examination of skin, hair, nails
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Actinic Keratosis
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superficial, flattened papules covered by dry scale; often multiple, can be round or irregular; pink, tan, or greyish; benign, though 1 of every 1000 per year develop into squamous cell carcinoma
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Alopecia Areata
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sudden, rapid, patchy loss of hair; affected skin smooth, normal appearing; usually on scalp or face may be from emotional disturbances, infections, chemotherapy
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Alopecia Areata
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sudden, rapid, patchy loss of hair; affected skin smooth, normal appearing; usually on scalp or face may be from emotional disturbances, infections, chemotherapy
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atrophy
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thinning of skin surface & loss of normal skin markings; skin translucent, paper like; examples: striae, aged skin, chronic steroid use
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Basal cell carcinoma
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most common form on skin cancer slow growing & rarely metastasizes usually appears on face fair skin & sun exposure risk factors Telangiectatic vessels often visible
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Basal cell carcinoma
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most common form on skin cancer slow growing & rarely metastasizes usually appears on face fair skin & sun exposure risk factors Telangiectatic vessels often visible
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Beau's lines
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transverse grooving in nails associated with acute severe illness lines emerge from under proximal nail weeks later ; gradually grow out with the nails
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Beau's lines
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transverse grooving in nails associated with acute severe illness lines emerge from under proximal nail weeks later & gradually grow out with the nails
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Bulla
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vesicle greater than 1 cm examples: blisters, pemphigus vulgaris, bullous erythema multiforme
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clubbing
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Distal phalanx of each finger becomes rounded & bulbous; nail plate more convex angle between the plate & the proximal nail fold increases to 180 degrees or more; causes: chronic hypoxia from variety of respiratory DO's (COPD, lung Ca), cardiac DO's (CHF), chirrhosis
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clustered pattern
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seen in herpes & poison ivy
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crust
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dried residue on skin of serum, blood or pus; Slightly elevated, varies in size & color; examples: scabs (eschars), eczema, impetigo
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cysts
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elevated, encapsulated lesion in dermis or subcutaneous tissues filled with liquid or semi solid material (purulent or sebaceous) examples: sebaceous cysts, cystic acne, inclusion cysts
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Ecchymoses
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Purple or purplish-blue (fades to green, yellow, brown with times) 'bruise' variable size, nonblanching causes: trauma, bleeding disorders
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Erosion
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loss of superficial epidermis depressed, moist, glistening follows rupture of vesicle or bulla; does not bleed examples: apthous stomatitis, area after ruptured vesicle
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Excoriation
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linear or punctate hollowed out crusted areas examples: scratch, abrasion
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Fissure
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linear crack or break in the skin often due to excessive dry skin Examples: athlete's feet (tinea pedis), cheilosis (cracking at the angle of the mouth)
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Hirsuitism
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Growth of hair in women in the male distribution pattern(face, body, pubic areas) symptom not disease causes: Cushing's disease, insulin resistance, adrenal hyperplasia, polycystic ovary syndrome
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Keloid
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irregularly shaped, hypertrophic elevated scar grows beyond the boundaries of the wound caused by excessive collagen formation during healing
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Koilonychia
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central depression of the nail with lateral elevation of the nail plate produces concave curvature associated with: Fe deficiency anemia Syphilis fungal Dermatosis Hypothyroidism
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Koilonychia
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central depression of the nail with lateral elevation of the nail plate produces concave curvature associated with: Fe deficiency anemia Syphilis fungal Dermatosis Hypothyroidism
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Lichenification
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Rough, thickening epidermis increased visibility of normal skin furrows Often due to chronic rubbing (flexor surfaces), itching, skin irritation
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Macule
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small, flat, circumscribed area that is changed color if skin less than 1 cm examples: moles (nevi), freckles, measles, drug reactions
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Macule
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small, flat, circumscribed area that is changed color if skin less than 1 cm examples: moles (nevi), freckles, measles, drug reactions
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Melanoma
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Asymmetry Irregular Borders variation in Color--mixtures of black, blue, red Diameter--greater than 6mm Elevation--may also be flat changing in nevi of concern--new swelling, redness, scalling, oozing, bleeding, itching/bumping/pain
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Mongolian spots
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flat, nonpalpable, irregularly shaped macule greater than 1 cm in diameter congenital birthmark--more common in Mongolain area of the world; tend to fade w/ age
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nail pitting
