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loss of color, anemia or lack of blood flow


bluish, hypoxia or impaired venous return


yellow-orange skin,sclera and mucous membranes, liver dysfunction , rbc


redness inflammation


presence of fluid in the tissues causing swollen tight and shiny skin surfaces


nonpapable, skin color change,freckle


palpable circumscribed,elevated nevi <.5 cm


palpable wart 5cm or>


serous fluid filled, <1cm, blister


pus filled acne


palpable,irregular borders, edematous, mosquito bite


lost epidermis, moist surface, no bleeding, ruptured vesicle


dried blood,serum or pus


flakes of skin that exfoliate, dandruff or psoriasis


linear crack,tinea pedis


loss of epidermis and dermis with possible bleeding and scarring, venous
stasis ulcer


red center with radiating legs that are red, up to 2 cm and can be raised



red, 1-3 cm round and can be raised


spider vein

bluish, spider shaped or may be linear with up to several inches in size


deep reddish purple, flat=1-3 mm,


deep reddish purple,>3mm


purple fading to green or yellow over time,variable in size and flat


raised ecchymosis

Stage I

Skin is unbroken but appears red; no blanching when pressed.

Pressure Ulcer

Stage II

Skin is broken, and there is superficial skin loss involving the epidermis

Pressure Ulcer

alone or also the dermis. The lesion resembles a vesicle, erosion, or blister.

Stage III

Pressure are involves epidermis, dermis, and subcutaneous tissue. The

Pressure Ulcer

ulcer resembles a crater. Hidden areas of damage may extend through the
subcutaneous tissue beyond the borders of the external lesion but not
through the underlying fascia.

Stage IV

Pressure are involves epidermis, dermis, subcutaneous tissue, bone, and

Pressure Ulcer

other support tissue. The ulcer resembles a massive crater with hidden
areas of damage in adjacent tissue.


Flat, non-palpable skin color change. Circumscribed border. This particular
lesion is LESS than 1 cm. (ie: freckles, flat moles)


Flat, non-palpable skin color change. Irregular border. This particular lesion
is GREATER than 1 cm. (ie: port wine stains, ecchymosis)


Elevated, palpable, solid mass; circumscribed border. This particular lesion
is LESS than 0.5 cm. (ie: warts)


Elevated, palpable, solid mass; circumscribed border. This particular lesion
is GREATER than 0.5 cm. (may be coalesced papule with flat top) {ie:


Elevated, solid, palpable mass; extends deeper into dermis than papule.
This particular lesion is 0.5-2 cm; circumscribed. (ie: squamous cell


Elevated, solid, palpable mass; extends deeper into dermis than papule.
This particular lesion is GREATER than 1-2 cm; does not always have sharp
borders. (carcinoma)


Circumscribed elevated, palpable mass containing serous fluid. This
particular lesion is LESS than 0.5 cm. (ie: herpes zoster, varicella, poison


Circumscribed elevated, palpable mass containing serous fluid. This

particular lesion is GREATER than 0.5 cm. (ie: contact dermatitis, large burn


Elevated mass with transient borders, often irregular. Size and color vary.
Caused by movement of serous fluid into the dermis; does NOT contain free
fluid in a cavity. (ie: hives, insect bites)


Pus-filled vesicle or bulla. (ie: acne, impetigo, carbuncles, furuncles)


Encapsulated fluid-filled or semi-solid mass; located in the subcutaneous
tissue or dermis.


Loss of superficial epidermis, but does not extend to dermis. Depressed
moist area. (ie: ruptured vesicles, scratches)


Skin loss extending past epidermis, necrotic tissue loss, bleeding & scarring
possible. (ie: pressure ulcer)


Skin mark left after healing of wound or lesion, represents replacement by
connective tissue, can be young- red or purple, or mature- white or
glistening (ie: healed wound)


Linear crack in the skin, may extend to the dermis. (ie: chapped lips)


Flakes secondary to desquamated, dead epithelium, may adhere to skin
surface. (ie: dandruff, psoriasis)


Dried residue of serum, blood, or pus on skin surface, large one maybe a
scab. (ie: residue left after ruptured vesicle)


Hypertrophied scar tissue, secondary to excessive collagen formation
during healing, greater incidence in African Americans. (ie: after ear


Thin, dry, transparent appearance of epidermis, loss of surface markings,

may be secondary to repeated rubbing. central body with radiating branches. (ie: contact dermatitis) Petechia Round red or purple macule. does not blanch. may blanch with pressure. associated with trauma. Telangiectasis Spider-like or linear. present at birth or few months after birth. (ie: aged skin) Lichenification Thickening & roughening of the skin. usually not clinically significant. associated with bleeding tendencies or emboli to skin. red or purple. and Vitamin B deficiency. this lesion is a round or irregular macule with varying color. bluish or red in color. Cherry Angioma Papular and round. accentuated skin markings. in diameter. Hematoma A localized collection of blood creating elevated ecchymosis.underlying vessels may be visible. irritation. caused by cluster of immature capillaries. normal agerelated skin alteration. or scratching. pregnancy. Spider Angioma Red. arteriole lesion. and is associated with trauma & bleeding tendencies. raised lesion about 2 to 10 cms. does not blanch with pressure. Ecchymosis Larger than petechia. Hemangioma bright red. can appear anywhere on body . associated with increased venous pressure states. associated with liver disease.

or deficiency vitamin C or K. scurby. appear anywhere on body. liver disease. caused by leakage of blood into skin and subcutaneous tissue as a result of trauma or surgical incision. bright red dot tiny radiating blood vessels from a pinpoint to 2 cms. pregnancy. anywhere at point of trauma. anterior chest and lower legs near varicose veins Petechiae flat red or purple rounded "freckles" 1 to 3 mm in diameter. caused by type of tenalgiectases (vascular dilation) caused by increased intravenous pressure in superficial veins. caused by release of blood from superficial vessels into surrounding tissue to to trauma. most common on face and head but may occur other sites Spider Angioma flat. common dependent surfaces of body (back. flat mass of blood vessels on the skin surface. irregularly shaped lesion similar to ecchymosis elevates skin and looks like a swelling.Port-Wine Stain flat. or surgical incision . deepens in emotional response. light skin bluish purpilish mark greenish yellow. hamephilia. buttocks) dark skin difficult to see may be seen in oral mucosa and conjunctivae Pupura flat. noticeably on legs. and capillary fragility in the odler adult (senile purpura). caused by large.. estrogen therapy. irregularly shpaed lesion ranging from palre red to deep purple red. septicemias. also anticoagulant therapy. reddish blue irregularly shaped extensive patches of varying size. caused by type of tenalgiectases (vascular dilation) by elevated estrogen levels. occurs anywhere on body at the site of trauma or pressure Hematoma raised. radiating. caused by minute hemorrhages resulting from fragile capillaries. arms. backs of hands Ecchymosis flat.. irregularly shaped lesion of varying size with no pulsation. pressure. cascading linear veins extending from the center 3 to 25cms. liver disease. vitamin B deficiency or liver disease. caused by bleeding disorders. vitamin c or K deficiency. present at birth. more common on upper half of the body Venous Lake flat blue lesion.

