NCMA111 LECTURE: SKIN, HAIR, NAILS, HEAD AND NECK

ADULT ASSESSMENT:  Secretion

SKIN, HAIR, NAILS, HEAD AND NECK - Sweat
Skin  Sensation
- The skin is the largest organ of the body, with a total area of - Sense of touch
about 20 square feet.  Absorption
- A physical barrier that protects the underlying tissues and - Absorption of Vitamin D
organs from microorganisms, physical trauma, ultraviolet  Excretion
radiation (UVR), and dehydration.
- Provides individual identity to a person's appearance. Key Points When Preparing to Examine the Skin
- Thicker on the palms of the hands and soles of the feet.  Inspect color, Temperature, Moisture, Texture, Integrity,
Lesions
 Use COLDSPA to explore health concerns:
 Character – describe s&s of rush
 Onset – when did it begin? Like rushes
 Location – saan banda?
 Duration – gaano na ito katagal? Kung bumabalik man
gaano kadalas?
 Severity – how bad is it? Gaano kasakit? Use pain scale
 Pattern – what makes it better or worse?
 Associated factors – how it affects the client like other
symptoms

Assessment of the skin

Epidermis
- Outer layer - Involves inspection and palpation.
- Made of squamous epithelial tissue - The entire skin surface may be assessed at one
- Provides water proof barriers - time or as each aspect of the body is assessed.
- Skin tone - In some instances, the nurse may also use the olfactory sense to
- It can replace every 3-4 weeks detect unusual skin odors; these are usually most evident in the
- Divided into 4 layers skinfolds or in the axillae.
a) Stratum corneum - Pungent body odor is frequently related to poor hygiene,
b) Stratum lucidum hyperhidrosis (excessive perspiration), or bromhidrosis (foul
c) Stratum granulosum smelling perspiration).
d) Stratum germinatum Assessment Findings - Inspection
Inspection Normal Abnormal
Dermis - Evenly colored skin tones
- Thick, deeper layer  Jaundice
without unusual or prominent  Pallor
- Consists of connective tissue and an extracellular material General discolorations
(matrix), which contributes to the skin’s strength and  Acanthosis
Skin color - Older client looks pale due to
pliability decrease melanin production and nigricans
- Location of blood vessels, lymphatic vessels, nerves, hair vascularity  Cyanosis
follicles, and sweat and sebaceous glands  Albinism
Color - Sun-tanned areas
 Erythema
variations - Freckles
Subcutaneous tissue (Hypodermis)  Vitiligo
- Beneath dermis and epidermis Skin Skin is intact and there are no
- Consists mostly of adipose and other connective tissues reddened areas
Pressure ulcers
integrity
- Containing of blood vessels and nerves, and the remaining  Primary
portion of sweat glands. - Smooth, without lesions,
lesions
- Restore fats and it will serve as energy reserve Lesions Stretch marks, Healed scars,
Moles, Freckles, Birthmarks  Secondary
- It also serves as caution to protect bones and internal organs lesions
from injury. Inspect also the Skin Odor:
 Unusual body odor – Poor hygiene or underlying disease
Functions of Skin
 Odors from excessive sweating (hyperhydrosis) – Possible
 Protection
- protective barrier to the human body against mechanical, thyrotoxicosis (excess thyroid hormone)
thermal and physical injury.  Odors from night sweats – Possible tuberculosis
- Prevent loss of moisture.  Urine odor – Incontinence problem
- Reduces harmful effects of UV radiation.  Mousy odor – Liver disease
 Heat regulation
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 HEALTH ASSESSMENT LECTURE: WEEK 8-9 - SKIN, HAIR, NAILS, HEAD AND NECK

