Skin, Hair, and Nails Exam Flashcards
What questions would you ask when taking history for a derm exam?
Any changes with your skin, hair or nails? Any discolorations? Any lumps? Any rashes?
What causes dryness of the skin?
A decreased oil layer, often due to over-bathing
What causes itchy skin?
Stimulation of nerve fibers
When examining the quantity of the hair, what are two things you should consider?
Cicatricial vs non-cicatricial, generalized vs localized
What could cause lumps?
Immunologic reactions or neoplastic transformation
What could cause rashes?
Infections, trauma, immunologic reactions, ischemia, or neoplastic transformation
What is red discoloration caused by?
Increased oxyhemoglobin (increased blood flow or increased redness of hemoglobin)
What causes blue discoloration?
Increased deoxyhemoglobin (bruise, poor blood flow, poor oxygenation)
What is pallor to black discoloration caused by?
Decreased oxyhemoglobin
What is yellow discoloration caused by?
Increased or abnormal breakdown of hemoglobin
What are examples of skin lesions with less tissue?
Erosion, fissure, ulcer
What is erosion?
Nonscarring loss of the superficial epidermis; the surface is moist, but does not bleed
What is excoriation?
Linear or punctate erosion caused by scratching
What is a fissure?
A linear crack in the skin
What is an ulcer?
A deeper loss of epidermis and dermis; may bleed and scar
What are examples of skin lesions with a “normal” amount of tissue?
Macule, patch, purpura (petechiae, ecchymosis)
What is the difference between a macule and a patch?
Both are non-palpable, but a macule is less than 1 cm while a patch is greater than 1 cm
What is purpura?
The name given to the discoloration of the skin or mucous membranes due to hemorrhage from small blood vessels
What are examples of solid lesions with more tissue?
Papule, plaque, nodule, scale, crust, lichenification
What are examples of fluid-filled lesions with more tissue?
Vesicle, bulla, cyst, pustule
What is the difference between a papule and a plaque?
Both are solid, palpable lesions, but a papule is less than 1 cm while a plaque is greater than 1 cm
What is a nodule?
A solid plaque greater than 0.5 cm and deeper than a papule
What is a scale?
Thin flakes of exfoliating epidermis
What is the difference between a vesicle and a bulla?
Both are serous fluid filled lesions, but a vesicle is less than 1 cm and a bulla is larger than 1 cm
What is a cyst?
A fluid filled lesion that is deeper than a vesicle or bulla
What is a pustule?
A pus filled lesion
What are some of the arrangements of skin lesions?
Annular, arciform (like annular plaque of tinea faciale); serpignious (like that of tinea corporus); linear (like that of linear epidermal nevus); clustered (like that of grouped vesicles of herpes simplex); geographic (like that of mycosis fungoides)
What could cause increased pigmentation of the skin?
Neurofibromatosus, addison’s disease
What could cause either increased or decreased pigmentation of the skin?
Tinea versicolor
What are the signs of melanoma?
Asymmetry (when half of the mole doesn’t match the other half), border (when the border of the mole is ragged or irregular), color (when the color of the mole varies throughout), and diameter (when the mole’s diameter is larger than a pencil eraser)
What could cause decreased pigmentation of the skin?
Vitiligo
What is the common description of normal skin characteristics?
Warm and dry
What is skin mobility vs turgor?
Mobility is how easily a fold of skin lifts up and turgor is how quickly it returns to place
When would you expect to see decreased skin mobility
Edema
When would you expect to see decreased skin turgor?
Dehydration
What is onycholysis?
A nail lifting up so it is no longer completely attached
What are the likely causes of onycholysis?
Injury from an aggressive manicure, injury from cleaning under the nails with a sharp object, a fungal infection, or psoriasis
Deep grooves that run the width of the nail suggest what?
That something (fever, injury, chemotherapy, or major stress) slowed or stopped the nail from growing for a while
What causes paronychia?
Infection from bacteria or fungi
Patients with pits in their nails may have which conditions?
Psoriasis, atopic dermatitis, alopecia areata
What is onychogryphosis?
Ram’s horn nails, where nails thicken and overgrow
Onychogryphosis is secondary to what?
Familial predisposition, psoriasis, ichthyosis, circulation problems
What does koilonychia suggest?
Iron deficiency
What is koilonychia?
Thin, spoon-shaped nails
What can cause onychotillomania?
A habit of picking at (or pushing back) the cuticles on your thumbnails
What does clubbing of the nails look like?
Nails curve downward, fingertips often swell, and nails start to feel spongy when pressed on; angle between nail plate and cuticle exceeds 180 degrees
What can curved nails be a sign of?
They can be a harmless trait that runs in the family or a sign of disease of the lungs or heart
What are white nails associated with?
Liver disease, diabetes, and anemia
What can cause yellow nails?
Lung disease, rheumatoid arthritis, and infections
What are red lunula associated with?
Lupus, heart disease, alopecia areata, arthritis, and dermatomyositis
What do blue lunula indicate?
Silver poisoning
What could a dark streak on the nails be caused by?
Melanoma