. heal without scarring examples: scratch marks.5 cm. vitiligo. or soft palpable mass extending deeper into dermis than a papule. solid. large burn blisters Wheal elevated. impetigo and carbuncles (large boils) Cyst elevated. examples freckles. usually 1 cm. small burn blisters. thickened. and petechiae. hemangioma Vesicle Bulla elevated fluid-filled round or oval shaped palpable mass with thiin. port-wine stains. examples nodules squamous cell carcinoma. Patch nonpalpable change in skin color smaller than 1 cm. often reddish are with irregular border caused by fluid in tissues rather than free fluid. smaller than 0. intradermal nevi. translucent walls and circumscribed borders. ruptured vesicles Lichenification rough. mongolian spots. Tumor elevated. carcinoma. epidermoid cysts Atrophy translucent. aged skin Erosion wearing awa of the superficial epidermis moist. fibroma. bullae: contact dermatitis. shallow depression. measles. hard. friction blisters. smaller than 0. Tumors: large lipoma. examples striae.5 cm. wrinkled skin surface from thinning or wasting of the skin due to loss of collagen and elastin. encapsulated. Plaque elevated. dry paperlike. solid palpable mass with circumscribed border. hardened area of epidermis resulting from chronic irritation such as scratching or rubbing examples: chronic dermatitis . herpes simplex. examples insect bites. poison ivy. fluid-filled or semisolid mass in the subcutaneous tissue or dermis. warts. or larger examples: sebaceous cysts. psoriasis Nodule. and hives Pustule elevated pus-filled vesicle or bulla with circumscribed borders examples: acne. and chloasma Papule.Macule. examples moles. chickenpox.

pityriasis rosea confluent lesions that run together examples: urticaria Discrete lesions taht separate and discrete examples: malluscum Grouped lesions that appear in clusters examples: purpural lesion Gyrate coiled or twisted Target lesions with concentric circles of color. new scars red. extends beyond original site on injury. yellow. athlete's foot scar flat. and eczema Crust dry. irregularly. orange. examples decubitus ulcer. psoriases. may bleed or leave a scar. extending into the dermis. kertanizied skin tissue color may be white. darkened area of excess scar tissue caused by excessive collage formation during healing. dandruff. gray or silver. impetigo. healed acne keloid elevated. example from ear-piercing or surgery annular lesions with a circular shape examples: tinea corporis. irregular are of connective tissue left after a lesion or wound has healed. or purple older scars silver or white examples: healed surgica wound or injury. examples: dry skin. scabs Ulcer deep. herpes. irregularly shaped area of skin loss extending into dermis or subcutaneous tissue. erythema multiforme Linear appear as a line examples: scratches . blood serum or pus left on the skin surface when vesicles or pustules burst. eczema.Scales shedding flakes of greasy. examples include corners of the mouth or in the hands. stasis ulcers Fissure linear crack with sharp edges. red-brown.

tiny whhite spots look like grains of salt.Polycyclic lesions that circular but united examples: psoriasis Zosteriform arranged in linear manner along a nerve route examples: herpes zoster Tinea fungual infection affecting the body the scalp and feet secondary bacterial infection may also be present appearance of the lesions varices. progresses to the face. papular rash begins on the Measles face. elbows. clusters of vesicles along the route of sensory nerves. mostly in children German german measles highly contagious disease pink. and legs. occurs mostly in children Herpes Simplex viral infection lesions on lips and oral mucosa. arms and legs. begins on (Rubeola) the face then progresses over the neck. then spreads over the body. occurs in genitals Herpes zoster eruption of dormant herpes zoster virus. May cause intense itching. chemical. begins a groups of (Varicella) small. fluid-filled vesicles on the trunk. lower pack and perianal area Contact Inflammation of skin an allergy to a substance that comes into contact with dermatitis the skin i.e. occurs (Rubella) mostly in children Chickenpox mild infection disease caused by herpes zoster virus. trunk. white scalr patches occurs with overproudction of skin cells resulting in buildup of cells faster than they can be shed. or cosmetics. progress from vesicles to pustules. jewerly. accompanied by swollen glands. vesicles or scales Measles highly contagious viral disease red tp purple macules or papules. then crusts. scalp. plants. red. and they present as papules. clothing. arms. intense pain ant itching. knees. typically invade the body during an attack of chickenpox. location of lesions aid in discovery of allergy usually accompained by intense itching . more common and more sever in older adults Psoriasis thickening of skin silver.

back of hands. crust soon forms over the are infection may spread Basal cell most common least malignant type of skin cancer.Eczema inflammation of the skin reddened papules and vesicles that ooze. causes intense itching Impetigo bacterial skin infection appears ont he skin around the nose and mouth. begins as reddend. face. knees. proliferation of the cells carcinoma of the stratum basale into the dermis and subcutaneous tissue. notched borders diamter greater than 6 mm Kaposi's malignant tumor of the epidermis and internal epithelial tissues. scaly papule carcinoma then formas a shallow ulcer with clearly delineated elevated border. spreads rapidly to lymph nodes and blood Melanoma vessels. begin as shiny papules tha tdevelop central ulcers with rounded pearly edges. torso. common HIV+ patients Seborrheic common in infants. scalp. highly contagious fungal disease transmitted fromthe soil. black to brown to blue or red edges are often irregular. lesion contains areas of varied pigmentation. contagious and common in children begins as patch of blisters that break exposing red. appears as eczema yellow-white greasy scales on the dermatitis scale and forehead also known as cradle cap Timea capitis patchy hair loss on the head with pustules on the skin. from animals or from person to person Alopecia Areata no known cause for the sudden loss of hair in round balding patches on the scalp . soft. macular or papular resemble keloids or bruises. weep and progress to form crusts. appears on scalp. blue to Sacrcoma purple and painless. lower lip. ears. forearms. occur on skin exposed to the sun Squamous cell arises from cells of the statum spinosum. and wrists. caused by exposure to the sun grow rapidly Malignant least common most serious. weeping area beneath.

