Ch 13: Hair, Skin, and Nails

What is Alopecia?

hair loss, baldness

what is a nodule?

A solid elevated lesion that is usually larger than one centimeter

What is confluent growth?

lesions running together and they look like one large growth

What is cyanosis?

blue discoloration of the skin

What is erosion?

tissue loss

What is Erythema?

redness of the skin

What is excoriation?

Skin sore or abrasion produced by scratching or scraping

What is a keloid?

abnormally raised or thickened scar

What is a hemangioma?

benign tumor of blood vessels

What is Maceration?

the softening and breaking down of skin resulting from prolonged exposure to moisture

What is a macule?

a flat lesion that differs in color from surrounding skin (<1 cm in diameter)

What is a papule?

small elevation of the skin that contains no fluid and may develop pus

What is pruitus?

itching of the skin

What is a pustule?

an elevated lump on the skin filled with pus/white blood cells ex: acne

what is plaque?

felt and caused by superficial thickening of the epidermis

What is a patch?

macules that are: > 1 cm

What is a vesicle?

A fluid-filled, very small (>1cm), elevated lesion, blisters

What is a wheal?

-Superficial, raised, transient and erythematous
-irregular in shape due to edema
ex: hives or insect bites

what is a cyst?

encapsulated fluid filled cavity

What is a bulla?

Larger than 1 cm diameter; usually single chambered (unilocular); superficial in epidermis; thin walled and ruptures easily.

-Examples: friction blister, pemphigus, burns, contact dermatitis.

what is a tumor?

large in diameter
firm or soft
deeper into dermis
may be benign or malignant

What is urticaria (hives)?

wheals coalesce to form extensive pruritic reaction

What is the largest organ system?

the skin
- covers 20 ft2 of surface area in adults
-first line of defense/protection from pathogens/environment

What are the 3 layers of the skin?

epidermis, dermis, hypodermis

What are the characteristics of the epidermis?

-outermost layer
-basal cell layer-forms new skin cells
-outer horny layer-dead keratinized skin cells
-Avascular
-Stratum Corneum and Cellular Stratum
- basement membrane lies beneath the cellular stratum and connects the epidermis to the dermis

What are the characteristics of the dermis?

-connective tissue or collagen
-elastic tissue
-highly vascular
-elastin,collagen,and reticulin fibers
-sensory nerve fibers
-autonomic motor nerves

what are the characteristics of the hypodermis?

adipose tissue: cushions, stores fat for energy, protects, provides increased mobility

and connects dermis to the underlying organs

What are the skin color sources?

-Melanin= brown
-Carotene= yellow/orange
-Red and purple tones in the underlying vascular bed

all people have all three variations of color, depending on skin thickness and presence of edema

What is hair?

threads of keratin

made of: shaft, and bulb

shaft- houses the melanocytes

What is vellus hair?

pale, fine body hair

What is terminal hair?

Course hair on head and in pubic region; men's facial hair.

What are sebaceous glands?

they secrete sebum= lipid substance through hair follicles

lubricates the skin and form emulsions

What are sweat glands?

2 different kinds: eccrine and apocrine

-eccrine= produce sweat, regulate body temp
-apocrine= produce milky secretion and open into hair follicles, emotional sweat response

What are nails?

hard plates of keratin on the dorsal edges of the fingers and toes

what is below the nail?

the vascular bed, gives nails the pink appearance

What does the stratum corneum cover in the nail?

the root= cuticle or the eponychium

what are the functions of the skin?

Protection, insulation, prevents water loss from the body surface, acts as a mini-excretory system, the site of vitamin D synthesis, regulates heat loss.

What is Lanugo in newborn infants?

fine downy hair of newborn infant

What is vernix caseosa in newborn infants?

thick, cheesy substance

What is sebum in newborn infants?

holding water in the skin producing mila

What changes in the epidermis in children?

it thickens, darkens, and becomes lubricated

What hair growth changes occur in children?

hair growth accelerates

What characteristics change in adolecents?

-secretions from aprocrine sweat glands increase
-subcutaneous fat deposits increase
-secondary sex characteristics

What occurs in pregnant women?

-increased metabolism= increase of sweat and sebaceous glands to dissipate heat

- fat deposits are laid down as maternal reserves for nursing baby

- expected skin color changes due to increased hormone levels

What are skin changes in the older adult?

