Common Integumentary Problems of the Adult Patient

Vocabulary flashcards covering skin layers, primary and secondary skin lesions, infectious and inflammatory skin conditions, melanoma screening, and nail disorders.

Layers of the Skin

The structural anatomy of the integumentary system consisting of the epidermis, dermis (with papillary and reticular layers), and subcutaneous layer.

Bulla

A circumscribed collection of free fluid $> 1\,\text{cm}$.

Macule

A circular flat discoloration $< 1\,\text{cm}$, which can be brown, blue, red, or hypopigmented.

Papule

A superficial solid elevated lesion, $\le 0.5\,\text{cm}$, with varying color.

Plaque

A superficial elevated solid flat-topped lesion $> 1\,\text{cm}$.

Nodule

A circular, elevated, solid lesion $> 1\,\text{cm}$.

Pustule

A vesicle containing pus (inflammatory cells).

Patch

A circumscribed flat discoloration $> 1\,\text{cm}$.

Vesicle

A circular collection of free fluid $\le 1\,\text{cm}$.

Wheal

An edematous, transitory plaque that may last a few hours.

Scale

Epidermal thickening consisting of flakes or plates of compacted skin.

Crust

Dried serum or exudate on skin.

Fissure

A crack or split in the skin.

Impetigo

A highly contagious skin infection commonly occurring on the face, hands, arms, and legs that begins as an itchy red blister or bump, leaking honey-colored fluid (strep) or clear/pus fluid (staph), and leaving red patches with yellowish brown crust.

Cellulitis

An infection of the subcutaneous tissue and dermis usually caused by group A beta-hemolytic streptococci or Staphylococcus aureus, characterized by a tender, warm, erythematous, swollen area that is usually well demarcated.

Herpes Zoster

An acute unilateral and segmental inflammation of certain nerve roots caused by the varicella-zoster virus, confined to a dermatome and presenting with severe deep pain, pruritus, and paresthesia or hyperesthesia.

Dermatome

An area of the skin innervated by sensory fibers from a single spinal nerve.

Paresthesia

Burning, itching, prickling, or tingling sensations.

Hyperesthesia

Increased sensitivity to touch.

Postherpetic Neuralgia

The most common complication of shingles, affecting nerve fibers and skin, causing burning pain that persists long after the rash and blisters disappear.

Intertrigo

A superficial inflammatory skin condition of flexural surfaces, irritated by warm temperatures, friction, moisture, maceration, and poor ventilation, frequently secondarily infected with Candida.

Scabies

A skin infestation caused by the microscopic human itch mite Sarcoptes scabiei var. hominis, which burrows into the upper skin layer to live and lay eggs.

Serpiginous Burrows

Pathognomonic tiny raised and crooked grayish-white or skin-colored lines on the skin created by female scabies mites tunneling intraepidermally.

Skin Abscess

A swollen, pus-filled lump under the surface of the skin, often accompanied by systemic symptoms of infection like fever and chills.

Melanoma

The most aggressive form of skin cancer with a high risk of metastasis, occurring when melanocytes in the stratum basale layer of the epidermis turn cancerous.

ABCDE Rule

An acronym for early detection of melanoma representing Asymmetry, Border irregularity, Color variation, Diameter $> 6\,\text{mm}$, and Evolving size, shape, or color.

Subungual Hematoma

Bleeding and bruising under the nail bed resulting from injury to underlying blood vessels.

Nail Trephination

A procedure where a small hole is made in the nail to drain pooled blood and relieve discomfort from a subungual hematoma.

Paronychia

Inflammation of the skin surrounding a finger or toenail, classified as acute ($< 6\,\text{weeks}$) or chronic ($> 6\,\text{weeks}$), commonly triggered by a break in skin integrity at the cuticle or nail fold.