and pus may ooze from it Beau's line trauma or illness affecting the nail formation.: Normally heard over muscles of the arms or legs. swollen. arms and legs. i. spleen.e. erythematous pus-filled Abscess lesions abscesses are cause dby bacteria entering hte skin larger lesions are furuncles Hirsutism excess body hair in females face. . chest. dull sound is elicited over relatively airless structures. Normally heard over the heart. abdmonen. appears as reddish-brown spots in the nail Hemorrhage Clubbing more convex than wide ange is greater than 160 degrees occurs in chronic respiratory and cardiac conditions which oxygenation is compromised Onycholysis the nail plate loosens from the distal nail and proceeds to the proximal portion Flat sound is heard over solid tissue where there is the least amount of trapped air. i.Folliculitis iinfections of the hair follicles. appears as pustules with underlying erythema Furuncle infected hair follicles give rise to furuncle hard. typically due ot endocrine or metablolic dysfunction though it may be idiopathic Spoon nails concavity and thinning of the nails congenital conformity Paronychia infection of the skin adjacent to the nail. linear depression develops at the base and moves distally as the nail grows Splinter result of trauma in endocarditis.e. usually caused by bacteria or fungi. and painful. liver. These too are solid tissues. following male pattern excessive hair on the female chin. affected area becomes red.

e.Resonance is the sound heard over normal lung tissue. living epithelial cells -Stratum Mucosum Contains melanocytes (skin pigment) which protects against ultra violet radiation -Forms keratin-tough protein substance found in hair and nails Dermis True Skin"-living epithelial cells highly vascular connective tissue Dermis True Skin"-living epithelial cells highly vascular connective tissue Dermis Contains peripheral vascular supply -Contains peripheral nerve supply Dermis Contains connective tissue.and hair follicles Hypodermis loose connective tissue interspersed Subcutaneous Fat Subcutaneous living epithelial cells tissue Subcutaneous Stores body fat tissue -Foundation for the dermis . i. sebaceous glands. With percussion. intestine. emphysema.e. COPD Tympany This sound is elicited when air is present in a closed structure. the air vibrates with the surrounding tissues. Normally heard over air-filled stomach. i. -Stratum Corneum outer horny layer of dead epithelial cells -Protects against invasion and evasion -Regulates heat through conduction -Stratum Mucosum inner cellular layer. Hyperresonanc This sound is heard over excessively air filled lungs.

Subcutaneous Regulates heat through insulation -Contains lower portion of hair follicle- tissue the root and the bulb Eccrine sweat -Secrete into the hair follicles glands Apocrine sweat -Secrete into the hair follicles -Non-functioning until puberty glands -Responsible for body odor Sebaceous oil -Secrete sebum into the hair follicle -Provide lubrication to skin surface glands and hair Hair -Cornified horny thin shaft of thread-like epithelial cells -Provides protection of the scalp. esthetic function -Color determined by the concentration of melanin Nails "Onychoid" Show structure of nail Plate horny epithelial cells forming rectangular convex firm plates Body exposed portion of nail -Root hidden portion at the proximal end of nail Lunula crescent shaped whitish area near the root due to a greater concentration of cells in the matrix Matrix inter-cellular material from which nail is formed -Nail highly vascular portion of the finger and toe covered by the nail Mantle dermal lip which forms the cuticle .

conjunctiva Pink or Silver lines -Stretch Marks (striae brown skin Genetic natural color due to generalized melanin brown skin Pregnancy: increased pigmentation of face. -Polycythemia hands. especially in areas of pressure or trauma such as knuckles. elbows and scars brown skin Suntan: increased pigmentation in areas 20 exposed to sunlight blue skin Cyanosis-decrease in oxygenated hemoglobin especially nail beds. pallor or pale May be due to decrease in hemoglobin. does not involve sclera Jaundice abnormal increase in bilirubin. vulva and the linea nigra brown skin -Addison's disease: Increased pigmentation. mouth. feet. specific to patch areas of involvement Albinism or pale Congenital lack of pigmentation. also involves sclera and mucous membranes -Reddish blue increase in total hemoglobin with capillary stasis involving face. nipples. generalized including hair and eyes .carotenemia increase in carotene. generalized pallor: anemia -Vitiligo or pale Acquired loss of pigmentation. mucous membranes. edema or vasoconstriction. lips.

A fine network Vascularity is normal in young children and those with a thin dermis skin layer. oral mucosa. & soles of feet of blacks Pallor Skin tone appears lighter than normal.Superficial Determine the presence or absence of a venous pattern. difficult to see unless it occurs in area of light pigmentation in blacks erythema Deeper brown or purple skin tone with evidence of increased skin temperature secondary to inflammation in blacks Jaundice Yellowish-green color most obviously seen in sclera of eye. may be evident in buccal mucosa or sclera Rash Not easily visualized but may be felt with light palpation scar Frequently has keloid development. Cyanosis Ashen-gray color most easily seen in conjunctiva of eye. Specifically evident is loss of underlying healthy red tones to skin. Light skinned African Americans may have yellowish brown skin. slightly raised red areas on . Petechiae Difficult to see. dark skinned African Americans may appear ashen. palms of hands. & nail beds in blacks Ecchymosis Deeper bluish or black tone. raised scar 21 Prominent venous over the abdomen may be pattern secondary to venous obstruction (patients with liver problems) Capillary fragility around eyes secondary to coughing Cherry Angioma Small. resulting in thickened.

arms and upper trunk.trunk. do not disappear spontaneously Senile lentigo age or liver spots) irregular shape. -Spider red on face. flattened acrochordon papules with central depression. flat pigmented macules -Seborrheic pigmented raised wart appearing lesions keratoses -Skin Tags- neck and upper chest sebaceous hyperplasia. reddened areas with sharp demarcation line. Nevi moles increased Systemic infection-generalized Local infection-specific to area of temperature infection Sun burn-specific to exposed areas Dehydration-generalized decrease Raynaulds disease-digits Shock-generalized temperature increased Hyperthyroidism-generalized Obesity-generalized Edema-specific to smoothness of skin area of edema . usually in older adults Strawberry Slightly raised. Strawberry appearance. blanching arteriole nevus/angioma Telangiectasia permanent dilation of superficial capillaries. neck. May be 2-3 Hemangioma cm in diameter & usually disappear by 5 years of age. go away by 5 years -Port wine large flat bluish purple capillaries over face. yellowish. Storkbite red spots seen on back of infant neck.

