Skin, hair, and nails

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Skin, hair, and nails
2014-10-12 03:47:39
skin hair nails

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  1. What is actinic purpura?
    Purple patches from leaky capillaries.
  2. Characteristics of childbearing women?
    • Increased blood flow to the skin (hands and feet) 
    • acceleration of west and sebaceous glands
    • Vascular spiders and hemangiomas (increased in size) 
    • Skin thickens, fat is deposited in sub dermal layers 
    • increased pigmentation. 
    • Linea Nigra: increased melanocyte stimulation hormone.
  3. What are basal cell carcinoma?
    • They are the most common cancer cell (immature cells) of the epidermis, around 80%. 
    • Usually found in sun exposure areas: Head and neck. 
    • Shiny and translucent, they grow slowly and rarely metastasize.
  4. What are squamous cell carcinoma?
    • usually more mature cells in the epidermis than basal cell carcinoma. 
    • Comprises 16% of skin cancer. 
    • Crusted, scaly, and ulcerated, they rarely metastasize. 
  5. What is melanoma?
    • Arise from pigment-productin melanocytes in the epidermis. 
    • It is the most lethal. 
    • Accounts for the remaining 4 to 5%. 
    • Indoor tanning increases risk by 75%. 
    • It is increasing more rapidly than any other cancer.
  6. What are Melanoma risk factors?
    • >50 moles, 1-4 atypical or unusual moles. 
    • Red/light hair; light/fair skin, light eye color. 
    • Heavy sun exposure. 
    • Family history.
  7. What are the ABCDE for screening moles for possible melanoma?
    • A: asymmetry. 
    • B: Borders. Irregular borders, especially ragged, notched, or blurred. 
    • C: change in color. Variation, specially blue or black. 
    • D: Diameter. >= 6 mm or different from other moles, especially changing, itching, or bleeding. 
    • E: Elevation/Enlargement.
  8. What is alopecia?
    The partial or complete absence of hair from areas of the body where it normally grows; baldness.
  9. What aspects of the skin should be examined?
    • Color: 
    • Moisture: 
    • Temperature: 
    • Texture: 
    • Mobility and Turgor: 
    • lesions:
  10. What aspects should of the hair should be examined?
    • Palpate and inspect hair. 
    • Quantity, distribution (alopecia), and texture.
  11. What is Macule?
    • Flat, non palpable area of discoloration
    • smaller than 1 cm. 
    • freckles or nevi. 
    • freckles or nevi: 
  12. what are patches?
    • Flat, non palpable areas of skin discoloration. 
    • Larger than 1 cm. 
    • Virtiligo (white patches). 
    • Virtiligo: 
  13. What are papules?
    • Raised, palpable (same size as macules, but palpable). 
    • less than 1 cm. 
    • warts, elevated moles. 
  14. What are plaques?
    • Raised, palpable, rough. 
    • greater than 1 cm. 
    • confluence of papules. 
    • EX: pcoriasis, actinin keratoses. 
  15. what are vesicles?
    • Fluid filled (serous fluid) circumscribed. 
    • Raised lesions, 
    • Less than 1 cm 
    • EX: herpes simplex, small pox. 
  16. What is Bullae?
    • Vesicles> 1 cm
    • EX: burns, large blisters. 
  17. what are Pustules?
    • Similar to vesicles but with pus (cloudy purulent) 
    • Viscous to solid inconsistency. 
    • EX: impetigo, acne. 
  18. what are wheals?
    • Raised circumscribed, edematous plaques. 
    • Pink or pale. (itchy, allergic rxn) 
    • Tansient. (they come and go) 
    • Mosquito bites, uticaria
  19. what are Nodules?
    • Raised palpable
    • Larger than 1 cm. 
    • Deep into dermis or outwards. 
    • EX: Rheumatoid arthritis. 
  20. What are tumors?
    • Nodules that are > 2cm. 
    • Or poorly demarcated. (weird shapes) 
    • They could be benign or malignant.
  21. What is a cyst?
    • Raised, encapsulated 
    • Fluid filled lesions. 
    • EX: sebaceous cyst, cystic acne.
  22. What is petechiae?
    • Reddish-purple discoloration. (bleeding or brushing, broken vessels) 
    • Small and flat. 
    • <0.5 cm 
    • Do not blanche. 
  23. What is purpura?
    • Ecchymosis. 
    • Large patches 
    • Looks like bruising. 
    • Does not blanche. 
  24. What is excoriations?
    • Secondary lesion
    • Scratch marks. 
    • Raised and linear. 
    • May appear as crust of primary lesion that has been scratched off. 
    • EX: abrasion, scratches from scabies. 
  25. what is Lichenification?
    • Secondary lesion. 
