Skin, Hair, Nails Ch. 13 Flashcards
Xerosis
skin dryness
Greek: ‘xero’ means ‘dry
Seborrhea
excessive discharge of sebum from the sebaceous glands.
Pruritus
itchy skin
vitiligo (vit-ih-LIE-go)
a disease that causes loss of skin color in patches
Nevus
moles
buccal mucosa
inside cheeks
acrocyanosis
blueness (hypoxia) of the extremities (the hands and feet)
normal in babies <12 hrs old
General cyanosis
blueness (hypoxia) of the entire body- not good
Jaundice (icterus)
what causes it?
yellowing of the palate and sclera followed by the skin
-liver dysfunction
Erythemia
inflammation, CO2 poisoning
what could cause pallor change?
shock, anemia,
Where can you look for color change in patients with dark skin?
under tongue palms mouth conjunctivae sclera
How is Edema graded?
1+ - 4+ (deep to very deep)
Diaphoresis
excessive sweating
cherry angiomas
little red bumps, normal starting in middle age
Anasarca
overall edema
Edema
swelling in the interstitial fluid
Purulent
pus, milky an thinck
Serous exudate
serum, watery
Hemorrhagic exudate
Bloody
Serosanguinous
thin, pink, and watery (more watery than pus)
what is a symptom of hyper/hypothyroidism?
Hyper: incredibly smooth soft skin
Hypo: rough , dry, flaky skin
Turgor
good
poor
taut
ability of skin to return to place promptly
elastic
tenting- dehydration
scleroderma or edema
Scleroderma
Hardening of the skin is one of the most visible manifestations of the disease.
comes from 2 Greek words: “sclero” meaning hard, and “derma” meaning skin.
Keloid
excess scar tissue
Linea Nigra
line down the abdomen in pregnancy
A skin disorder that causes skin cells to multiply up to 10 times faster than normal. This makes the skin build up into bumpy red patches covered with silvery/ pink scaly patches.
Psoriasis
What 6 things do you do when assessing skin?
1- inspect for color, pigmentation
2- palpate for temp, moisture, texture, thickness, edema, turgor, vascularity, bruising
3- note lesions size, shape, configuration, size, location
4- inspect and palpate the hair for texture, distribution, lesions
5- inspect and palpate the nails for shape contour, consistency
6- teach skin self-exam
During the inspection and palpation of the nails, the shape contour should be what?
about 160 degrees
what is clubbing?
pitting?
Concave?
- nail contour is >180 degrees, a symptom of late chronic pulmonary or cyanotic heart disease
- a symptom of psoriasis
- a symptom of anemia
How do you do a Cap Refill test?
what are you testing?
peripheral circulation
depress nail bed for 5 seconds then release
color return in < 2 seconds = normal (can be an indication of shock)
How do you do a self skin exam?
ABCDEF
- Asymmetry
- Border
- Color change
- Diameter (>6mm, the size of a pencil eraser)
- Evolving
- Funny looking
Vernix Caseosa
cheesy substance covering a baby when born. Normal, do not wipe off
Lanugo
downy hairs covering a new born (typically preterm) babies body, sheds in a few months
Milia
sm. white spots on face, do not pop
Mongolian Spots
Purple pigmentation on babies buttock, abdomen, arms or legs.
90% of black babies are born with this, do not mistake for bruising!!
Mongolian Spots vs Bruising
Mongolian Spots: ill defined edges, does not hurt to palpate
Bruising: defined edges, pain w/ palpation
Cafe-au-lait
birthmark
Erythema Toxicum (Erythematous and symmetric )
rash, usually generalized.
Cutis Marmorata
Blue red mottling, means the baby is cold.
If they do not go away with warmth, can be a sign of Downs
Physiological Jaundice
yellowing of the skin >3 - 4 days after birth.
<3 - 4 days is concerning
Carotenemia
Orange skin due to an over ingestion of vit. A (orange foods: carrots, squash, sweet potato, oranges)
Stork bite, Red skin between the eyes or at the base of the neck
nevus simplex
What are 3 physiological changes that occur in adolescents?