-loss of elasticity= skin folds and sags
-decrease in sweat and sebum
-senile purpura= discoloration due to capillary fragility
-skin breakdown= cell replacement is slower and wound healing is delayed
-hair melanocytes decrease=gray hair

What are the signs of clubbing of the nail?

180 degrees=early clubbing

What is the ABCEDF skin assessment?

to detect suspicious lesions
◦A: asymmetry
◦B: border irregularity
◦C: color variations
◦D: diameter greater than 6 mm
◦E: elevation or evolution
◦F: funny looking—"ugly duckling" —different from others

Annular or Circular

begins in center and spreads to periphery

confluent

lesions run together (hives)

discrete

Distinct, separate

grouped

clusters of lesions

gyrate

twisted, coiled spiral, snakelike

target or iris

resembles iris of eyes, concentric rings

linear

a scratch, streak, line, or stripe

polycylic

annular lesions grow together

Zosteriform

linear arrangement along a unilateral nerve route

what is crust?

thickened dried out exudate

what is a scale?

compact flakes of desiccated skin from shedding of dead excess keratin cells

what is a fissure?

A linear crack with abrupt edges extending into dermis

ex. chapped lips and athlete's foot

what is erosion?

scooped out but shallow depression

what is an ulcer?

deeper depression extending into dermis, irregular shape; may bleed; leaves scar when heals

what is excoriation?

self-inflicted abrasion; superficial; sometimes crusted; scratches from intense itching

what is a scar?

permanent fibrotic change after healing

What is an atrophic scar?

the resulting skin level is depressed with loss of tissue; a thinning of the epidermis

what is the lichenification?

Scratching => thick leathery skin

producing tightly packed set of papules

what is a keloid?

benign excess of scar tissue beyond original injury

what are the stages of pressure injuries?

◦Stage I: Non-blanchable erythema

◦Stage II: Partial-thickness skin loss

◦Stage III: Full-thickness skin loss

◦Stage IV: Full-thickness skin/tissue loss

What is folliculitis barbae?

Razor bumps

what is melasma?

hyperpigmentation associated with pregnancy

-chloasma, Mask of pregnancy

What is a Penduculated lesion?

has an attachment smaller than the top (base is called a stalk or pedicle)

What are the Cafe au lait spots?

Smooth edged tan-to-brown pigmentations on the skin

-in infants

What are mongolian spots?

bluish discoloration over buttocks and base of spine

What is harlequin color change?

Occurs when the baby is in a side-lying position.

The lower half of the body turns red and the upper half blanches

What is eryhtema toxicum?

tiny, punctate red macules and papules on the cheeks, trunk, chest, back, and buttocks (newborn rash)

What is nervus simplex?

"stork bite"

pink/red capillary on face or neck

What are comdeones?

open/closed

blackheads

What is straie?

stretch marks

What is linea nigra?

Dark streak down the midline of the abdomen seen during pregnancy

what are vascular spiders?

tiny red centers with radiating branches and occur on the face, neck, upper chest, and arms

What are solar lentigines?

Flat lesions found in areas of sun exposure

older adults

What is seborrheic keratosis?

Rubbery warts with aging, greasy

What is actinic keratosis?

pre-malignant growth

what is xerosis?

dry skin

What is an acrochordon?

skin tag

what is sebaceous hyperplasia?

Benign lesion formed in oilier areas of the face

What is nervus flammeus?

permanent purple birthmark;

Port-wine stain

what is infantile hemangioma?

strawberry mark

what is a venous lake?

blue-purple dilation of venules and capillaries in a star-shaped, linear, or flaring patternl

What is petechiae?

a small red or purple spot caused by bleeding into the skin.

What is ecchymosis?

bruising

What is tinea corporis?

ringworm of the body

What is tinea pedis?

athletes foot

what are labial herpes simplex?

cold sores

what is tinea vericolor?

tricolor yeast infection

what is psoriasis?

chronic skin condition producing red lesions covered with silvery scales

what is toxic alopecia?

patchy, asymmetric balding

What is seborrheic dermatitis?

cradle cap

what is a furuncle?

boil from infected hair follicle

What are Beau's lines?

white lines across the fingernails

usually a sign of systemic disease or injury

what is onyxhomycosis?

fungal infection of the nail