Skin Hair Nails Flashcards
1
Q
What are the major functions of skin to keep the body in homeostasis?
A
Provides boundaries for body fluid
Protects underlying tissues
controls body temperature
Synthesizes Vit D
2
Q
What is the heaviest organ in the body?
A
Skin making up 16% of body weight
3
Q
What are the three layers of skin?
A
Epidermis
Dermis
Subcutaneous tissue
4
Q
Hair, nails, and sebaceous, sweat, and ceruminous glands are what to skin?
A
appendages of skin
5
Q
Common or concerning symptoms of skin?
A
Hair loss
rash
moles
6
Q
What to ask the patient about skin in health history?
A
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?
7
Q
Clinicians play an important role in educating patients about?
A
early detection of suspicious moles
protective measures for skin care
hazards of excessive sun exposure
8
Q
What are the most prevalent types of cancer in the U.S.?
A
Skin cancers
9
Q
Where are skin Cancers most prevalent?
A
hands, neck, and head
10
Q
Melanoma often presents on the?
A
Lower leg
11
Q
What is a good practice for skin cancer prevention?
A
Sunscreen
SPF 15 or greater every day
12
Q
What type of cancer comprises 80% of skin cancers?
A
Basal Cell Carcinoma
13
Q
How does basal cell carcinoma present?
A
shiny and translucent
they grow slowly and rarely metastasize
14
Q
What type of skin cancer comprises 16% of skin cancers?
A
Squamous cell carcinoma
15
Q
How does squamous cell carcinoma present?
A
crusted, scaly, and ulcerated, they can metastasize
16
Q
What type of skin cancer comprises 4% of skin cancers?
A
Melanoma
17
Q
How does Melanoma present?
A
Rapidly increasing in frequency
they spread easily
18
Q
Risk Factors for Melanoma
HARMM acronym
A
History of previous melanoma
Age over 50
Regular dermatologist absent
Mole changing
Male gender
19
Q
Additional Risk Factors for Melanoma include?
A
> /= 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
20
Q
ABCDE: Screening Moles for Possible Melanoma
A
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
21
Q
Techniques of Examination
Examination of the skin, hair, and nails begins with?
A
The general survey of the patient
22
Q
Techniques of Examination
Make sure the patient wears a gown. Drape appropriately to facilitate inspection of?
A
hair, anterior and posterior surfaces of body, palms, and soles, and web spaces
23
Q
Techniques of Examination
Inspect the entire skin surface in what conditions?
A
Good light
preferably natural light (or artificial light that resembles natural)
Artificial light often distorts colors
24
Q
Techniques of Examination
Patient often notice what before anyone else?
A
Change in color
25
Techniques of Examination
Look for what?
increased pigmentation,
loss of pigmentation
redness
pallor
cyanosis
yellowing
26
Techniques of Examination
Red color of oxyhemoglobin is best assessed at what locations?
In Dark skinned people?
fingertips
lips
mucous membranes
palms and soles
27
Techniques of Examination
For central cyanosis look at?
lips
oral mucosa
tongue
28
Techniques of Examination
For jaundice look at?
sclera
29
Techniques of Examination
Dryness, sweating, oiliness describes what?
Moisture
30
Techniques of Examination
To assess temperature use what?
Look for areas of what?
back of fingertips
areas of warmth or coolness of skin
31
Techniques of Examination
Roughness or smoothness describes?
Texture
32
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)
33
Techniques of Examination
Lesions: note what characteristics?
Anatomic location and distribution
Patterns and shapes
Type of lesion (macules, papules, nevi, vesicles)
Color
34
Techniques of Examination
Lesions: Assess what?
Margins
Pigment
35
Techniques of Examination
Lesions: Palpate for?
texture and consistency
36
Techniques of Examination
Lesions: Measure what?
Size of lesion
area covered if numerous
37
Techniques of Examination
Hair
Inspect and palpate
Note quantity, distribution, and texture
Pattern baldness vs. alopecia
Brittle/Break vs. loss
38
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
39
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
40
Nail Changes
What is Onychomycosis?
A fungal infection that affects the fingernails and toenails
41
Nail Changes
Clubbing has what characteristics?
Indicates what?