1- increase secretions from apocrine glands = body odor
2- increase in subcutaneous fat deposits
3- Appearance of secondary sex characteristics (breast tissue, pubic & axillary hair)
Where is there increased pigmentation during pregnancy?
face, nipples, vulva, abdomen
“mask of pregnancy”
brown patches appear on the face. May go away in a few months after the baby is born (sunscreen)
Chloasma
Striae Gravidarum
Stretch marks during pregnancy (50% get them)
A common, small, soft, benign skin tag. Usually develops in areas of friction.
Common in pregnant, elderly, or obese
Acrochordons (acro-cro-don)
Spider angiomas
swollen blood vessels found slightly beneath the skin surface, often containing a central red spot and reddish extensions which radiate outwards like a spider’s web.
Senile Lentigines
Liver spots, small, flat, brown macules, hyperpigmentation from sun exposure
seborrheic keratosis
Raised, thickened areas of pigmentation. They look crusted, scaly, warty, dark, greasy, and “stuck on”
They develop mostly on the trunk but also on the face and hands and on both unexposed and sun-exposed areas.
They do not become cancerous!
actinic (senile or solar) keratosis
Red-tan scaly plaques that increase over the years to become raised and roughened. They may have a silvery-white scale adherent to the plaque.
They occur on sun-exposed surfaces and are directly related to sun exposure.
They are premalignant and may develop into squamous cell carcinoma!!
Senile purpura
increased vascular fragility that leads to easy bruising
What causes hair to grey?
decreased number of melanocytes
Sm. flat area of pigmentation (eg: freckle)
Macules
sm. elevated are of pigmentation (eg: nevus)
Papules
macules >1 cm (eg: birthmarks)
Patches
papules coalesce to >1 cm (eg: psoriasis)
Plaques
Wheals
red, ichy, slightly raised (eg: mosquito bite, poison oak)
Hives. coalesced wheals
Urticaria
Vesicles
elevated blister < 1 cm (herpes zoster- shingles, varicella)
What is a secondary skin lesion?
it is the result from a change over time in a primary lesion
Ulcer
deep depression into dermis
Excoriation
self-inflicted usually from scratching
Lichenification
Prolonged, intense scratching eventually thickens skin and produces tightly packed sets of papules
looks like surface of moss (or lichen).
Candidiasis (intertrigo)
yeast infection
Rubeola
(measles) rash starts behind the ears and spreads to the rest of the body
Koplik spots in the mouth
Koplik spots
clustered, white lesions on the buccal mucosa.
a symptom of measles
Varicella
(chicken pox) sm. vesicles on trunk, spreads to body (not palms or soles), significant pruritus
How does the skin react to a common allergic drug reaction?
generalized, bilateral rash
Manifestation of Herpes simplex
(cold sores) tight vesicles emerge, followed by pustules and many shallow, painful ulcers.
Common location is upper lip, in oral mucosa and tongue.
Manifestation of herpes zoster
Small, grouped vesicles emerge along route of cutaneous sensory nerve, then pustules, then crusts. Painful.
Manifestation of Lyme Disease
Bull’s eye rash: The rash radiates from the site of the tick bite (5 cm or larger) with some central clearing
Basal cell carcinoma
most common type of skin cancer, slow-growing, red ulcer with pearly borders
Squamous cell carcinoma
erythematous scaly patch, fast growing
Malignant Melanoma
lesions often dark, but can be any color; often with irregular borders.
Can be lethal
What are the manifestations of dehydration?
- dry mucosa membrane
- cracked lips
- Tongue fissure
- poor turgor
- bad breath
- low urine output (oliguria)
- Dizziness upon standing (orthostatic hypotension)
Toxic Alopecia
hair loss due to severe illness or use of chemotherapy
Kaposi sarcoma
common vascular cancer in HIV-infected persons. Considered an AIDS-defining illness.
multiple patch-stage early lesions are faint pink on the temple and beard area.
Hirsutism
Excess body hair. In females this forms a male pattern on the face and chest and indicates endocrine abnormalities