rough lesion which is greater than 1 cm Vesicle Elevated lesion filled with clear fluid less than 1 cm Bulla vesicle which is greater than 1 cm Wheal elevated. sun -specific to exposed areas decreased skin se in turgor turger Aging Rapid weight loss Dehydration increased skin Edema-specific to affected areas Obesity-generalized turger fingertips determine the presence or absence of moisture. edematous elevation. never appear originall Scale Desquamation of surface cells . if present the amount and location with ________ Primary Lesions Appear as immediate result of cause Macule Flat non-substantive change in color less than 1 cm Patch Macule which is greater than 1 cm Papule Elevated substantive lesion of any color less than 1 cm Plaque- Elevated.Increase in Hypothyroidism-generalized Excessive exposure to water. roughness chemicals. firm. wind. white to pink to skin color Comedones Plug of keratinous debris filling the pilosebaceous opening (Blackhead) Secondary Lesions Alterations in the primary lesions.

and hygiene habits and agents.Excoriation Scratch. superficial abrasion Crust Dried serum. and lymph containing. blood vessels. may involve portion of dermis Fissure Linear versicle separation through epidermis and dermis Lichenification thickening of skin due to chronic rubbing or scratching Scar Dense collection of connective tissue replacing lost tissue Olfaction Determine general body odor. characteristic body odor non. scrape. pus. cushioning Sebaceous Glands oil glands (lipdd substance that emulses with water to prevent water loss) Eccrine Glands Sweat glands that produce odorless sweat . temp control. Subcutaneous contains fat cells for energy. odor is an index of activity. Tough and resists skin tearing.existent prior to puberty when the apocrine sweat glands begin to function. Epidermis outer protective layer of the skin. or blood overlaying skin surface Erosion Superficial loss of a portion of the epidermis Ulcer Loss of entire epidermis. and health status. Replaced every 4 weeks Dermis collagen. anxiety.

May produce diffuse vesicles. Tinea pedis Athlete's Foot. Jaundiced Yellow Cyanotic blue Ruddy red 6 General 1) Color 2) Texture 3) Turgor 4) Temp 5) Moisture 6) Edema observations of the Skin: 6 Functions of the 1) Protection 2) Prevention against water/electrolyte loss 3) Sensory Skin perception 4) Repair 5) Absorption/Secretion 6) Temp regulation Linear lesions that appear in a straight or curved line Generalized located all over the body Localized located to a specific body region Discrete individually separate Dermatomal follows the dermatomes on the abdomen/back Mongolian Spots appear on dark skinned newborns. Irregular. A fungal infection that produces vesicular. abraided . flat areas over the sacrum that look like bruising Contact Dermatitis acute reaction to a substance. genitals.Apocrine Glands sweat glands in underarms. breast areas that respond to emotional/sexual stimulation.

plaques. Squamous Cell arise from actinic keratosis as indurated red papules. Precancerous. II crusty. Reflective on the elasticity of the skin. Diameter. acute severe illness. malnutrition. Chronic viral infection that produces vesicular. THE ABCDEs of Assymetry. Produced vesicular to pustular rash that follows a nerve dermatome. Nail bed should turn white. Herpies Simples I and I= mouth II= genitals. associated with trauma. Capillary Refill Press down on nail. Basal Cell Carcinoma a nodular ucerative red/pink lesion with raised pearly margins. red. Actinic Keratosis Flesh colored/pink slightly scaly raised lesions. Border. Extremely painful. They are ulcerative and crusted. painful lesions on lips and genitalia Herpes zosters Shingles. Results from latent virus of chicken pox.fissures. should return to pink color instantly or in less than 3 seconds . Melanoma have irregular borders and colors and readily metastasize. fungal infections Thin = nutritional anemia. decreased peripheral vascularization Beau lines transverse indentations on the nail. It is local invasive and usually slow growing. May metastasize. Dry and rough. Upon release. Color. or Carcinoma nodules. Appear on sun exposed areas. Nails Spoon shape = iron deficiency anemia Clubbing = Oxygen deficiency Thick = age. Check above clavicle. Evolving Melanoma Turgor the tenting test.

widely distributed Fissure a linear crack in the skin Induration hardening of the skin.Annular a lesion that forms a ring around a clear center of normal skin. usually caused by edema . fluid filled lesion greater than 1 cm in diameter Congruen describes lesions that run together t Contusio Bruising n Diffuse Spread out. Atrophy decrease in size or wasting Bulla an elevated. circumscribed.

often irregularly shaped. elevated superficial lesion 1 cm or less in diameter Wheal elevated. pigmented area on the skin Nodule solid skin elevation 1 cm or more in diameter that extends into the dermal layer Papule a solid. an edematous response . pruritic wheals often transient and allergic in origin Vesicle Fluid filled. superficial lesion. solid transient lesion. elevated circumscribed. elevated circumscribed lesion greater than 1 cm in diameter Pustule vesicle or bulla that contains pus Ulcer circumscribed crater on the surface of the skin or mucous membrane Urticaria Hives.Keloid hypertrophic scar tissue. 1 cm or less in diameter Petechiae flat red/purple spots on the surface of the skin or mucous membranes resulting in minute hemorrhage Plaque a solid. prevalent in people who have dark skin Macule flat circumscribed lesion 1 cm or less in diameter on skin or mucous membrane Nevus a congenital.

Dermis.Epidermis. What are the layers of the Integumentary System? Hypodermis (subcutaneous tissue) 20 square feet How much skin covers the average adult? Sebaceous What are sebum producing glands found everywhere in the dermis except for the palmar and plantar surfaces? Apocrine What are sweat glands associated with hair? Eccrine What are sweat glands not associated with hair follicles? Karotine What are Nails made of? Cyanosis What color is Lack of O2 to the skin called? Petechiae Bleeding under the skin Ecchymosis Bruising Macule Freckle Macule and Patch What are Non palpable lesions? .