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small depressions on the nail surface causes: psoriasis, lichen planus, eczema, alopecia areata, idiopathic
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Nodule
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Elevated, firm, marble-like lesion deeper than papule (in dermis) generally 0.5-2cm (if >2cm=tumor) examples: erythema nodosum, dermatofibroma, lipomas
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Onycholysis
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painless separations of the nail plate from the nail bed; start distally often multiple nails included Causes: hyperthyroidism, psoriasis, eczema, mycotic diseases of nails
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Papule
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raised, firm, circumscribed area less than 1 cm examples: verruca (wart), raised moles, lichen planus
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Paronychia
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infection of nailbed often related to trauma
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Paronychia
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infection of nailbed often related to trauma
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Patch (Vitiligo)
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flat, nonpapule, irregular shaped macule greater than 1 cm in diameter
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Patch (cafe au lait spots)
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develop as people age; first indication of neurofibromatosis flat, nonpalpable, irregularly shaped macule greater than 1cm in diameter
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Petechiae
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red-purple nonblanching discoloration (blood outside vessels) 1-3mm diameter Causes: intravascular defects (thrombocytopenia, increased INR), endocarditis, vasculitis
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Port wine stain
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type of patch
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Purpura
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larger petechie may be palpable (vascultis) meningiococcal--******** producing bacterium
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Plaque
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elevated, superficial, firm lesion with flat top surface greater than 1 cm in diameter Examples: psoriasis (velvety texture), actinic & seborrheic keratosis
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Squamous Cell Carcinoma
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most commonly in sun-exposed areas, particularly scalp, back of hands, lower lip & ear lesions are soft, elevated w/ surface scale, base of lesion may be inflamed may develop actinic keratosis usually grow more quickly, are firmer, and redder
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Splinter hemorrhages
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linear hemorrhages in the nail bed common in people who perform manual labor (more distal) also seen in endocarditis (more proxmial)
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Spider Angioma
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Fiery red, central body (sometimes raised) surrounded by erythema + radiating 'legs' up to 2 cm common on face, neck, arms, trunk; almost never below waist causes: liver disease, pregnancy, vitamin B deficiency, normal variant in some people
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Serpiginous
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worm-like
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Seborrheic Keratosis
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common, benign yellowish to brown raised lesions slightly velvety, greasy, warty--have 'stuck on' appearance typically multiple, symmetrically distributed
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Seborrheic keratosis
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common, benign yellowish to brown raised lesions slightly velvety, greasy, warty--have 'stuck on' appearance typically multiple, symmetrically distributed
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Scale
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thin flake of dead, exfoliated epidermis irregular, thick or thin, varies in size examples: seborrheic dermatitis, dry skin, cellulitis
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Pustule
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similar to vesicle except filled with purulent material less than 1 cm Examples: acne, impetigo, smallpox
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Pustule
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similar to vesicle except filled with purulent material less than 1 cm Examples: acne, impetigo, smallpox
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Wheal
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Elevated, irregularly shaped area of cutaneous edema; classic hive variable diameter, solid, transient Examples: insect bite, urticaria, allergic reactions
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Vesicle
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Elevated, circumscribed, superficial (not into dermis) Filled with serous fluid (yellowish, viscous fluid; typical ascites) less than 1 cm Examples: varicella (chicken pox), shingles, HSV
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Ulcer
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deep loss of epidermis & dermis examples: decubiti, vascular ulcers
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Trichotillomania
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loss of scalp hair due to physical manipulation usually an unconscious habit affected area has irregular border, hair density is greatly reduced, but site is not totally bald
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Terry's nails
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nails mostly whitish with a distal band of reddish brown lunulae may not be visible seen with aging ; with chronic diseases (cirrhosis, CHF, DM)
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Telangiectasia
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fine, irregular red lines (0.5-1mm) caused by dilation of capillaries--blanch when palpated causes: hereditary, pregnancy, liver disease, CREST syndrome
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Subungual hematoma
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collection of blood under nail due to trauma
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Squamous cell carcinoma
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most commonly in sun-exposed areas, particularly scalp, back of hands, lower lip ; ear lesions are soft, elevated w/ surface scale, base of lesion may be inflamed may develop actinic keratosis usually grow more quickly, are firmer, and redder
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Impetigo
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honey colored crusts
