Assessing the SKIN, HAIR and NAILS

Skin

Skin

Largest organ of the body / Protects the underlying tissues and organs

Epidermis, Dermis, Subcutaneous tissue

Three Layers of Skin

Epidermis

Outer layer of skin

Dermis

Inner layer of skin

subcutaneous tissue

Tissue, largely fat, that lies directly under the dermis and serves as an insulator of the body.

Keratin

hard protein material found in the epidermis, hair, and nails

dermal papillae

connect the dermis to epidermis

fingerprint

The unique patterns created by skin ridges found on the palm sides of fingers and thumbs.

sebaceous glands

secrete sebum (oil) into the hair follicles where the hair shafts pass through the dermis

sweat glands

The glands that secrete sweat, located in the dermal layer of the skin.

eccrine glands

glands that produce sweat; found over most of the body

apocrine glands

Sweat glands in the pubic and underarm areas secrete thicker sweat, that produce an odor when coming in contact with bacteria on the skin

vellus and terminal

two types of hair

Vellus

Thin, soft, unpigmented hair covering the body

terminal

coarse, long hair of eyebrows, scalp, axillary, and pubic regions

hair follicle

sac within which each hair grows/ sheath of epidermal cell

hair shaft

The portion of hair that projects above the epidermis

hair root

The part of the hair contained within the follicle, below the surface of the scalp.

Anagen

The period of active growth

Hair grows about

1 cm every 28 days

Telogen

Resting phase of hair growth

alopecia

hair loss/ most distressing change in hair

Nails

hard keratinized cell, protective coverings on the ends of the fingers and toes

free edge

part of the nail plate that extends over the tip of the finger or toe

nail bed

epithelial layer of the skin/ Portion of the living skin that supports the nail plate as it grows toward the free edge.

lunula

proximal part/ The half-moon-shaped, whitish area at the base of a nail

yellow nails

Usually from a fungal infection, cigarettes, psoriasis

distal band of reddish brown pink

renal disease, hypoalbuminemia

Blue (cyanotic) nails with clubbing

Peripheral disease or hypoxia

White nails (leukonychia)

trauma, cardiovascular, liver, or renal disease

Rashes

may be localized or generalized and caused by a dermatologic problem or underlying systematic problem

Cold Urticaria

temperature fluctuations

Warm Weather Skin Rash

air humidity

Cutaneous anthrax

exposure to contaminants

Non - healing sore or chronic ulceration

Often associated with an underlying diseases.

The most common types are caused by vascular disease or pressure or by diabetes.

nail changes

reflect an underlying systematic problem/ in color and texture are frequent complaints

pallor

decrease in color of the skin caused by lack of oxygen

cyanosis

bluish discoloration of the skin due to lack of oxygen or poor tissue perfusion

fingernails, lips, and the mucous membranes of the mouth and palpebral conjunctiva

pallor best observe around:

lips and nails bed

cyanosis best observe around:

Two types of cyanosis

central and peripheral

central

cause by diseases of heart and lungs/ bluish discoloration of the tongue and linings of the mouth

peripheral

results from the decreased peripheral circulation/ seen at the arms and legs

jaundice

Also known as icterus; a yellowish appearance of the skin, sclera, mucous membrane, and excretions related to hepatobiliary disorders or hemolytic diseases.

erythema

redness of the skin due to capillary dilation

hyperpigmentation

darkened areas of skin caused by excessive amounts of melanin

hypopigmentation

areas of skin lacking color because of deficient amounts of melanin

vitiligo

white patches on the skin caused by the destruction of melanocytes associated with autoimmune disorders

Albinism

complete or partial lack of melanin

Unusual body odor

Poor hygiene or underlying disease

odors from excessive sweating (hyperhydrosis)

possible thyrotoxicosis (excess thyroid hormone)

Odors from night sweats

Possible tuberculosis

urine odor

Incontinence problem

Mousy odor

liver disease

skin edema

Excessive accumulation of fluid in body tissues - cardiovascular problem.

1+

barely detectable

2+

indentation of less than 5 mm

3+

indentation of less than 5-10 mm

4+

indentation of more than 10 mm

primary skin lesions

Initial alteration in the skin, abscess, ulcer, tumor, and open wound

secondary skin lesions

changes that take place in the primary lesion due to infection, scratching, trauma, or various stages of a disease

ABCDE of lesions

useful for assessment of skin cancers

asymmetry, border irregularity , color variation, diameter, elevation

ABCDE of lesions types

macule/patch

Small, flat, non-palpable skin color change

Lentigines

small brown patches on the skin typically on elderly people

petechiae

tiny circular bleeding under the skin

scarlet fever

bright red rash the covers most of the body, develops in people with strep throat

chloasma

mask of pregnancy

Mongolian spots

congenital dermal melanocytosis

port-wine stain

discoloration of the human skin caused by a vascular anomaly

papule

palpable, raised but superficial

plaque

elevated, palpable, solid mass

wheal

Elevated mass with transient borders that is often irregular. Size and color vary. Collection of edema fluid into the dermis. Raised, superficial, and temporary.

hives

outbreak of swollen, pale red bumps or plaques (wheals) on the skinthat appear suddenly

nodule and tumor

solid, round or oval elevated lesion 2 cm or more in diameter

lipoma

lump of fatty tissue/ feel rubbery/ painless, harmless not cancerous

squamous cell carcinoma

second most common form of skin cancer

dermatofibroma

superficial benign fibrous histiocytoma

cyst

encapsulated fluid-filled or semisolid mass that is located in subcutaneous tissue or dermis

Vesicle/Bulla

palpable, fluid filled

vesicles

less than 0.5 cm

bullas

greater than 0.5 cm

herpes simplex

set of viruses that produce viral infections in the majority of humans

Varicella

chicken pox

poison ivy rash

allergic reaction to an oily resin called urushiol

second degree burns

partial thickness burns

pemphigus

rare group of blistering autoimmune diseases

contact dermatitis

red itchy rash caused by direct contact wt a substance or an allergic reaction to it

large burn blisters

caused by burns

bullous impetigo

caused by bacterial infection

Lichenification

Thickening and scaling with increased skin markings, ex. Eczema

scales

shedding of dead skin cells

crust

dried exudates, dried serum, bloods or pus on the surface of the skin

scar

A mark on the skin that is left after a cut or other wound has healed.

keloid

hypertrophic scarring because of excess collagen formation

excoriations

abrasion or other loss that does not extend beyond the superficial epidermis

erosions

loss of superficial epidermis

Fissures

linear crack in the skin that may extend to the dermis

Ulcers

skin loss extending past dermis