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Health assessment test 2 ch.11
ch11
74
Medical
Professional
10/10/2008

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Term
Macule
Definition
nonpalpable change in skin color. Smaller than 1 cm, with a circumscribed border
primary lesion
Eg: freckle, measles, petechiae, cherry angioma
Term
Papule
Definition
smaller than 0.5 cm, palpable, solid mass with circumscribed border
primary lesion
eg: elevated moles, warts, basal cell carcinoma, kaposi's sarcoma, psoriasis
Term
Nodule
Definition
solid, hard or soft palpable mass extending deeper into the dermis than a papule
eg: small lipoma, squamous cell carcinoma, fibroma
Term
pustule
Definition
elevated, pus-filled vesicle or bulla with circumscribed border
Term
vesicle
Definition
elevated, fluid-filled, round or oval-shaped, palapable mass with thin, translucent walls or circumscribed borders
eg: herpes simplex/zoster, early chickenpox, poisen ivy, small burn blisters
Term
plaque
Definition
large, slightly elevated lesion with flat surface, often topped by scale
eg; psoriasis, actinic keratosis
Term
crust
Definition
dry blood, serum, or pus left on the skin surface when vesicles or pustules burst
secondary lesion
eg. eczema, impetigo, herpes, or scabs
Term
lichenification
Definition
thick, dry rough surface (leather-like)
Term
keloid
Definition
an elevated, irregular, darkened area of excess scar tissue cause by excessive collagen formation during healing. it extends beyond the site of the original injury
secondary lesion
Term
fissure
Definition
small, deep linear crack or tear in skin
Term
ulcer
Definition
cavity with loss of tissue from the epidermis and dermis, often weeping or bleeding
Term
erosion
Definition
shallow, moist cavity in epidermis
secondary lesion
eg: abrasion, dermatophyte infection, fragile skin, impetigo
Term
comedone
Definition
mass of sebum, keratin and debris blocking the opening of a hair follicle
Term
wheal/hive
Definition
raised, superficial
primary lesion
allergic reation, hives, insect bite
Term
cyst
Definition
<2cm if nodule is fluid filled and encapsulated,called a cyst
palpable, solid with depth
bartholin's cyst, erythema nodosum, lipoma
Term
scales
Definition
shedding, dead skin cells, scales can be dry, or oily, adherent, or loose
variable in color
secondary lesion, may result from changes in primary lesions
eg: psoriasis
treatment: lotion
Term
excoriation
Definition
abrasion or other loss that does not extend beyond the superficial epidermis
secondary lesion
eg. aptopic dermatitis; insect bites; scabies; statis dermatitis
Term
inflammatory disorders: secondary
Definition
contact dermititis
hive (urticaria)
atopic dermatitis (eczema)
psoriasis
discoid (cutaneous) lupus
pemphigus
scleroderma
Term
skin bacterial infections: secondary
Definition
cellulitis
furuncles (boils)
impetigo
acute necrotizing fasciitis
Term
skin viral infections: secondary
Definition
herpes simplex
herpes zoster (shingles)
verrucae (warts)
Term
skin fungal infections: secondary
Definition
tinea
Term
other secondary skin infections
Definition
scabies
pediculosis (lice)
Term
skin tumors
Definition
keratoses
squamous cell carcinoma
malignant melanoma
kaposi's sarcoma
Term
contact dermatitis
Definition
causes: exposure to an allergen, direct chemical or mechanical irritation of skin
Term
urticaria (hives)
Definition
hypersensitivity reaction
common cause: ingestion of shellfish, fruits or drugs
histamine release-->eruption of hard, raised, erythematous lesions often scattered all over body
lesions are highly pruritic
may develop in the pharyngeal mucosa and obstruct airway
EMERGENT SITUATION
Term
atopic dermatitis (eczema)
Definition
pruritic lesions are moist, red, vescular, covered with crusts
adults: affected skin: dry scaling with lichenification but moist in skin folds
pruritis
arms, hands, feet, legs
complications: secondary infections due to scratching
Term
xerosis/asteatic eczema
Definition
the skin becomes dry and flakes easily as the oil contents of skin decreases with age
dry skin becomes itchy
sensations of dryness and tautness are common
