Skin, Hair, Nails Flashcards
types of sweat glands
- eccrine = open directly into skin
- apocrine = open into hair follicles
fitzpatrick scale
- light, pale white ALWAYS burns, never tan, red heads
- white, fair, USUALLY burns, difficult tan
- medium, white/olive, MILD burn, gradually tan to olive
- olive, moderate brown, RARELY burns, tans with ease
- brown, dark brown, VERY RARELY burns, tan very easily
- black, very dark brown/black, NEVER burns, tans very easy, deeply pigments
I and II high risk for cancer
brown
cutaneous color change
darkening of melanin pigment
distributed generally
liver or adrenal disease
white
cutaneous color change
absence of melanin
general or local
i.e. albinism, vitiligo
red
cutaneous color change
inc cutaneous blood flow
local or general
i.e. inflammation, urticaria
yellow
cutaneous color change
inc bile pigmentation/jaundice
generalized
liver disease
blue
cutaneous color change
inc unsaturated hemoglobin secondary to hypoxia
@lips, mouth, nail beds
i.e. cardiovascular and pulm disease
most concerning color
violaceous
cutaneous color change
damage to blood vessels or extravasation of blood into skin
localized
i.e. vasculitis, bruising
pallor
dec blood flow (fainting, arterial occlusion)
less hemoglobin (anemia)
see @conjuctava of eye or mucous membranes, fingertips
lesion shapes
- linear= poison ivy
- clustered = shingles
- geographic = hives
- serpiginous = hook worm
- annular = ring worm
- reticular = viral illness
flat lesions
primary
- macule (less than 1 cm, clear borders)
- patch (irregular shape, greater than 1 cm)
elevated lesions
primary
- papule (circumscribed, less 1 cm)
- plaque (firm, rough, greater 1 cm)
- wheal (swollen, irregular, any size)
- nodule (firm, circumscribed, deeper in dermis, 1-2 cm)
- tumor (solid, deeper in dermis, greater 2 cm)
fluid filled lesions
primary
- vesicle (elevated, circum, superficial, less 1 cm, serous fluid)
- bulla (elevated, circum, serous filled, greater 1 cm)
- pustule (elevated, superficial, pus filled, usually less 1 cm)
- cyst (elevated, circum, encapsulated, liquid or semisolid filled)
burrow
primary
slightly raised tunnel in epidermis
i.e. scabies, itchy at night, will have someone in household w/ similar symptoms
secondary lesions types
- scale - cradle cap, accum keratitinzed cells
- lichenification- excessively rough/thick skin
- crust- scabs, dried serum, blood, exudates, elevated
- scar- thin/thick fibrous tissue from injury
- keloid- hypertrophic scarring from xs collagen formation beyond borders
- excoriation- loss of dermis, linear, hollowed out or crusted, from too much scratching
- fissure- linear crack from epidermis to dermis, athletes foot
- erosion- loss of superficial epidermis, most, depressed,
- ulcer- deeper loss of epidermis and dermis, concave
- atrophy- thinning of skin surface + loss of usual markings, stretch marks
vascular skin lesions
- telangiectasia - dilated capillaries
- capillary hemangioma- will clear up
- petechiae- less than 0.5 cm, non blanchable
- purpura- less than 0.5 cm, non blanchable
- ecchymosis- bruising
risk factors basal and squamous cell carcinoma
- age (50 +)
- exposure to sunlight/UV radiation
- skin type
- exposure to arsenic, creosote, coal tar, petroleum
- overexposure to radium, radioisotopes, xrays
- repeated trauma or irritation to skin
risk factors melanoma
- expose to sunlight or UV radiation (severe blistering burns, indoor tanning bed, geographic)
- personal/family hx
- atypical nevi/large # (moles)
- immune suppression
- skin type (I or II)
ABCDE of melanoma
A= asymmetry or one side darker than other
B= border, irregular edges, pigment spreading
C= color, uneven, different shades
D= diameter, usually greater 6 mm (pencil eraser) but can be smaller
E= evolution, changed in past weeks or months, itchy/scaling/bleeding
get biopsy
body hair
- vellus- covers most of body except palms/soles of feet
- terminal- head, facial, pubic, axillary
alopecia
hair abnormalities
can be areata (patches, treat with steroids, smooth skin) OR
totalis (complete loss)
scalp abnormalities
- trichotillomania - hair pulling, evidence of remnants
- tinea capitis - ring worm of scalp/fungal
- seborrheic dermatitis
- psoriasis
nail abnormalities
- subungual hematoma - trauma, if no hx then worry melanoma
- paronychia- drainage, tender, infection
- pitting- systemic disease
- koilonychia- spoon nail, anemia
- onychomycosis- fungal, almost always discolored, hard to treat
- melanonychia- stripes on nails, almost exclusive black sin, inc melanin
shamroth’s test
for clubbing
if no space b/t fingers when touching
