
How quickly it returns to place
What is decreased mobility of the skin seen?
Edema
When is decreased turgor seen?
Dehydration
What do we look for in the nails?
Color, shape, and any lesions
What are 6 things related to nails?
- Clubbing of the fingers
- Terry’s nails
- Transverse White Bands (Mee’s Lines)
- Transverse Linear Depressions (Beau’s Lines)
- Onycholysis
- White Spots (leuhonychia)
Finger Clubbing
Vasodilation, congenital HF
Terry’s Nails
Decreased vascularity
Mee’s Lines
Disrupted matrix of proximal nail
Beau’s Lines
Transverse depressions of nail plates, usually bilateral
Onycholysis
Trauma from excess manicuring
White Spots
Nonuniform white spots, could be from excess manicuring
