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Examination of the Skin, Hair, & Nails
Clinical Assessment Module 1
53
Medical
Graduate
06/29/2009
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Term
functions of the skin
 Definition
 LARGEST ORGAN IN BODY
 Protection
 Prevent Fluid Loss
 Regulate Body Temperature
 Sensory
 Excretory
 Vitamin D Synthesis
 Immune Function
Term
woods lamp
 Definition
About 50% of M. canis strains
produce metabolites which
fluoresce an apple-green color. Cornybacterium
on the skin will
fluoresce a coral-
red color.
Term
examination of the skin
 Definition
Head to toe exam
 Avoid “peek-a-boo”
exam
 In segments
 Preserve Dignity of
patient
 Learn to elegantly
describe findings
 Use nurse or other
personnel as “standby”
during exam and record
Term
skin inspection
 Definition
Ensure adequate lighting
• Ensure adequate exposure
attention to modesty
inspect and re-cover portions
• Dry or Moist
• Color of skin or skin lesion(s)
jaundice
erythema
violaceous (purple)
pallor
cyanosis
Term
skin palpation
 Definition
Moisture
• Oiliness
• Temperature
• Texture
• Turgor
• Mobility
• Tenderness
Term
circumscribed flat
discoloration <1cm
•
 Definition
macule
Term
circumscribed flat
discoloration >1cm
•
 Definition
patch:
Term
superficial raised
solid lesion up to 1cm
•
 Definition
papule:
Term
superficial elevated
lesion >1cm
•
 Definition
plaque
Term
circumscribed
collection of free fluid <1cm
•
 Definition
vesicle:
Term
circumscribed
collection of free fluid >1cm
 Definition
bulla:
Term
same as nodule, but
>2cm
 Definition
• tumor:
Term
circumscribed solid
lesion 1-2cm,
(some depth implied by this
description)
 Definition
• nodule:
Term
edematous, transitory
plaque
 Definition
• wheal:
Term
•vesicle containing
pus (inflammatory cells)
 Definition
pustule:
Term
circumscribed lesion with a wall and a lumen.
Can be fluid filled or solid.
 Definition
Cyst:
Term
dilated
superficial blood
vessels, also called
vascular spiders
 Definition
Telangiectasia:
Term
skin changes resulting from some external factor
(like scratching, trauma, infection, or changes caused by
healing).
 Definition
Secondary Lesions
Term
hypertrophic scar, extends beyond
borders of wound
 Definition
 Keloid:
Term
flaky skin, irregular, may be thick or
thin, dry or oily
 Definition
Scale:
Term
rough, thickened skin,
results from chronic rubbing, itching
 Definition
 Lichenification:
Term
skin thicker than surrounding area
following injury
 Definition
 Scar:
Term
loss of epidermis
and dermis
 Definition
 Ulcer:
Term
superficial loss of
epidermis
 Definition
 Erosion:
Term
linear crack in the
skin, involves the dermis
 Definition
 Fissure:
Term
loss of
epidermis secondary to
scratching
 Definition
Excoriation:
Term
thinning of
skin, more fragile, can be
epidermal or dermal
 Definition
“scab”
 Atrophy:
Term
dried serum, a
 Definition
Crust:
Term
pale-white, edematous
 Definition
macerated:
Term
drop like
 Definition
guttate:
Term
 purplish pigment
 Definition
violaceous:
Term
 extravasated blood, non-blanchable
reddish pigment
 Definition
purpura:
Term
 attached by a stalk
 Definition
pedunculated:
Term
 attached directly at the base, no stalk
 Definition
sessile:
Term
 thickened
 Definition
hyperkeratotic:
Term
 dermatitis, eczema like
 Definition
eczematous:
Term
 ability to “press out” redness
 Definition
blanching:
Term
 dilated capillary
 Definition
telangiectasia:
Term
 wart-like
 Definition
verrucous:
Term
body surface estimates
 Definition
back, chest, each leg= 18%. arms, head=9%. groin, hand=1%
Term
hair phases
 Definition
catagen, telogen, early anogen, mature anogen
Term
Female Pattern Hair “Loss”
 Definition
“Vertex” hair thinning
 Best referred to as
“Female Pattern Hair
Thinning”
 Almost never results in
complete loss of hair
Term
is a form of alopecia, or gradual hair loss, caused primarily by pulling force being applied to the hair
 Definition
Traction Alopecia
Term
Complete loss on scalp
 Definition
Alopecia
Totalis
Term
Complete loss of body hair
 Definition
Totalis Universalis
Term
Telogen effluvium
 Definition
Most common cause of
hair loss in women
• Childbirth
• Severe infection
• Severe chronic illness
• Severe psychological
stress
• Major surgery
• Hypo/hyperthyroidism
• Severe anemia
• Crash diets inadequate
protein
• Drugs
Term
a nail disease that can be a sign of hypochromic anemia, especially iron-deficiency anemia.[2]:656[3] Koilonychia literally means "spoon nails." It refers to abnormally thin nails (usually of the hand) which have lost their convexity, becoming flat or even concave in shape. In a sense, koilonychia is the opposite of nail clubbing.
 Definition
Koilonychia
Term
is a medical term for white discoloration appearing on nails. The most common cause is injury to the base of the nail (the matrix) where the nail is formed.
 Definition
Leukonychia
Term
psoriasis
 Definition
Pitted Nails
Term
refers to the detachment of the nail from the nail bed, starting at its distal and/or lateral attachment.[1] It is said to occur particularly on the ring finger but can occur on any of the fingernails.
 Definition
Onycholysis
Term
fungal infection of the nail.[1] It is the most common disease of the nails and constitutes about a half of all nail abnormalities
 Definition
Onychomycosis
Term
Fever
• Childbirth
• Severe Illness
• Trauma

Nail growth
- about 1mm/week
Finger: 4-6 months
Great Toe: 8-12 month
 Definition
Beau’s Lines
Term
cause peeling and roughening of the surface on both feet and hands. They appear elevated and irregular. Warts of this kind often cause damage to the nail either by lifting the nail from the skin or causing the nail to partially detach.
 Definition
Periungual warts
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