common in older adults
Term
psoriasis
Definition
chronic inflammatory skin disorder
unknown cause, onset in teens,remissions and exacerbations
face, scalp, elbows, knees
autoimmune disorder
chronic, non-infectious process with raised, red, round silvery scales on scalp, arms, legs, kness, hands
aggravated by stress, season change; hormones
Term
lichen planus
Definition
inflammatory condition of skin and mucous membranes
unknown cause
seen in adults, lasts 1-2 years, pruritic purplish papules found on wrists, lower legs, trunk
Term
DLE (discoid (cutaneous) lupus erythematosus)
Definition
inflammatory skin disease due to abnormal immune reation
women: 30-40 years old
1 or more lesions on areas exposed to light
butterfly pattern over nose and cheeks
leaves hypopigmentation
alopecia
Term
pemphigus
Definition
autoimmune disorder
blisters
Term
scleroderma
Definition
skin disorder and systemic disorder
unknown cause
hard, shiny, tight, IMMOVABLE areas of skin (leatherlike)
fingertips: narrowed and shortened
facial expressions lost
hardening of skin and organs
Term
cellulitis
Definition
infection of dermis and subcu tissue
usually SECONDARY to injury, boil, or ulcer
lower trunk, legs
red, swollen, painful, red streeks running along lymph vessels proximal to infect area
Term
furuncles
Definition
infection begins in hair follicle, and spreads to surrounding dermis
face, neck, back
firm, red, painful nodule-->large painful mass that frequently drains large amounts of pus
squeezing spreads infection
carbuncles are a collection
Term
impetigo
Definition
HIGHLY contagious, infants and children
face, small vesicles which rapidly enlarge and rupture, pruritis
Term
acute necrotizing fascitis
Definition
severe inflammation and tissue necrosis
flesh eating disorder
marked inflammation, very painful, rapid increase in size, gangrene present
fever, tachycardia, hypotension, mental confusion, disorientation, mulitorgan failure
Term
herpes simplex
Definition
most common cause of cold sores or fever blisters
primary stage: asymptamatic
latent stage: lesion
recurrence: triggered by infection, sun exposure, stress
burning or tingling sensation along nerve and lips, lastes 2-3 weeks
spread by direct contact with fluid from lesion
cause blindness if it spreads to eye
Term
herpes zoster (shingles)
Definition
must have had chicken pox first
pain, parastesia, vesicular rash developing in a line, unilateral
face, lumbar nerves
lesion persists for several weeks
visual impairments, pain may persist long after lesion disappears
Term
verrucae (warts)
Definition
HPV
location: face, fingers, soles of feet
initially firm, raised papule
later: rough surface
color: white or tan
spreadL infection spreads by viral shedding or surface skin, may be painful is pressure applied
Term
fungal infections
Definition
tinea cruris
candidiasis
tina pedis
tinea capitis
tinea corporis
Term
tinea capitis
Definition
fungal infection of scalp, common in children, transmitted to cats and dogs, circular bald patch as hair is broken off above scalp, erythema and scaling
Term
tinea corpis
Definition
fungal infection of body
lesion: round, erythmatous ring of vesicles of papules with clear center (ringworm) scattered over body
Term
tinea pedis
Definition
fungal infection of foot "athlete's foot
skin b/w toes: inflamed, macerated, painful, pruritic fissures, foul odor
secondary bacterial infection is common
Term
tinea unguium or onchyomycosis
Definition
fungal infection of nails, particularly toenails
begins at tip of 1-2 nails
nail becomes white then brown--> nail thickens and cracks
infecetion spreads to other nails
Term
scabies
Definition
burrows on skin: tiny, light brown lines with small vesicles and eythema-->inflammation and pruritis
b/w fingers, wrists, inner surface or elbows, waistline
spread: close contact
Term
pediculosis (lice)
Definition
small, brownish-white parasites that feed of human blood
site of each bite is a macule or papule
very pruritic, leads to excoriations
Term
risk factors for skin cancer
Definition
>50
fair skin
light--colored eyes
blistering sunburns as a child
overexposure to sun, frost, wind
