Skin Hair Nails Flashcards
What are the major functions of skin to keep the body in homeostasis?
Provides boundaries for body fluid
Protects underlying tissues
controls body temperature
Synthesizes Vit D
What is the heaviest organ in the body?
Skin making up 16% of body weight
What are the three layers of skin?
Epidermis
Dermis
Subcutaneous tissue
Hair, nails, and sebaceous, sweat, and ceruminous glands are what to skin?
appendages of skin
Common or concerning symptoms of skin?
Hair loss
rash
moles
What to ask the patient about skin in health history?
Have you noticed any changes in your skin or your hair?
Have you noticed any moles that have changed size, shape, color, or sensation?
Have you noticed any new moles?
Have you had a history of sunburns?
Clinicians play an important role in educating patients about?
early detection of suspicious moles
protective measures for skin care
hazards of excessive sun exposure
What are the most prevalent types of cancer in the U.S.?
Skin cancers
Where are skin Cancers most prevalent?
hands, neck, and head
Melanoma often presents on the?
Lower leg
What is a good practice for skin cancer prevention?
Sunscreen
SPF 15 or greater every day
What type of cancer comprises 80% of skin cancers?
Basal Cell Carcinoma
How does basal cell carcinoma present?
shiny and translucent
they grow slowly and rarely metastasize
What type of skin cancer comprises 16% of skin cancers?
Squamous cell carcinoma
How does squamous cell carcinoma present?
crusted, scaly, and ulcerated, they can metastasize
What type of skin cancer comprises 4% of skin cancers?
Melanoma
How does Melanoma present?
Rapidly increasing in frequency
they spread easily
Risk Factors for Melanoma
HARMM acronym
History of previous melanoma
Age over 50
Regular dermatologist absent
Mole changing
Male gender
Additional Risk Factors for Melanoma include?
> /= 50 common moles
/= 1-4 atypical or unusual moles (especially if dysplastic)
Red or light hair
Actinic lentigines, macular brown or tan spots (usually on sun exposed areas)
Heavy sun exposure (especially severe childhood sunburns)
Light eye or skin color (especially freckles/burns easily)
Family hx of melanoma
ABCDE: Screening Moles for Possible Melanoma
A for asymmetry
B for irregular borders, especially ragged, notched, or blurred
C for variation or change in color, especially blue or black
D for diameter >/=6mm or different from other moles, especially changing, itching, or bleeding
E for elevation, evolution or enlargement
Techniques of Examination
Examination of the skin, hair, and nails begins with?
The general survey of the patient
Techniques of Examination
Make sure the patient wears a gown. Drape appropriately to facilitate inspection of?
hair, anterior and posterior surfaces of body, palms, and soles, and web spaces
Techniques of Examination
Inspect the entire skin surface in what conditions?
Good light
preferably natural light (or artificial light that resembles natural)
Artificial light often distorts colors
Techniques of Examination
Patient often notice what before anyone else?
Change in color
Techniques of Examination
Look for what?
increased pigmentation,
loss of pigmentation
redness
pallor
cyanosis
yellowing
Techniques of Examination
Red color of oxyhemoglobin is best assessed at what locations?
In Dark skinned people?
fingertips
lips
mucous membranes
palms and soles
Techniques of Examination
For central cyanosis look at?
lips
oral mucosa
tongue
Techniques of Examination
For jaundice look at?
sclera
Techniques of Examination
Dryness, sweating, oiliness describes what?
Moisture
Techniques of Examination
To assess temperature use what?
Look for areas of what?
back of fingertips
areas of warmth or coolness of skin
Techniques of Examination
Roughness or smoothness describes?
Texture
Techniques of Examination
To assess mobility and turgor do what?
Note what?
lift fold of skin
note ease with which it lifts up (mobility) and speed with which it returns to place (turgor)
Techniques of Examination
Lesions: note what characteristics?
Anatomic location and distribution
Patterns and shapes
Type of lesion (macules, papules, nevi, vesicles)
Color
Techniques of Examination
Lesions: Assess what?
Margins
Pigment
Techniques of Examination
Lesions: Palpate for?
texture and consistency
Techniques of Examination
Lesions: Measure what?
Size of lesion
area covered if numerous
Techniques of Examination
Hair
Inspect and palpate
Note quantity, distribution, and texture
Pattern baldness vs. alopecia
Brittle/Break vs. loss
Techniques of Examination
Nails
Inspect and palpate fingernails/toenails
Note color and shape
Note Lesions: longitudinal bands of pigment may be a normal finding in people with darker skin
Nail Changes
What is Paronychia?
A skin infection that occurs around the fingernails and toenails, including the tissues that borders the nails roots and sides
Nail Changes
What is Onychomycosis?
A fungal infection that affects the fingernails and toenails
Nail Changes
Clubbing has what characteristics?
Indicates what?
Loss of angle > 180*
Loose or spongey feel
Chronic hypoxia
Interstitial Lung disease or CA
Nail Changes
Pitting indicates what?
Psoriasis
picking behavior
dermatitis
Nail Changes
Transverse Linear Depressions (Beau’s) indicate what?
Illness
Trauma
Cold exposure in Raynaud’s disease
Nail Changes
Transverse White Bands (Mees’) indicate what?
Arsenic, chemotherapy carbon monoxide poisoning
Hodgkins, heart failure, leprosy
Hair Changes
Round or oval patches indicate?
alopecia areata
Hair Changes
Trichotillomania is what?
A mental disorder that causes patients to have a strong compulsion to pull out hair or eye lashes
Hair Changes
What is tinea capitis?
A contagious hair infection that affects the scalp, hair shaft and follicles
Hair Changes
What characteristics describe male pattern baldness?
Crown or forehead hair loss
Hair Changes
Note what about texture?
brittle vs. falling out
Skin Lesions
What is a primary lesion?
a lesion that develops on previously unaltered skin
Skin Lesions
What are macules?
flat lesions less than 1cm, without elevation or depression
Skin Lesions
What is a secondary lesion?
a lesion that changes over time or when a primary is scratched
Skin Lesions
What are patches?
Disease example?
Flat > 1 cm, no elevation or depression
Café au lait
Skin Lesions
What are papules?
Disease Example?
elevated, solid lesion less than 1cm
Fibroma
Skin Lesions
What are nodules?
elevated, solid lesion greater than 1cm
Skin Lesions
What are tumors?
greater than a few cm, firm or soft, benign or malignant