Solid Lesion (wart) What is an example of a papule lesion? Eczema. skin is red.painful. sweat glands and nerve endings are destroyed. black. skin is red. Also called partial thickness burn Third Degree Burn What type of burn is characterized by: Epidermis and dermis are destroyed. hair follicles. skin is white. Also called full thickness burn Alopecia What is Losing Hair called? . red. painful Second Degree Burn What type of burn is characterized by: Epidermis and upper layers of dermis are destroyed. psoriasis What is an example of Plaque Lesions? Lipoma What is an example of a Nodule Lesion? Carcinoma What are Tumor lesions called? Lichenification What are Layers of thickened and rough skin as a result of rubbing over a prolonged period of time called? Excoriation What is it called when the Outer layer of skin is rubbed off? Stage 2 Pressure Ulcer What stage of pressure ulcer is characterized by which Epidermal and dermal layers are injured Stage 3 Pressure Ulcer What stage of pressure ulcer is characterized by which Subcutaneous tissues are injured Stage 4 Pressure Ulcer What stage of pressure ulcer is characterized by which Muscle and perhaps bone are injured First Degree Burn What type of burn is characterized by: Epidermis is injured or destroyed.blistery. subcutaneous tissue is injured. dry.

impermeable to bacteria. Contains melanocytes (produces our pigment) Dermis Supportive layer of connective tissue or collagen. blanch ~Wound Repair . stops water and electrolyte loss ~Temperature regulation .replaces itself ~Excretion of waste thru sweat ~Production of Vitamin D . Contains the skin appendages (hair follicles and sweat glands) Subcutaneous Tissue Adipose tissue (where fat is stored and gives us insulation) Hair Vestigial (no longer needed for protection).sweat glands ~Communication .prevents injury. Responsible for LUBRICATING our skin Appendages of Skin Ecrine Glands SWEAT glands.converts cholesterol into Vitamin D Epidermis Outer layer.Hirsutism What is having too much hair called? Skin Largest organ that covers 20 square feet in the average person Function of Skin ~Protection . Made of keratin Appendages of Skin Sebacious Glands SEBUM or oil.blush. Open directly unto the skin Appendages of Skin .

apocrine. Gland produces milky substance (found in AXILLA and ANOGENITAL area. linea nigra ~ connective tissue is fragile (striae) ~↑ sweat gland production Aging ~epidermis thins ~dermis thins and wrinkles ~↓ muscle tone ~↓ collagen and elasticity ~sweat glands ↓ ~vascular fragility History ~Previous history of skin disease ~Change in pigmentation ~Change in a mole ~Excessive dryness (xerosis) ~Excessive oiliness (seborrhea) ~Excessive moisture (diaphoresis) .Apocrine Glands Open into hair follicles. sebacious) Pregnancy ~hormone levels ↑ ~ ↑ skin pigmentation. responsible for BODY ODOR) Appendages of Skin Nails Plates of keratin Appendages of Skin Infants and Children ~more PERMEABLE to water (don't put sun block or topical medications) ~sebacious glands ↓ (require lotion) ~temperature regulation is IMMATURE (don't shiver) ~pigment system is NOT developed Puberty ~Epidermis thickens ~Glands function (eccrine. chloasma.

lotions. spread. confluent. shock. pendunculated (sac . peripheral vasoconstriction. very common History ~Excessive bruising ~Rash or lesions: location. duration. grouped.~Pruritis (itching). polycythemia ~Cyanosis: hypoxia. appearance. exposure. shock. use of artificial nails) Preparation ~Strong direct light ~Small centimeter ruler ~Penlight: tangential to assess contour of the skin ~Gloves Inspection: Color General pigmentation. linear ~Shape: regular or irregular ~Primary vs Secondary ~Size Annular Lesions that are Circular (ringworm) Confluent Lesions that run together (hives) . raised. self care ~Medications ~Hair loss (alopecia) ~Excess hair (hirsutism) ~Change in nails (brittleness .like) ~Pattern: annular. heart failure ~Jaundice: liver problems (seen in 1st junction of hard and soft pallet) Lesions ~Color ~Elevation: flat. widespread color changes ~Pallor: fear. anemia ~Erythema: fever. soaps. smoking.vitamin deficiency) ~Environmental hazards ~Self care behavior (use of sun screen. inflammation.

along nerve route Macule ~Flat. mole or nevus (nevi).e. café au lait spot or vitiligo Primary Lesion Papule Solid. circumscribed and elevated (< 1 cm) ~i. freckle Primary Lesion Patch Macule that is (> 1 cm ) ~i.e. ( < 1 cm) ~i. elevated mole. circumscribed area of COLOR CHANGE only.e. fibroma . xerosis Primary Lesion Nodule Solid.e.Discrete Dinstinct (pimples) Grouped Clustered (contact dermatitis) Gyrate Twisted (poison ivy) Target Lesion within a lesion (erythema multiforme) Linear Scratch or streak (poison ivy) Zosteriform Linear. wart Primary Lesion Plaque Papules that coalesce to form an elevation (> 1 cm) ~i.e. elevated. DEEPER into the dermis ~i. hard or soft (> 1 cm).

acne Primary Lesion Crusts Dried exudate (serum. intensily PRURITIC (itchy) ~i. erythematous.e.e.e. sebaceous_____ Primary Lesion Pustule Vesicle that contains PUS ~i. raised. early stages of chicken pox Primary Lesion Bulla Vessicle that is (>1 cm) i. hives Primary Lesion Vessicle Elevated lesion containing FLUID (< 1 cm) ~i. transient.e.e. impetigo. lipoma Primary Lesion Wheal Superficial.Primary Lesion Tumor (> 2 cm) and can be firm or soft ~i.e. 2° edema ~i.e. blood) when vessicle or pustules burst . mosquito bite Primary Lesion Uriticaria Wheals that coalesce. pus. burn or blister Primary Lesion Cyst Encapsulated fluid filled cavity in dermis or SQ layer i.

extends into the dermis Secondary Lesion Erosion Scooped out shallow depression.5 mm) smooth. will BLANC (Capillary that becomes DESCENDED) Vascularity and Bruising Telangiectasis FIERY RED STAR shaped lesion with a red body. sheds excess keratin Secondary Lesion Fissure Linear crack. BRIGHT RED. will BLANCH with pressure (common w/ liver disease or pregnancy) . superficial epidermis loss Secondary Lesion Ulcer Deeper depression. extends into the dermis Secondary Lesion Excoriation Scratch marks Secondary Lesion Lichenification Thickening of the skin. happens with prolonged scratching or rubbing Secondary Lesion Angiomas ~(1 .Secondary Lesion Scales Flakes of skin. slightly raised.

