Skin, Hair & Nails

Question 0

Inspecting Lesions

Answer 0

colour
elevation
pattern/shape
size
any exudate
location/distribution on body.

Question 1

Inspect and Palpate Skin

Answer 1

Colour - look at general pigmentation; overall skin tone and at freckles, moles, and birthmarks. Look for widespread colour change, normally none ((no cyanosis, jaundice, erythema or pallor)

Temperature - use dorsal side of hand and check bilaterally. Expect warm

Moisture - perspiration in normal regions

Question 2

Palpate Lesions

Answer 2

Palpate lesions wearing gloves.

Gently roll between thumb and index finger feeling for depth

Gently scrape a scale to see if it comes off. Note if it bleeds when scale comes off. Note surrounding colour and temperature. Does it blanch with pressure

Question 3

Inspect and Palpate the Hair

Answer 3

Colour

Texture

Distribution

Lesions

Question 4

Inspect and Palpate Nails

Answer 4

Shape and Contour - expect 160 degree angle between nail and nail bed. Note cleanliness and care appropriateness to vocation and socioeconomic situation

Consistency - smooth and regular, not brittle or splitting. Thickness is uniform and nail is firmly adhered to nail bed

Colour - translucent with pink underneath

Capillary refill - normally returns in a couple seconds

Question 5

Mole Assessment

Answer 5

Asymmetry? Typically none

Border? Normally smooth

Colour? Wide range of normal, but should only be one colour

Diameter greater than 6mm? Typically not

Elevation or enlargement? Can be raised, but if elevation changes or size changes, it is abnormal