Loss of angle > 180*
Loose or spongey feel
Chronic hypoxia
Interstitial Lung disease or CA
42
Nail Changes
Pitting indicates what?
Psoriasis
picking behavior
dermatitis
43
Nail Changes
Transverse Linear Depressions (Beau's) indicate what?
Illness
Trauma
Cold exposure in Raynaud's disease
44
Nail Changes
Transverse White Bands (Mees') indicate what?
Arsenic, chemotherapy carbon monoxide poisoning
Hodgkins, heart failure, leprosy
45
Hair Changes
Round or oval patches indicate?
alopecia areata
46
Hair Changes
Trichotillomania is what?
A mental disorder that causes patients to have a strong compulsion to pull out hair or eye lashes
47
Hair Changes
What is tinea capitis?
A contagious hair infection that affects the scalp, hair shaft and follicles
48
Hair Changes
What characteristics describe male pattern baldness?
Crown or forehead hair loss
49
Hair Changes
Note what about texture?
brittle vs. falling out
50
Skin Lesions
What is a primary lesion?
a lesion that develops on previously unaltered skin
51
Skin Lesions
What are macules?
flat lesions less than 1cm, without elevation or depression
52
Skin Lesions
What is a secondary lesion?
a lesion that changes over time or when a primary is scratched
53
Skin Lesions
What are patches?
Disease example?
Flat > 1 cm, no elevation or depression
Café au lait
54
Skin Lesions
What are papules?
Disease Example?
elevated, solid lesion less than 1cm
Fibroma
55
Skin Lesions
What are nodules?
elevated, solid lesion greater than 1cm
56
Skin Lesions
What are tumors?
greater than a few cm, firm or soft, benign or malignant
57
Skin Lesions
What are vesicles?
elevated, fluid-filled lesion, usually <1cm
58
Skin Lesions
What are wheals?
raised, discolored patch of skin that can be itchy and change shape
59
Skin Lesions
What is a cyst?
closed cavity or sac, fluid or semisolid filled, normal, or abnormal epithelium
60
Skin Lesions
What are pustules?
elevated, fluid-filled lesion, usually <1cm
61
Skin Lesions
What are plaques?
Disease example?
flat but elevated lesions, usually greater than 1cm
Psoriasis
62
Skin Lesions
What are bulla?
elevated, fluid-filled lesion, usually >1cm
63
Skin Lesions
What are burrows?
tunnel-like markings caused by a parasitic infestation, such as scabies mites
64
Skin Lesions
What are scales?
desquamated stratum corneum
65
Skin Lesions
What are crusts?
dried exudate (serous, hemorrhagic, purulent to begin)
66
Skin Lesions
What is excoriation?
hemorrhagic excavation from scratching
67
Skin Lesions
What are keloids?
A raised scar that grows beyond the original injury site after the skin has healed
68
Skin Lesions
What is lichenification?
thickening of skin
69
Skin Lesions
What is erosion?
partial break in epidermis
70
Skin Lesions
What are fissures?
linear crack in epidermis
71
Anatomic Distributions
Where are herpetic lesions found?
lips
tongue
roof of the mouth
gums
72
Patterns and Shapes
What are linear skin lesions?
Disease example?
Scratch, streak, line, stripe
contact dermatitis
73
Patterns and Shapes
What are clustered/grouped skin lesions?
Disease Example
skin lesions appearing in clusteres
herpes zoster
74
Patterns and Shapes
What are annular skin lesions?
Disease Example?
Circular beginning in center and spreading to periphery
tinea corporis
75
Patterns and Shapes
What are nummular skin lesions?
circular, raised spots
76
Patterns and Shapes
What are coalescing/confluent skin lesions?
lesions run together
77
Patterns and Shapes
What are gryate skin lesions?
Disease example?
twisted, coiled, spiral, snake-like
Scabies
78
Patterns and Shapes
What are Polycyclic lesions?
Disease example?
annular lesions merge
lupus erythematous
79
Patterns and Shapes
What are Solitary or discrete lesions?
Disease Example?
individual and distinct lesions that remain separate
Ringworm
80
Patterns and Shapes
What are target lesions?
Disease example?
Lesions with concentric rings of color (like iris of the eye)
lyme disease
81
Patterns and Shapes
What are zosterform lesions?
