Skin, hair and nails

vitiligo

Loss of pigment → white patches of skin

dermatosis papulosa nigra

Small, benign dark bumps on face/neck, often called flesh moles

pityriasis alba

Light, scaly patches, often on the face

keloids

Overgrowth of scar tissue after injury, Scar extends beyond original wound boundaries

seborrheic keratosis

non cancerous skin growth, looks like wax brown or black patches, very common with aging

sinile lentigines

also called age spots or liver spots, flat, brown patches from sun exposure over time

cherry angiomas

small, bright red benign blood vessel growths, look like tiny red dots or moles

purpura

purple discoloration from small blood vesels leaking under the skin, skin looks brusied without injury

cutaneuous tags

small, soft flesh colored skin growths, often found in folds (neck, armpits, eyelids)

cutaneous horns

hard, cone shaped growth made of keratin, can sit on top of benign or precancerous lesions,

sebum

older adults skin may feel drier due to decrease in what production

acanthosis nigricans

a skin condition where there are dark, thickened, velvety patches of skin, associated iwth insulin resistance

erythema

redness of the skin caused by increased blood flow

striae

commonly called stretch marks, linear streaks or lines on the skin caused by stretching and thinning of the dermis

stage 1 pressure injury

intact skin with non-blanchable redness, no open wound

stage 2

partial thickness skin loss, skin damage involves epidermis and part of dermis

stage 3

full thickness skin less, damage extends into subcutaneous fat

stage 4

full thickness tissue loss with exposed deeper structures, damage extends to muscle, tendon, bone

macule

size less than 1 cm, well defined and circumscribed border, small flat, nonpalpable skin color change

patch

greater than 1 cm, often irregular borders, small flat, nonpalpable skin color change

papules

elevated, palpable, solid mass: circumscribed border, less than 0.5 cm, elevated nevi, warts, lichen plansu

plaques

raised, flat topped- palpable skin lesion that is larger than a papule, usually less greater 0.5 cm,can form when multple papules merge together

nodules

0.5 to 2 cm and circumscribed, elevated, solid palpable mass that extends deeper into dermis

than papule Keloid, lipoma, poorly absorbed injection dermatofibroma.

tumors

greater than 1 to 2 cm and do not always have shapr boarders, elevated, solid palpable mass that extends deeper into dermis

than papule, larger lipoma and carcinoma

vesicle

less than 0.5 cm, circumscribed elevated, palpable mass containing serous fluid. Herpes simple/zoster, varicella, poison ivy and second- degree burn

bulla

greater than 0.5 cm, circumscribed elevated, palpable mass containing serous fluid. Pemphigus, contact dermatitis, large burn blisters, poison ivy and bullous impetigo

wheal

elevated mass with transiet borders, often irregular, size and color vary, caused by movement of serous fluid into the dermis, does not contain free fluid in a cavity like a vesicle. Hives and insect bites

pustule

pus-filled vesicle or bulla. Acne, impetigo, furuncles and carbuncles

cyst

encapsulated fluid filled or semisolid mass located in the subcutaneous tissue or dermis

erosion

loss of superficial epidermis that does not extend to the dermis. Depressed, moist area: rupture vesicle, scratch mark, apthlous ulcer, commly called canker sore

ulcer

skin loss extending past epidermis, with necrotic tissue loss. bleeding and scarring possible

scar

skin mark left after healing of wound or lesion that represents replacement by connective tissue of the injured tissue

fissure

linear crack in the skin that may extend to the dermis and may be painful, ex chapped lips or hands and athlets foot

petechia

round red or purple macule that is 1 to 2 mm in size, secondary to blood extravastion and. associated with bleeding tendencies or emboli to skin

ecchymosis

round or irregular macular lesion larger than petechial lesion, color varies and changes: black, yelloe and green hues. secondary to blood extravasation, associated with truama and bleeding tendencies

hematoma

a localized collection of blood creating and elevated ecchymosis, associated with trauma

cherry angioma

papular and round, red or purple lesion found on the trunk or extremities, may blanch with pressure, normal age-related skin alteration and usually not clinically significant

spider angioma

red arteriole lesion with a central body with radiating branches, usually noted on the face, neck, arms and trunk. Rare below the waist, compression of the center of the arteriole completely blances the lesion. associated with liver disease, pregnancy, and vitamin b deficiency

telangiectasis

bluish or red lesion with caryinng shape (spider like or linear) found on the legs and anterior chest. does not blanch when pressure is applied, secondary to superfilation dilation of venous vessels and capillaries and associated with increased venous pressure states

linear configuration

straight ine, as in a scratch or streak, an example is dermatographism

annular configuration

circular lesions, an example is tinea corporis (scabies)

clustered configuration

lesions grouped together (herpes simplex)

discrete configuration

individual and distinct lesions, like multiple nevi

nummular configuration

coin shaped lesions

confluent configuration

smaller lesions run together to form larger lesion, like tines versicolor

longitudinal ridging

vertical lines or ridges that run from the cuticle to the tip of the nail

half and half nails

a nail color changer where hald is pale/white and the distal half is brown/red, strongly associated with chronic kidney disease/uremia

koilonychia

thin, spoon-shaped nails that curve upward at the edges, often from iron deficiency anemia

yellow nail syndrome

a condition where nails become thick, slow-growing and yellow

paronychia

infection or inflammation of the nail fold (skin around nail) from bacteria or fungi, nail biting trauma or manicures

melanoma

type of skin cancer where african americans, asians, and hispanics are susceptible

basal cell carcinoma

type of skin cancer that is more common in whites

squamous cell carcinoma

more common in darker skin

nonmelanocyte skin cancer

most common worldwide, inceasing in heavily exposed to sunlight. refers to skin cancers that do not come from melanocytes, instead they arise from other skin cells like basal cells or squamous cells

malignant melanoma

most serious skin cancer

xereoderma pigmentosum

a rare inherited disorder where the body cannot properly repair DNA damage from UV light

bowen disease

a very early form of squamous cell carcinoma, means cancer cells are present but have not invaded deeper skin layers yet, looks like scaly red thickened patch

asymmetry, borders, color, diameter, elevated

ABCDE of skin cancer

vitamin b

what vitamin needs to be evaluated for skin cancer

MRSA

type of infection resistant to many antibiotics, may be hospital acquired infection or community acquired infection

MRSA bundle approach

nasal swabbing and testing for MRSA colonization, contact precautions, hand hygiene, institutional culture of infection control for all personnel in contact with clients

skin integrity

highest risk factor for MRSA