Skin, Hair, Nails

Question 1

What are some changes that occur in older adults?

Answer 1

• Sebaceous and seat gland activity decreases
• epidermis thins and flattens
• Dermis is less elastic; loss of collagen and elastic fibers
• subcutaneous tissue decreases
• axillary and pubic hair decline
• Hair follicle size changes, terminal scalp hair -progressively transitions to villus hair, hair growth slow.

Question 2

What is lanugo?

Answer 2

Newborn fine hair on body. Sheds around 4 months of age.

Question 3

What is the blanch test?

Answer 3

used to determine underlying skin color by pressing on arm/forehead

Question 4

what questions would you ask in “symptom focused information gathering of skin condition?”

Answer 4

• Any recent skin/hair/nail changes? Any dryness, pruritus, sores, rashes, lumps, color changes or changes in texture or odor?
• What s/s are present (rash, single or multiple skin lesions, bleeding, itching, pain, color changes etc) Any s/s of fever, malaise, loss of appetite, upper respiratory symptoms?
• Where is the skin problem located?
• when did it start, sequence of occurrence, rapidity of onset, is this a recurrence? any allergies, any hx of illness like strep?
• any recent exposure to drugs, new skin products, new foods, detergents, repellents, any environmental toxins or family member with similar condition? family hx of disease like psoriasis? hx of recent tx?
• what has been done to treat problem, including medications (and OTC), did problem get better or worse?

Question 5

How would you assess a skin disorder?

Answer 5

“Nannies Say Children Should Take Pills Less Commonly”

N: number: solitary/single, multiple/many
S: size: in mm/cm
C: color: erythematous, brown, tan, purple etc.
S: Shape: circular, nummular (coin shaped), oval, annular (ring-like), irregular
T: Texture: smooth, verrucous (warty), rough
P: Primary Lesion: flat, raised, fluid filled
L: Location/distribution: where on body and how arranged (random, asymmetric,symetric,dermatone)
C: Configuration: linear, annular (ring-like)

Question 6

What is a macule? examples?

Answer 6

circumscribed flat area of change in color of skin <1cm in diameter.

freckles, flat moles, port win stains and rashes of rickettsial infections, rubella and measles

Question 7

What is a papule? examples?

Answer 7

small solid elevation of the skin >1cm

nevi, warts, lichen plants, insect bites, seborrheic keratoses, actinic keratoses, some lesions of acne and skin cancers

Question 8

What is a patch?

Answer 8

circumscribed flat area of change in color of the skin >1 cm

Question 9

What is a plaque? ex?

Answer 9

larger flatter elevation of the skin, sometimes formed by paupers coalescing.

psoriasis and granuloma annulare

Question 10

what is a nodule? ex?

Answer 10

solid elevation of the skin >1cm that usually extends into deeper skin layers. (Basically a papule that goes deeper under the skin)

cysts, lipomas, and fibromas

Question 11

What is a pustule? ex?

Answer 11

small circumscribed elevation of epidermis filled with purulent fluid

Common in bacterial infections and folliculitis

Question 12

What is a vesicle? ex?

Answer 12

small circumscribed elevation of the epidermis containing clear fluid <1cm in diameter

characteristic of herpes infections, acute allergic contact dermatitis, and some autoimmune blistering disorders such as dermatitis herpetiformis

Question 13

What is a bulla? ex?

Answer 13

cirumscribed elevation of they epidermis containing clear fluid >1cm

Classic autoimmune bullies diseases include: pemphigus vulgarisms and bullies pemphigoid

Question 14

What is a wheal? ex?

Answer 14

circumscribed, raised lesion consisting of dermal edema and is also known as a HIVE or UTICARIA. Wheals typically last <24hs.

Common manifestations of: drug hypersensitivity, stings or bites, autoimmunity, and less commonly physical stimuli including tempo, pressure and sunlight