Health Assessment: Chapter 8: Skin Color Changes, Texture, Lesions

darker skin color

hyperpigmentation

lighter skin color

hypopigmentation

pale skin is seen in anemia, decrease in circulating red blood cells or blood flow, absence of oxygenated blood

pallor/pale

blue, gray, slate, or dark purple discoloration of skin/mucous membranes caused by deoxygenated or reduced hemoglobin in blood; may occur w/decreased cardiac output

peripheral cyanosis

autoimmune disorder that causes smooth, white patches of skin all over the body

vitiligo

changes in skin color could indicate

systemic disease/problems with circulation

inherited disorder caused by total/partial absence of an enzyme that produces melanin

albinism

a yellowing of skin due to increased dietary intake of carotene in diet from foods such as carrots, sweet potatoes, pumpkin, corn, yams, spinach, and beans; sclera of the eye does not yellow

carotenemia

bluish discoloration to the skin related to decreased circulating oxygen; best assessed in oral mucosa, conjunctiva of the eyes, lips, and tongue

central cyanosis

Red, pink skin color; may indicate inflammation, fever, or increased blood flow. In carbon monoxide poisoning, the individual will have a bright red cherry face and upper trunk.

erythema

yellowing of skin due to excessive levels of bilirubin in blood

jaundice

conditions that affect skin texture

autoimmune diseases, acne vulgaris, eczema, hormonal conditions, rosacea

causes chronic inflammation of skin; itchy, dry, scaly patches of skin; skin disorder has familial tendencies

eczema

can change texture of skin to be dry, oily, moist; may change skin color

hormonal conditions

inflammatory skin condition causing redness, swelling, spider-like blood vessels to develop on middle of face

rosacea

occur in reaction to the external/internal environment; they may be present at birth or develop during an individual's lifetime

primary skin lesions

circular, small, flat, nonpalpable spot less than 1 cm in diameter

red, brown, white in color; color not the same as that of nearby skin; present in different shapes; example - freckles

macule

irregular, flat, nonpalpable macule greater than 1 cm; example - mongolian spots

patch

solid, elevated, spot that appears rough in texture and measures less than 1 cm in diameter

pink, red, brown in color

example - seborrheic keratosis

papule

a patch of closely grouped thickened papules measuring greater than 1 cm across.

red, brown, pink in color w/rough texture

example - psoriasis

plaque

raised, circumscribed, round, or oval w/serous blood or clear fluid measuring less than 1 cm in diameter

example - herpes zoster

vesicle

solid, elevated, palpable, measuring greater than 1.5 cm in diameter

example - vascular nodule

nodule

raised, circumscribed vesicle usually < 1 cm in diameter, filled w/pus

infection is primary cause

example - acne

pustule

elevated, circumscribed, fluid filled; > 1 cm in diameter

example - friction blister

bulla

small, dilated blood vessels that occur near the surface of the skin

example - rosacea

telangiectasia

solid, elevated, palpable, measuring greater than 2 cm; may vary in size/shape

example - fatty lipoma

tumor

defined by raised swelling, red bumps, welt, itchy skin

red in color

caused by allergic reaction usually

wheal

scale, crust, excoriation, erosion, ulcer, fissure, scar, keloid, moles

examples of secondary skin lesions

macule, papule, patch, plaque, vesicle, nodule, pustula, bulla, telangiectasia, tumor, wheal

examples of primary skin lesions

dry build-up of dead skin cells that usually flakes off the surface of the skin, such as psoriasis

scale

lesions are progressive changes in primary lesions, trauma, injury to primary lesion

secondary skin lesions

dried collection of blood, serum, or pus; part of the normal healing process; such as dried herpes zoster

crust

hollow, crusted area w/loss of epidermis and an exposed dermis; may be caused by scratching the area as in chronic incontinence

excoriation

depressed area that is moist and shiny; loss of superficial epidermis; such as candidiasis erosion

erosion

concave, exudative, variable in size

erode different layers of skin; pressure ulcer

ulcer

linear crack/break in skin that involves epidermal and dermal layers

create small, deep, red fissures in the skin

fissure

discolored fibrous tissue that appears over healed surgical incisions and wounds; can be red, blue, white, silver in color

scar

created by excessive collagen production extending beyond original boundaries of a wound/incision; thick and raised

keloid

a proliferation of melanocytes, also called nevus; nevi is plural for nevus

color is usually pigmented in shades of brown w/smooth borders

measure less than 6 mm; hair can grow out of them

individuals average between 10-40 nevi

moles

dysplastic nevi/Clark's nevi

larger w/irregular, poorly defined borders

color varies between shades of brown, tan, pink

greater potential for developing into melanoma

atypical moles

present at birth

vary in size; can be greater than 10 cm

categorized as small, medium, giant in size

color is usually tan, brown, red, or shades of black

congenital nevi

rashes can be

acute or chronic

related to:

- diet

- stress

- medications

- allergies

- hormone imbalance

- autoimmune disease

- kidney disease

- toxic reactions

- digestive problems

- body imbalances

- chemicals

- sun exposure

rashes

ecchymosis, hematoma, telangiectasia, petechiae, purpura

vascular lesions

bruise under skin or mucous membranes; occurs as a result of local trauma

ecchymosis

elevated collection of clotted blood within tissue caused by a break in a blood vessel

hematoma

caused by vascular dilation of small group of blood vessels, occurs anywhere on body but most often on face and legs

telangiectasia

tiny, pinpoint hemorrhages caused by superficial bleeding from capillaries of skin; measure less than 3 mm; may be related to platelet deficiencies

petechiae

hemorrhagic red/purple spot or rash that is flat and does not blanch; measures 3-10 mm; may be associated w/platelet disorders

purpura

presents as a pearl white, dome-shaped papule w/overlying random telangiectasia

enlarges slowly and may ulcerate in center

most common form of cutaneous malignancy

basal cell carcinoma

malignant cutaneous malignancy arising from keratinocytes of skin or mucosal surfaces

thick, rough, scaly w/crusted surface and irregular borders

second most common type of skin cancer

squamous cell carcinoma

malignancy of melanocytes arising in skin

develops from pre-existing lesion usually with an increase in size, change in color/appearance of nevus

vary considerably in appearance; curable with early detection

malignant melanoma