soles of feet Basal Cell Carcinoma ~Most COMMON skin cancer ~Exposure to UV ~Presents with NON HEALING sore ~Lesions look like papule and inside becomes like an ulcer ~Common locations: head and back Seborrheic Keratosis Raised thickened areas of pigmentation (develop on trunk. Immature capillaries (Will resolve between 5 and 7 years old) Hemangiomas Danger Signs of Lesions Asymmetry (not round? oval?) Border irregularity (notching? ragged?) Color Variation (combos of color in one mole?) Diameter (>6 mm) pencil eraser size? Elevation and enlargement (has it gotten bigger?) Burns or bleeds? Malignant Melanoma ~Caused by exposure to UV ~People at risk: blond. Macular patch Hemangiomas Strawberry Mark A macular plaque covering the scalp or face. legs. red hair.Vascularity and Bruising Echymosis Bruising (should be consistent with normal living) Vascularity and Bruising Portwine Stain Benign proliferation or blood vessels. back (most sun exposure) ~Black population . palms. .under fingernail. head. blue eyes (1: 65) ~Lesions look like mixed pigmentation ~Common locations: trunk.

tiny hemorrhages. Check ankly maleolus and tibia 1+ = Mild Pitting 2+ = Moderate Pitting (subsides quickly) 3+ = Deep Pitting (indentation stays for a short period of time) 4+ = Very Deep Pitting (indentation lasts alot longer) .hands) Skin Lesion of Aging Acrochordons Overgrowth of normal skin. polyp.old age and PVD pts) Purpuric Lesions Caused by blood flowing out of breaks in the blood vessels. paper thin . RBCs are deposited in the tissues Petechiae Very small. round and very discrete (WILL NOT BLANCH) Purpura Extensive patches of petechiae (look like bruising) Mobility and Turgor ~where to test: anterior chest under clavicle in adults. abdomen in children ~tenting: indicates dehydration Edema Fluid that accumulates in the tissues. cheek. back) Skin Lesion of Aging Palpation Temperature ~Hypothermia (circulatory problems) ~Hyperthemia (increased metabolism) Moisture (diaphoresis) Texture ~Hyperthyroidism (smooth silky skin) ~Hypothyroidism (dry scaly skin) Thickness (uniformly thick. skin tags (develop on eyelids.

Genetic Beau's Lines Transverse grooves in the nails (trauma or illness) Paronychia Inflammation of the nail folds Onycholysis (fungal) Loosening of the nail plate . straight ~Distribution: appropriate to gender ~Lesions: check scalp Tinea Capitis Fungal infection (ringworm) Alopecia areata Sudden appearance of bald spots Trichotillomania Self-induced hair loss Pediculosis Capitis Lice Hirsutism Excessive hair Furuncle Infected hair follicle Inspection and Palpation ~Shape of the Nails ~Contour ~Consistency (without ridges. grooves or thickening) ~Color (pallor. cyanosis) ~Profile test or Schamroth technique Capillary Refill ~Depress nail edge ~Normal return < 3 sec ~Sluggish return (problems with peripheral circulation) Koilonychias Spoon nails.Inspection and Palpation ~Color: melanin production (grey hair is a loss of melanin) of the Hair ~Texture: fine. thick. curly.

and they result from anatomic changes in the epidermis.Onchodystrophy YELLOW hard nails 2° lack of O₂ Clubbing Normal <160° Abnormal >180° Nursing Diagnoses ~Risk for impaired skin integrity ~Impaired skin integrity ~Risk for infection ~Impaired physical mobility ~Body image disturbance Macule a primary skin lesion that is typically less than one centimeter in diameter. an example being freckles or moles. dermis. or subcutaneous tissue.) . they are the most common lesions of the skin. (Primary skin lesions arise from normal skin. nonpalpable and flat.

The infection is sometimes tender and can be acute or gradual with onset. Pruritis itching which can be caused by skin disease or and internal disorder Purpura red or purple discolorations of the skin (which are greater than 0. Petechiae vascular skin lesions. Also. They are also located in the eye. Oncolysis the reduction of a tumor. but rather by the activity level of the cells. Nodule A nodule is considered a primary skin lesion that is 1-2 centimeters in diameter.5 cm in diameter) and are caused by internal bleeding Pustule a primary skin lesion that is palpable and filled with pus. sometimes caused by capillary leakage which allows the red blood cells out of the blood vessels (nonblanching). Papule a primary skin lesion that is smaller than 1 centimeter in diameter and is a papule. Melanocytes produce melanin. the reduction of any swelling or mass. Platyonychia flattening of the nail bed (many times among the elderly) Plaque a plaque is an elevated area of skin with a relatively broad. flat surface that is greater than 0. solid mass that may sometime vary in color.Melanocyte Cells located in the bottom layer of the skin's epidermis. meninges. solid mass. ear.5 cm in diameter. Petechiae is usually smaller than 0. An example is erythema nodosum. An example is a nevus.5 cm. an example is acne or impetigo . and is a palpable. bone and heart. which produces pigment. Skin color is not determined by the number of melanocytes. Paronychia Often a bacterial or fungal infection that affects the hands and feet in the area where the finger or toenail meets the skin. or neoplastic cells. or a wart.

Scale a secondary skin lesion (secondary skin lesions result from changes in a primary lesion. Varicella commonly known as chickenpox. relatively permanent dilation of superficial blood vessels (many times capillaries) Tumor characterized by a primary skin lesion that is a palpable. itchy rash with white scales. varicella is a virus that is extremely contagious and produces a head-to-toe rash with red. They run Hemorrhages in the direction of nail growth. An example is dandruff. solid mass and is greater than 2 cm. . and is commonly called dandruff when it is present on the scalp. It presents in the form of a wheal or hive. or non-allergic. or psoriasis Seborrhea a common skin problem that causes red. An example is cutaneous larva migrans Splinter small areas of bleeding (hemorrhage) under the finger or toenails. Urticaria The trigger to cause an urticaric lesion can either be allergic. developing during the course of a cutaneous disease) which is characterized by "heaped-up" keratinized cells. and many times leaves scar tissue in one area while it spreads to the next area. The epidermis is not affected while the dermis shows edema. red. raised. itchy lesions or blisters that appear in waves over the course of the virus. which are degenerated epithelial cells from the keratin layer of the skin. A tumor can also be called a neoplasm in which the cells are neoplastic (having abnormal growth) Tzanck Test scraping of an ulcer base to look for certain cells. It can be present in any area of the body. raised bumps that are often ithcy. It is a skin rash with dark. such as Tzanck cells. Splinter hemorrhages are common and are many times an indication of underlying disease. Telangiectasis fine. Serpiginous a skin lesion that is characterized as "snake-like" or "creeping".