Disease example?
linear arrangement along a nerve root
82
Other Skin Conditions
What is the most common skin disorder?
Acne
83
Other Skin Conditions
What is the presentation of acne?
pustules or papules
comedomes
cysts
nodules
scarring
84
Other Skin Conditions
What are the Comedomes of acne?
Open-blackhead
closed-whitehead
85
Other Skin Conditions
What is Actinic Keratosis?
rough, scaly patch or bump on the skin
86
Other Skin Conditions
What is seborrhea keratosis?
noncancerous skin growth that looks like a wart
87
Other Skin Conditions
Basal cell
Starts as red
depressed center
raised borders
> age 40
88
Other Skin Conditions
Squamous cell
arise from actinic keratosis
reddish
scaling
> age 60
89
Disease Related Skin Conditions
Addison's results in?
hyperpigmentation/bronzing
90
Disease Related Skin Conditions
Cushing's results in?
stria
atrophy
ecchymosis
telangiectasis
acne
91
Disease Related Skin Conditions
Liver disease results in?
Jandice
Telangiectasis
Linear excoriations
stria
92
Disease Related Skin Conditions
Peripheral Vascular Disease results in?
dry
shiny
hairless
brittle nails
ulceration
pallor/cyanosis
93
Disease Related Skin Conditions
Pregnancy results in?
cholasma
94
Disease Related Skin Conditions
Scleroderma results in?
thickened creases
pitting of fingertips
decreased mobility
95
Infectious Disease
Coxsackie
Hand/foot/mouth
macules papules
96
Infectious Disease
Fifth Disease
Slapped cheeks
Truck to extremities
97
Infectious Disease
Roseaola
Erythematous
Macular papular
head to to distribution
Petechial rash on the palate
98
Infectious Disease
Pityriasis rosea
Hearld patch
Christmas tree distribution
99
Infectious Disease
Folliculitis
Inflammation of the hair follicle
100
Infectious Disease
Furuncle:
Boil?
Most common bacteria?
localized infection originating in hair follicle
Staphylococcus aureus
101
Infectious Disease
Carbuncle:
Most common bacteria
Larger than furuncle and may be necrotizing
staphylococcus aureus
102
Infectious Disease
Cellulitis is what?
Most common bacteria?
Deep dermis infection, subQ adipose tissue
Staphylococcus aureus
103
Infectious Disease
Cellulitis presents as?
localized pain, erythema, swelling, heat
lesion is NOT raised indistinct line between involved and uninvolved tissue
104
Infectious Disease
Erysipelas is what?
Most common bacteria?
Upper dermis infection
Rapid progression
Streptococcus
105
Infectious Disease
Erysipelas presents as?
Local redness, heat, swelling, with characteristic raised indurated border
106
Infectious Disease
What is Hidradenitis suppurativa?
Most common bacteria?
Abscess formation is common
commonly found in armpits and groin
inflammation and infection of sweat glands
Staphylococcus aureus
107
Infections Disease
What is Impetigo?
Most common bacteria?
Begins as vesicle (primary lesion) develops into honey colored crust
can spread to remote areas of skin
Staphylococcus aureus
108
Infectious Disease
What is Paronychia?
Staphylococci around nail fold
109
How to recognized bacterial infections of the skin
Inflammation
Swelling
redness
pain
warmth
vesicles
pustules
purulent drainage
regional lymphadenopathy
110
How to recognize bacterial infections of the skin
Systemic
Fever
malaise
chills
anorexia
111
Fungal Infections
Candida Balantis
Inflammation superficial tissue of penis head caused by candida albicans
112
Fungal Infections
Candida Intertrigo
Irritation of fold of skin commonly between toes and other warm moist areas
113
Fungal Infections
Tinea Capitis
Dermatophyte infection of scalp caused by Trichophyon or Microsporun
114
Fungal Infections
Tinea Corporis
(Ringworm)
Dermatophyte infection caused by Trichophyon or Michosporun
115
Fungal Infections
Tinea Cruris
(Jock Itch)
Dermatophyte infection caused by Trichophyton, Epidermophyon, Microsporun
T. rubrum, E. floccosum are most common
116
Fungal Infections
Tinea Pedis
(Athlete's foot)
Dermatophyte infection of the foot caused by t. rubrum, T. Mentagrophytes
117
Fungal Infections
Tinea Manuum (hand/palm)
Dermatophyte infection of the hand/palm caused by T. rubrum, T. Mentagrophytes
118
Fungal Infections
Tinea Unguium (Onychomycosis)
Persistent dermatophyte infection of the toenails and fingernails
119
Fungal Infections
Tinea Versicolor (hyper/hypopigmentation macules on limbs)
Fungal infection caused by the yeast Pityrosporun orbiculare
120
Common Skin Disorders
What is Eczema (Atopic Dermatitis)
Acute flares look like?
