Skin, Nails Flashcards
Hair, nails, sebaceous glands and sweat glands are_____
Appendages of the skin
5 Roles of the skin
Protect from infection and trauma Prevent fluid loss Regulate temperature Sensory Produce Vitamin D
What equipment is needed for an examination of the skin?
Ruler (cm)-clear and bendy
Light source
Is it OK for the pt to leave their clothes on for a skin exam?
No- adequate exposure is important.
Armpit, butt, back of thighs, between toes….everywhereeeee needs to be checked
What 4 things are checked during the “Inspection” part of a skin exam?
Symmetry (is rash bilateral etc)
Color (pigmentation, pallor, cyanosis, jaundice)
Hair (distribution, amount)
Nails (color, lesions, capillary refill)
What 4 things are checked during the “palpation” part of a skin exam?
Moisture
Temperature-use back of hand
Texture
Mobility&Turgor-do forearm except in old people, use thigh
What does a generalized/disseminated rash look like?
Lesions appear widely distributed
What does a regional distribution of a rash look like?
Lesions appear in a specific region of the body
What is an annular lesion?
A round lesion with active margins and a central clearing
Annular means ring shaped
What does it mean if a lesion has a zosteriform shape?
It follows a dermatome/Nerve segment
What does an iris/target shaped lesion consist of?
A pink macule with a purple papule in the middle
Pink flat spot with purple bump
What does morbilliform mean?
Measles-like. Usually associated with viruses
What does violaceous mean?
Light purple
What are the ABCDEs of malignant melanoma? (E could be two things)
Asymmetry Borders (irregular) Color- variable Diameter- over 6mm Elevation or Evolving
What are primary skin lesions?
Arise from previously normal skin
What is a secondary skin lesion?
Arise from changes in primary lesions, such as scratching an initial lesion until it gets worse/infected
What is a macule?
Flat
Smaller than 1cm
Any color
Well circumscribed
What are some examples of macules?
Measles
Freckles
Petechiae
What is a patch?
Flat spot
BIGGER than 1cm
What is the difference between a macule and a patch?
A patch is bigger than 1cm
Mongolian spots, cafe au last spots, port wine stain, vitiligo… these are all examples of what type of lesion/
Patch
What is a papule?
Palpable
Circumscribed bump
No bigger than 1cm***
Can join together to form plaques
Warts, nevi and mollusum contagiasum are examples of?
Papules
What is a plaque?
Elevated, palpable rough lesion that is
Bigger than 1cm**
Psoriasis and eczema (when it’s elevated) are examples of
Plaques
Difference between papule and plaque?
Plaque is bigger than 1cm
What is a nodule?
A lesion that is deeper and firmer than a papule
Bigger than .5cm***
What is the difference between a papule and a nodule?
A nodule is deeper and firmer than a papule
What is a tumor?
A large nodule that is OVER 2cm**
Sticks deeper into the dermis too
Difference between a nodule and a tumor?
A tumor is deeper and bigger (over 2cm)
What is a wheal?
A transient**, superficial edema
Irregular borders
Mosquito bites and hives are examples of what/
Wheals
What is a vesicle?
Fluid filled, round lesion that is 1cm or smaller**
Herpes simplex, which looks like “dew drops on rose petals” is an example of ?
Vesicles
What is a bulla?
A fluid filled round lesion that is bigger than 1cm***
BLISTER
What is a hemorrhagic bulla?
A bulla that is filled with blood instead of serous fluid
What is a pustule?
Elevated lesions that are filled with pus**
Acne, impetigo and fire ant bites are examples of?
Pustules
Do erosions bleed or scar?
No, it is loss of superficial epidermis
What is an erosion?
Loss of superficial epidermis with a moist surface, but doesn’t bleed.
What is an ulcer?
Loss of epidermis and dermis
What is the difference between an erosion and an ulcer?
An erosion is only the superficial epidermis, it doesn’t bleed and it doesn’t scar.
An ulcer involves loss of dermis, so it bleeds and it scars when it heals.
What is a fissure/
A linear crack from the epidermis to the dermis
What is an excoriation?
Abrasion or scratch mark usually from scratching
What is a crust?
Dried residue of serum, pus or blood
What is a scale?
A thin flake of epidermis that has been shed
Dandruff is an example of?
Scales on scalp
What is lichenification?
Skin become thick, rough and leathery due to so much scratching.
What type of skin condition is associated with increasing the visibility of skin markings?
Lichenification
What is atrophy (wrt skin)
Thinning of skin with loss of normal skin markings
Skin is shinier and more translucent
Topical steroid use is associated with what type of skin condition?
Atrophy
What are petechiae?
Small, dark round/purple spots that represent blood outside the vessel.
Smaller than .5cm**
NON BLANCHABLE**
What are purpura?
Dark red/purple spots that are BIGGER than .5cm**
Non blanchable
Represent blood outside vessel
Difference between purpura and petechiae?
Purpura are bigger than .5cm
What is ecchymosis?
Purple lesions that represent blood outside of vessels due to trauma or bleeding disorder.
Fade to green/yellow
How would you tell the difference between spider angioma and a petechiae?
Push on it. Spider angiomas do blanch.
How big are spider angiomas?
Up to 2cm
What are cherry angiomas?
Small bright red papules on the trunk, associated with aging
How big are cherry angiomas?
1-3mm
Do cherry angiomas blanch?
No
Do telangiectasias blanch?
Yes
What are telangiectasias associated with?
BCC
What are hemangiomas?
Big red bump secondary to dilation of dermal capillaries.
Similar to cherry angiomas, but much bigger and usually seen in children.
What is a papulosqaumous lesion?
One that has:
Papules
Plaques
Scales
What rash is associated with the 5 P’s?
Lichen Planus
Pruritic Polygonal Planar Purple Papules
Are nodular lesions benign or malignant?
Can be both
Nevi, cherry angiomas, SCC, BCC
What is a vesiculobullous lesions
Has vesicles and bullae together
Herpes, impetigo, pemphigus
What is pemphigus?
An autoimmune disease that has vesicles and bullae that rupture and the skin sloughs off.
Can be fatal
What is clubbing a sign of?
Chronic hypoxia
Congenital heart disease
Lung cancer
What are Beau’s lines?
Linear depressions in the nail due to trauma (or acute illness?) the lines grow out with the nail**
Are Beau’s lines permanent?
No they grow out with the nail
What is paronychia?
Inflammation of the nail folds (cuticle area) often due to frequent immersion in water
What is onychocrypotosis?
INGROWN TOENAIL
What are Terry’s nails?
White nails with a reddish brown stripe due to aging, diabetes, cirrhosis, heart failure
What is leukonychia?
White spots on nails due to trauma or repeated manicuring
What is koilonychia?
Spoon nail, possible iron deficiency anemia
What is onycholysis?
Painless separation of the nail and the nail bed
What can cause nail pitting?
Autoimmune disorders such as psoriasis, rheumatoid arthritis, lupus, alopecia areata