geographic location
family history
overexposure to radium, radioisotopes on x-rays
repeated trauma or irritation to skin
precancerous dermatomes
Term
basal cell carcinoma
Definition
80% of skin cancer
shiny, translucent, grow slowly; rarely metastasize
Term
sqaumous cell carcinoma
Definition
16% skin cancer
crusted, scaly, ulcerated; can metastasize
Term
melanoma
Definition
4% of skin cancer
rapidly increasing in frequency
spread rapidly
Term
ABCDE: screening for moles for possible melanoma
Definition
A: assymetry
B: irregular Borders
C: Color, variation or change
D:Diameter >6mm of different from others especially changing, itching or bleeding
E: elevation or enlargement
Term
SKIN TUMORS
Definition
keratoses
squamous cell carcinoma
malgnant melanoma
kaposi's sarcoma
Term
keratoses
Definition
benign lesions assosiated with aging or skin damage
routinely check skkin, (exposed areas, moles, lesions, dark spots)
waxy type of "shedding"
lead to an oval elevation that may be smooth or rough and often dark in color
Term
squamous cell carcinoma
Definition
malignant tumor of epidermis; excellent prognosis if removed in time
painless
exposed areas: skin, neck, face
smokers: lower lip region and mouth
appears scaly, slightly elevated, reddish lesion with an irregular border and central ulceration
grows slowly in all directions, spreads to regional lymph nodes
rarely metastasizes
Term
malignant melanoma
Definition
serious form of skin cancer
develops from melanocytes
risks: genetics, exposure to sunlight, hormonal imbalance
appear multicolored lesions, irregular border, grow quickly, metastasize quickly to regional lymph nodes then other organs
Treatment: surgical removal of melanoma, surrounding tissues, radiation and chemotherapy
Term
kaposi's sarcoma
Definition
associated with immunocompromised pts, especially AIDS or HIV
appear purplish maculs on face, scalp, oral mucosa, lower extremities
nonpruritic, non-painful
NAIL ABNORMALITIES
Term
nail abnormatlities
Definition
caused by bacterial andocarditis
trauma
cyanotic nails
peripheral disease
hypoxia
Term
half-and-half nail
Definition
renal disease, hypoalbuminemia
Term
white nail
Definition
trauma, CVS, liver, or renal disease
Term
spooning or concave nail
Definition
severe iron deficiency anemia; thyroid and circulatory diseases
Term
oncylosis
Definition
fungal infections; psoriasis; thyrotoxicosis; eczema; allergic reaction to nail products
Term
pitting
Definition
psoriasis; eczema; alopecia
Term
red and inflamed perionychium
Definition
infection; ingrown nail; tuberculosis
Term
soft, boggy nails--clubbing
Definition
poor oxygenation, hyperthyroidism, malnutrition, calcium and iron deficeincy, repeated use of nail products
Term
beaus line--transverse ridges
Definition
serious illness that cause nail growth to slow or halt
Term
longitudinal ridges
Definition
usually benign
Term
folliculitis
Definition
staph-aureaus hail follicle
Term
erysipelas
Definition
chills, fever, mailse 4-20 days before lesion appears
lesion: firm, bright, red raised hot lesion--pain, itching, burning
Term
impetigo
Definition
vescile or postule: ruptures leaving open area draining serous-yellow liquid that crusts
highly contagious
Term
Pressure ulcer stages 1
Definition
a persistent area of skin redness (without a break in the skin) that does not disappear within 30 minutes when pressure is relieved
Term
pressure ulcer stage 2
Definition
a partial thickness loss of skin layers involving the epidermis that presents clinically as an abrasion, BLISTER, or shallow crater
Term
pressure ulcer stage 3
Definition
a full thickness or skin is lost, exposing the subcutaneous tissues-presents as a deep crater with or without undermining adjacent tissue
Term
pressure ulcer stage 4
Definition
a full thickness of skin and subcutaneous tissue is lost, exposing muscle and/or bone
Term
risks for pressure ulcers:
Definition
not all are preventable
elderly
obesity
emaciated
sedated persons
restrained persons
paralyzed persons
edema
fever
pain
incontinent
persons wearing braces/casts
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