(ex blister.Vesicle a primary skin lesion that is smaller than 1 cm in diameter. herpes simplex) Wheal a primary skin lesion that is characterized by a superficial area of cutaneous edema that is caused by hives or insect bites Zosteriform A skin lesion that is characterized by a linear arrangement along a nerve distribution (like in herpes zoster) Seborrhea Oily Xerosis Abnormal dryness of the skin Pruritis itching Alopecia Hair loss Hirsutism excessive hairiness . palpable and filled with serous fluid.

usually present at birth Harlequin color lower half of body turns red and upper half blanches with a distinct change demarcation line down the midline Erythema common rash that appears in the first 3 to 4 days of life toxicum Acrocyanosis bluish color around the lips. neck.Mongolian spot common variation of hyperpigmentation. and sometimes thighs Linea nigra brownish black line down the midline Cholasma an irregular brown patch of hyperpigmentation on the face Vascular spiders tiny red centers with radiating branches and occur on face. blue-black to purple macular area Cafe au lait spot large round or oval patch of light-brown pigmentation. breasts. upper . caused by sebum that occludes the opening of the follicles Striae jagged linear "stretch marks" of silver to pink color that appear during the second trimester on abdomen. and across the nose and chin. sclera. hands and fingernails. comes from ingesting large amounts of foods containing carotene Millia tiny white papules on cheeks. and mucous membranes develops after 3rd or jaundice 4th day of life Carotenemia produces yellow-orange color in light-skinned persons but no yellowing in sclera or mucous membranes. and feet and toenails Cutis transient mottling in the trunk and extremeties in response to cooler room marmorata temperature Physiological yellowing of the skin. forehead.

and arms Senile lentigines small. looks dark. brown macules. "liver spots" Seborrheic develop mostly on the trunk but also on the face and hands. and "stuck on" Actinic keratosis lesions that are red-tan. scaly plaques that increase over the years to become raised and roughened sebaceous glands produce sebum. keratosis greasy. which is forms an emulsion to retard water loss. Are verywhere except palms and soles exocrine glands produce sweat apocrine glands produce milky secretion Sebacous and two glands that decrease production with age apocrine melanocytes decrease in theses causes greying of hair senile purpura minor trauma produces dark red discolored areas due to decrease . flat.chest.

Macule a category of primary lesions ..flat. Papule solid palpatable <1 cm... macule. scarlet fever. Ex. which will not blanch.5 cm are indicative of neurofibromatosis. disk shaped. meales. p239 Plaque p 252 a category of primary lesions. >1 cm.: NEVUS. cafe au lait spot cafe au lait spot oval light pigmented area superior to gluteus maximus. ephelides a primary lesion. border irreg.mongolian spot. <1 cm and include petechia. genetic. normal.1. color variation diameter >6 (pencil eraser). is tiny red or brown and may indicate a disesae of abnormal ABNORMAL CLOTING FACTORS / BLEEDING as seen in thrombocytopenia. secondary lesions lesion develpment secondary to time. ephelides. can coalesce to plaque Nevus mole Patch a category of primary lesions. subacute endocartitis. Ex. scratches or infection. caused by supercial thickening of skin. changes. color change. characteristics of elevation/enlargement as an adult (abcde) nevi primary lesions development as the immediate result of specific causative factors and develop in ualtered skin. They are papules which . MART.vascularity of skin with aging 8 critical . Six or more of . characteristics 5 suspicious asymmetry. sepsis. macule resulting from sun exposure petechia primary lesion.

transient and erythematous. ??lichen planus. >1 cm Tumor primary lesion category which is > few cm. Rx benedryl Uticaria primary lesion category in which wheels coalesce to from extensive reaction .hives Cyst primary lesions category . deeper in dermis Wheal Ex MOSQUITO BITE. Bulla primary lesion category >1 cm Ex: friction BLISTER. allergic rxn.thickening litchen like appearance 2 to scratching (p 255) Nodule Solid. burn. HERPES ZOSTER. firms. elevated. THIN walled chamber which rupurtures easily and is SUPERFICIALin dermis Pustule primary lesion category Ex: ACNE impetigo. which are superficial.elevated fluid filled cavity in dermis or subdermis. (as opposed to a bullaa which is superficial or a pustule which is pus filled) Vescicle primary lesion category elevated clear fluid filled cavity up 1 cm Ex: HERPES SIMPLEX.have coalesced p 252Ex psoriasis. early varicella( chicken pox). Turbid PUS filled cavity Late clubbing nail elevation > 180 degrees indicative of COPD. contact dermititis . raised and irreg due to edema. Chrons erythema intense skin redenning 2 to excedd blood in dialated superficial capillaries vitiligo patchy white spots from destruction of melanocytes Urticara (Hives) Coalesced wheels which ire intensely pruitic . soft.

clawlike pediculosis capitis head lice. rubbery.Plaque Papules coalesce to form _____ Hives/Urticara Wheels coalesce to form _______ chloasma facial hyperpigentation with pregnancy keloid secondary lesion. which is ___ to the node . esp areound occipital area/ears diaphoresis profuse prespiration secondary to increased metabolic rate Ecxema atopic dermititis Seborrheic cradle cap . smooth."greasy yellow pink lesions. More common in AA. check the area they drain." absense of puritius dermatitis Herpes zoster small grouped vescicles caused by varicella zoster virus common in abdominal area of 50 yr old Tinea pedis ringworm of the foot submental lymph lymph node behind the mandible node superficial cervical lymph node overlying the sternomastoid muslce Supraclavicular enlargement of this lymph node is bhind the clavicle is indicative of Hotchkins proximal When nodes are enlarged. hypertrpohic scar.

