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Physical Examination of the Skin

Physical Examination of the Skin

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Published by dhainey

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Published by: dhainey on Mar 02, 2009
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04/30/2013

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PHYSICAL EXAMINATION OF THE SKIN
 
Anatomy and Physiology
: , 16% , 1.2-2.3
Skin heaviest single organ of body weight
 
meters squared
 
Layers of the Skinepidermis
-
outer horny layer
-
inner cellular layerdermis
 
subcutaneous tissuePigments
()
melanin brown
( )
carotene golden yellow
oxyhemoglobin
 
deoxyhemoglobin
 
nspectandPalpate
: , /, , , ,
Color brown grayish bronze blue reddish blue red
 
 jaundice
Moisture
Temperature
/
Mobility Turgor
Texture
Lesions
Lesions
: ,
Anatomic location generalized localized
: , , ,
Patterns and shapes linear clustered annular
 
dermatomal
/ : , ,
Appearance type of skin lesion macules papules
 ,
vesicles pustules
Color
 
Measurement or dimension
Tenderness
 
econdarylesions
:
 
Loss of skin surface
Erosion loss of superficial epidermis
-
Ulcer deeper loss of the skin surface
-
Fissure linear crack of the skin
 
 
Material on skin surface
= ,
Crust dried residue of serum pus orblood
=
Scale thin flakes of exfoliated epidermis
 
Crust scale
Miscellaneous
:
lichenification thickening and roughing of the
 
skin with increased
 
visibility of the normal skin furrows
atrophy thinning of the skin with loss of normal
 
skin furrow
 
Lichenification
 
atrophy
excoriation scratch mark
scar replacement of destroyed tissue by fibroustissue
keloid hypertrophied scar
 
Excoriation scar keloid
, , -
rimarycircumscribedflatnonpalpablelesions
1. 1
Macule small up to cm
2. - > 1
Patch cm
 
Macule
 
patch
,
alpableelevatedmasses
1. 0.5
Papule up to cm
2. - > 0.5
Plaque cm
3. 0.5 1-2 ; &
Nodule to cm deeper firmer
4.
- > 1 2
 Tumor to cm
5.
, ,
Wheal irregular relatively transient superficial
 
area of a localized skin edema
 
 
 
Papule plaque
 
nodule
 
 Tumor wheal
, , ,
ircumscribedsuperficialelevatedformedbyfree
 :
luidinacavity
1.
– 0.5
Vesicles up to cm
2.
- > 0.5
Bulla cm
3.
Pustule filled with pus
 
Vesicles bulla
 
pustule
,
Comedo blackhead plugged opening of a
 
sebaceous gland
 Telangiectasia dilated small blood vessels
; , ,
Nevus mole flat to slightly elevated round
 
evenly pigmented lesion
 
Comedo telangiectasia nevus
:
nfancy
1.
Cutis marmorata
 
mottled appearance
,
common on the trunk arms and legs
 
secondary to vasomotor changes of the dermis
 
and SQ
 
response to cooling or chronic exposure to radiant
 
heat
-,
prominent among pre terms cretin and Trisomy
2.
Harlequin dyschromia
&
one side of the body is red the other pale a
 2
border separates the sides
:
transient Unknown etiology
3.
Acrocyanosis
 
blueness of the hands and feet
8 ,
if it won t disappear within hours rule out CHD
4.
Mongolian spots
-
blackish blue areas located over the buttocks and
 
skin of the scrotum
 
due to pigmented cells of the deeper layers of the
 
skin
 
Acyanosis Mongolian
 
spots
5.
Lanugo
,
fine downy hair mostly on the shoulders and
 
back
2
shed within weeks
6.
Vernix caseosa
 
cheesy white material composed of sebum and
 
desquamated epithelial cells
7.
Milia
.
a
-, , ,
pinhead sized smooth white raised areas
 
without surrounding erythema
.
b
,
common in the nose chin and forehead
 
Lanugo vernix caseosa
 
milia
8.
Miliaria rubra
 
scattered vesicles on an erythematous base
 
usually on the face and trunks
 
secondary to the obstruction of ducts of sweat
 
glands
1-2
disappear spontaneously in weeks
9.
Erythema toxicum
2-3
usually appear on the nd rd day of life
 
erythematous macules with central urticarial
 
wheals or vesicles
 
disappear spontaneously within a week

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