    • Thickening of the skin. (the skin over time reacts and becomes hard) 
    • Hardened and leather like. 
    • Flexor surface of extremity. 
    • EX: Chronic pruritis, chronic dermatitis. 
  26. what are scales?
    • Raised lesions. 
    • Thickening of the uppermost layer of the epidermis. 
    • White, gray, or tan. 
    • Small to large. 
    • EX: dandruff, psoriasis, ringworm. 
  27. What are crusts?
    • Raised lesions, dried serum or blood cells. 
    • Scab.
    • EX: impetigo. 
  28. What are erosions?
    • Depressed lesions. 
    • epidermis is removed or sloughed. 
    • Moist, usually red, well circumscribed. 
    • EX: ruptured chicken pox vesicle. 
  29. What are ulcers?
    • Depressed lesions epidermis and part of all of dermis. (bigger than erosions) 
    • Concave lesions. 
    • Moist, inflamed or hemorrhagic. 
    • EX: Decubitus ulcer (bed sores) 
  30. What are the stages of decubitus ulcer (pressure ulcer)?
    • I: intact skin red but not broken. 
    • II: Partial thickness skin erosion with loss of epidermis. Superficial, looks shallow. (starts to open the epidermis) 
    • III: Full thickness extending into the subcutaneous tissue. Crater-like. (need packing) 
    • IV: Full thickness involves all skin layers and exposes muscle, tendon, or even bone. 
    • * Can use Braden scale to predict risk of pressure ulcer. 
  31. What are fissures?
    • Depressed lesions. (really dry skin) 
    • Narrow and linear skin cracks. 
    • Penetrate through the dermis. 
    • EX: Athletes foot. 
  32. what is atrophy?
    • Nonspecific end product of skin disorder. 
    • Pale, shiny area with loss of skin markings and full skin thickness. 
    • EX: Steroid use, aged skin. 
  33. what is Melanoma lesions?
    • Asymmetry lesions. 
    • Border are irregular. 
    • Color blue/black or variegated. 
    • Diameter > 6mm. 
  34. What are common pediatric skin alterations? first 3 ...
    • Atopic demititis (eczema) 
    • Cafe-au-lait spots: linked with neurofiber metosis. 
    • Dipper dermatitis: 
  35. What are the most common pediatric skin alterations? last 3 ...
    • milea: common in new borns. 
    • Mongolian spots: Looks like bruising, don't disregard child-abusing option.
    • Hemanginoma: Redish area, they go away by themselves. 
  36. What are the parts of the nails?
  37. What is onycholysis?
    • Separation of nail plate from the nail bed.
    • It is very difficult to treat. (fungus). 
    • EX: thyroid disease, psoriasis, mycosis of the nails. 
  38. What is nail pitting?
    • Early signs of psoriasis. 
    • Small depression in the nail. 
  39. What is nail clubbing?
    • Condition results from low oxygen levels in your blood and could be a sign of lung problems (COP, asthma, or some type of hypoxia) 
  40. What is spooning/koilonychia?
    • Iron deficiency. 
  41. What is Terry's nails?
    • Whitening of the proximal 80% of the nail. 
    • Small rim peripheral reddening. 
    • Older adults. 
    • They are not dx, they are just interesting parts to assess. 
    • EX: heart failure, cirrhosis, adult onset DM. 
  42. what are Beau's lines?
    • Transverse grooves on the fingernails. (seriously ill) 
    • EX: After an MI, malnutrition, DM
  43. What is alopecia?
    • Area of hair loss. 
    • Traction alopecia: 
  44. what are some questions to ask the pt abt skin, hair, and nails?
    • 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? 
    • ask everyone what grooming products do they use.
  45. what are the characteristics of older adults skin, nails, and hair?
    • wrinkle and loses turgor (elasticity) 
    • Vascularity decreases: looks more pale. 
    • Actinic purpuraL purple patches from leaky capillaries. 
    • Nails yellow and thicken. 
    • Hair: loses pigment, amount of scalp hair decreases, diameter of hair shaft decreases, hair loss in all areas of the body. 
    • Females: facial hair after 55 yrs. 
    • Some of the changes may not be as prominent in darker skinned individuals. 
    • Sebaceous and sweat glands decreased.
  46. What are the characteristics of children/adolecents skin, hair, and nails?
    • Skin thinner and sensitive to hear and sun. 
    • Smooth and soft, not as "tough" 
    • Subcutaneous fat less developed and risk for hypothermia. 
    • Lanugo (soft hair on back) shed 4 months. 
    • glands: 
    • Eccrie glands function after 1st month (so cannot sweat) 
    • Apocrine glands not producing. 
    • Adolescent: Aprocrine glands enlarge and become active, sebaceous glands increase sebum, coarse remittal hair (pubic and axillae)