epidermis Outer layer of skin. sensory receptors. Contains melanin. subcutaneous Adipose tissue. and production of vitamin D. skin identification. prevents penetration. apocrine glands Open into the hair follicles and produce a thick. lymphatics. milky secretion when emotionally or sexually stimulated. dermis Inner supportive layer consisting mostly of connective tissue. perception. provides insulation for temperature control. Mature in puberty. blood vessels. sebaceous glands. hair follicles. 9 functions of protection. sebum Oils and lubricates the skin and hair and forms an emulsion with water that retards water loss from the skin. Contains nerves. Mature in the 2-month-old infant. eccrine glands Coiled tubules that open directly onto the skin surface and produce sweat. Stores fat. wound repair. . aids layer in protection by its soft cushioning effect. and sweat glands. absorption and excretion. communication. temperature regulation. Major ingredient is keratin.

asian. The lower half of the body change turns red and the upper half blanches with a distinct demarcation line down the midline. early clubbing angle straightens out to 180 degrees and nail base feels spongy to palpation. Found in young adults cherry angiomas small smooth slightly raised bright red dots that commonly appear on the trunk in all adults over 30 years old. chloasma Increased pigment in the face during pregnancy. linear dark streaks/ linear bands in the nail of dark-skinned people. red macules and . erythema common newborn rash consisting of tiny punctate. harlequin color Occurs when the baby is in a side-lying position. pigmentation leukonychia white hairline linear markings from trauma or picking at the cuticle striata mongolian spot Common variation of hyperpigmentation in black. and hispanic newborns.lanugo Fine downy hair of the newborn infant. ephelides freckles nevus mole junctional nevus mole.macular only. cheesy substance made up of sebum and shed epithelial cells on some children and adolescents compound nevi mole. striae stretch marks senile purpura dark red discolored areas resulting from minor trauma in older adults. american indian. Blue-black to purple macular area at the sacrum or buttocks. vernix caseosa Thick.macular and papular.

Premalignant. seborrheic look dark.but six or more at 1. café au lait spot Large round or oval patch of light brown pigmentation. greasy. fingernails.flat irregularly shaped red or pink patch found on the forehead. and stuck on keratosis actinic keratosis red-tan scaly plaques that increase over years to become raised and roughened. hands. eyelid. keratoses raised. xerosis dry skin acrochordons skin tags sebaceous raised yellow papules with a central depression hyperplasia annular circular. thickened areas of pigmentation that look crusted. feet. and toenails.begins in center and spreads to periphery confluent lesions run together discrete distinct individual lesions that remain separate . flat. back. and across the nose and chin cause by sebum that occludes the opening of the follicles. Silvery white scale possible.toxicum papules on the cheeks. cutis marmorata transient mottling in the trunk and extremities in response to cooler room temperatures. forehead. storkbite salmon patch. Clusters of melanocytes that appear after extensive sun exposure. chest.5 cm or larger are indicative of neurofibromatosis. and buttocks. and warty.small. acrocyanosis bluish color around the lips. trunk. milia tiny white papules on the cheeks. or upper lip. brown macules.but most commonly at the back of the neck. Directly related to sun exposure. senile lentigines liver spots. scaly. Usually normal.

clear serum flows if ruptured bulla > 1 cm.grouped clusters of lesions gyrate twisted. of less than 1 cm. slightly irregular shape due to edema tumor > a few centimeters in diameter. erythematous. A plateaulike. deeper into dermis. . streak. raised.. spiral. hard or soft. < 1 cm patch macules larger than 1 cm plaque papules coalesce to form surface elevation wider than 1 cm. benign or malignant urticaria hives vesicle elevated cavity containing free fluid up to 1 cm. Ruptures easily. disk-shaped lesion nodule solid. coiled.caused by superficial thickening in epidermis. elevated. Thin walled. Usually single chambered (unilocular). flat and curcumscribed. larger than 1 cm. firm or soft.. or stripe polycyclic annular lesions grow together zosteriform linear arrangement along a nerve route macule solely a color change. Superficial in epidermis. resembles the iris of the eye. concentric rings of color in the lesions. wheal superficial. papule something you can feel. line. transient. Blister. snakelike target iris. linear a scratch.

ulcer deeper depression extending into dermis. looks like surface of moss. purple. pustule turbid fluid (pus) in cavity. keloid hypertrophic scar. flat macular patch covering scalp or face. lichenification prolonged intense scratching eventually thickens the skin and produces tightly packed sets of papules. excoriation self-inflicted abrasion. hematoma a bruise you can feel contusion bruise port-wine stain large. superficial. strawberry mark raised bright red area with well-defined borders about 2 to 3 cm in diameter. sometimes crusted. skin level elevated by excess scar tissue. dry or moist.cyst encapsulated fluid-filled cavity in dermis or subcutaneous layer. superficial. a thinning of the epidermis. dk red. may bleed. Non-blanching. cavernous reddish-blue irregularly shaped solid and spongy mass of blood vessels. atrophic scar resulting skin level depressed with loss of tissue. crust thickened dried out exudate scale compact desiccated flakes of skin fissure linear crack with abrupt edges. 1 to 3 mm. circumscribed and elevated. round and discrete. tensely elevating skin. Extends into dermis. hemangioma petechiae tiny punctate hemorrhages. erosion scooped out but shallow depression. . frequently along the distribution of cranial nerve V.

texture. tinea capitis scalp ringworm toxic alopecia balding from illness or chemo trichotillomania traumatic self-induced hair loss. purpura confluent and extensive patch of petechiae and ecchymoses >3 mm flat. pediculosis head lice capitis folliculitis superficial infection of hair follicles koilonychia spoon nails beau's lines transverse furrow or groove in nail. Chronic. red to purple.usually resulting from compulsive twisting or plucking.usually bacteria. habit-tic depression down middle of nail or multiple horizontal ridges caused by dystrophy continuous picking of cuticle by another finger of same hand. change in color. macular hemorrhage. caused by endocrine or metabolic dysfunction or occasionally idiopathic. . with nail crumbling or breaking and loosening of nail plate.usually fungal onycholysis slow persistant fungal infection of finger/toenails. paronychia red swollen tender inflammation of nail folds. hirsutism excess body hair in females forming a male sexual pattern. thickness. Occurs with trauma that temporarily impairs nail formation.injuring nail base and matrix.or brown in color. acute.