Chronic skin condition with intense itching
Acute flare: red, shiny, thickened, patches, inflamed/scabbed with erythema/scaling, dry, leathery, lichenification
121
Common Skin Disorders
Allergic Contact Dermatitis is?
Acute or chronic condition: inflammation at site of contact with allergen
Redness, pruritis, scabbing, sharp defined borders
122
Common Skin Disorders
Psoriasis
Acute or chronic hyperproliferative inflammation of skin
Itching, red, defined plaques with silvery scales
123
Common Skin Disorders
What is Auspitz sign in psoriasis?
blood droplets present when scales are removed
124
Common Skin Disorders
Psoriasis can be the first sign of what?
HIV infeciton
125
Common Skin Disorders
Pityriasis Rosea
Acute, mild inflammatory disorder lasting 4-8 wks
Herald Patch - initial lesion 2-10cm
Pruritic rash on trunk and proximal extremities
Christmas tree pattern rash following cleavage line of trunk
126
Common Skin Disorders
Xanthelasma
Yellow plaques/build up of fat as a result of hyperlipidemia/uncontrolled DM
Common on medial side of upper eyelid (inner canthus)
127
Lyme Disease
Spreads by?
24-48 hours for spread of?
Appears as?
Systemic symptoms?
it is the most common what?
bite of infected blacklegged tick, deer ticks
borellia burgdorferi to host
bull's eye macular or papular rash
expanding red lesion with central clearing - erythema migrans
flu-like symptoms
vector born disease in US
128
Rocky Mountain Fever
Transmitted by?
What type of bacterial infection? How long for transmission to host?
Appears as?
Tick bite
lethal bacterial infection - R rickettsia (24 hour transmission to host)
Maculopapular rash, petechial rash, abdominal pain, join pain, flu-like symptoms
129
Common Wart (verruca vulgaris appears as?
flesh colored papule with rough surface
130
Filiform Wart (digitate) appears as?
fingerlike appearance - multiple projections
131
Flat Wart appears as?
pink or light yellow
132
Plantar Wart appears as?
slightly raised, rough surface which may be painful
133
Genital Wart appears as?
Pale pink, broad base and multiple projections - "cauliflower"
134
What is a subungual hematoma?
blood between nail bed and fingernail commonly caused by blunt or sharp trauma to finger or toes
bleeding from vascular rich nailbed increases pressure under nail and causes significant pain
135
What is the treatment for subungual hematoma?
trephination - drilling a small hole through the nail into hematoma to release pressure
136
What is Herpes Zoster?
Acute Vesicular eruption from infection with varicella-zoster virus
137
How does Herpes Zoster present?
Pain along dermatomal distribution (usually the trunk)
Regional lymphadenopathy
Grouped vesicle eruption of erythema and exudate along dermatome
138
What is Smallpox?
Infectious disease caused by virus variants which localizes in the skin mouth, throat
139
How does Smallpox present?
Sudden onset flu-like symptoms
Rash - flat red spots/lesions which turn into small clear fluid, then pus filled blisters
Initial blisters appear after 2 days
PAINFUL
140
Hallmark distribution of smallpox?
Lesions appear oral mucosa/palate, face, forearm
Centrifugal concentrating on face, distal extremities
ALL lesions will be at same stage of development regardless of part of body
Scabs lead to deep scars
141
What is Lichen Planus?
Non-infectious condition causing swelling and irritation of skin, hair, nails, mucous membranes
142
Lichen Planus presents as?
Wickham's striae with purplish, flat, bumps on wrist, lower back, ankles, genitals, scalp, nails
Itching
Painful around genitals or mouth