o Jaundice – whites of the eyes and mucous membranes turn

yellow because of a high level of bilirubin.
o Pallor – simply by retracting eyelid; pale color
o Acanthosis Nigricans – dark discoloration in body folds and
creases; It typically affects the armpits, groin and neck; it can
be seen if they are a stress person or diabetic patient.
o Cyanosis – bluish discoloration of the skin; poor peripheral
circulation of the client.
2 Types of Cyanosis
1. Central – Cause by diseases of heart and lungs. Bluish
discoloration of tongue and linings of the mouth.
2. Peripheral - results from decreased peripheral
circulation. Seen at the arms and legs.
o Albinism –little or no production of the pigment melanin,
which determines the color of the skin, hair and eyes; very
sensitive to the sunlight
o Erythema – redness of the skin or mucous membranes, caused
by hyperemia (increased blood flow) in superficial capillaries.
o Vitiligo – the skin loses its pigment cells (melanocytes).
o Pressure ulcers – injuries to the skin and underlying tissue,
primarily caused by prolonged pressure on the skin; there is
poor circulation; nursing interventions – you have to turn the
client every 2hrs para umayos yung circulation ng client.
Risk Factors For Pressure Ulcers:
 Impaired mental status o Stage 1 – intact balat pero namumula
 Impaired nutritional status o Stage 2 – loss in some part of dermis and epidermis
 Sensory deficits o Stage 3 – sugat umabot na sa subcutaneous tissue
 Immobility o Stage 4 – worst, halos umaabot na sa buto ung sugat
 Mechanical forces o Pressure sore – kapag nasa hospital it is an indication of a bad
nursing care
 Shearing and friction
 Increased by temperature
Braden Scale
 Excessive exposure to moisture from bodily
Sensory perception Completely limited
secretions, such as urinary and fecal Ability to respond Very limited
incontinence meanigfully to pressure Slightly limited
related to discomfort No impairement
Constatntly moist
Moisture
Very moist
Degree of moisture to which
Occassionally moist
the skin is exposed
Rarely moist
Bedfast
Activity Combined to chair
Degree of physical activity Occassionally walks
Frequently walks
Completely immobile
Mobility
Very limited
Ability to change and control
Slightly limited
body position
No limitation
Skin Integrity Very poor
 Braden Scale Assessment tool used to predict pressure sore Nutrition Probably inadequate
risk Usual food initiate pattern Adequate
 PUSH (Pressure Ulcer Scale for Healing) tool to document Excellent
the degree of skin breakdown to provide a baseline to compare Problem
Friction and shear
degree of healing or deterioration over time. Potential problem
Apparent problem

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 HEALTH ASSESSMENT LECTURE: WEEK 8-9 - SKIN, HAIR, NAILS, HEAD AND NECK
Primary Lesions
- Initial alteration in the skin
- Directly associated with a disease process
- Example: tumor, cyst, pustule
Name Description
Skin color change without
Macule elevation
Skin color change greater than
Patch 1cm
Elevated, solid lesion of less
Papule than 1cm varying in color
Raised flat lesion formed from
Plaque merging papules or nodules;
very itchy
Elevated, palpable, solid mass,
Nodule 0.5-2cm; it is moveable
Extend deeper into dermis,
Tumor 1-2 cm
a small fluid-filled bladder,
Vesicle sac
a fluid-filled sac or lesion that
Bulla appears when fluid is trapped
under a thin layer of your skin.
-an area of the skin which is
temporarily raised, typically
reddened, and usually
Wheal accompanied by itching.
-allergy reaction
-nakagat ng langgam/ insecto
Pustule Pus filled vesicles
-Encapsulated fluid filled or
semi solid mass
Cyst -Located in the subcutaneous
tissue or dermis
Flat – nonpalpable
 include freckles, flat moles, petechiae, vitiligo, ecchymosis
Raised/ Elevated – palpable
 Examples of papules: elevated nevi, warts
 Examples of Plaque: psoriasis and actinic keratosis
Secondary Lesions
- Arises from a change in a primary lesion
- Maybe initiated by external forces (scratching, infection) or the
Image healing process
- Example: scale, crust, erosion, scars
Name Description Image
- Loss of superficial epidermis
Erosion - Does not extend to the dermis
- Depressed, moist area
- Skin loss extending dermis
Ulcer - Necrotic tissue loss
- Bleeding and scarring possible
- Skin mark left after wound heal
- Represent replacement by
Scar connective tissue of the injured
tissue
- Linear crack in the skin
- May extend to the dermis
Fissure
- Nakikita natin to sa mga taong
hindi nagtsitsinelas
Vascular Lesions
Name Description Image
- Round or irregular macular
lesions that is larger than
petechia
Ecchymosis - a discoloration of the skin
resulting from bleeding
underneath
- caused by bruising
- very small patches around the
skin.
- Minsan red/violet
- formed when tiny blood
Petechia vessels called capillaries break
open.
- When these blood vessels
break, blood leaks into your
skin.
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 HEALTH ASSESSMENT LECTURE: WEEK 8-9 - SKIN, HAIR, NAILS, HEAD AND NECK

Assessment Findings – Palpation

- round red or purple lesions
Cherry Palpation Normal Abnormal
that can be found on the trunk/
Angioma extremities Rough, flaky,
Texture Smooth and even
dry, itchy
- commonly known as "spider -Increased moisture or
veins" diaphoresis (profuse
Telangiectasis
- dilated or broken blood sweating) may occur in
vessels conditions such as fever or
- a radiating branches. Moisture Moist and dry
hyperthyroidism
- containing a central red spot -Decreased moisture occurs
Spider
and reddish extensions which with dehydration or
angioma radiate outwards like a spider's hypothyroidism
web. -Cold skin may accompany
shock or hypotension, arterial
Capillary - red color irregular shape disease.
hemangioma macular patch. Temperature Warm
-Very warm skin may
indicate a febrile state or
- Capillary angioma directly hyperthyroidism.
below epidermis Skin pinches easily
- Non elevated, red to purple, -Decrease mobility is seen
Port-wine Mobility and immediately
dense areas of capillaries with edema
stain and turgor returns to its original
-Client dehydrated
- Commonly appearing on face position
- No fading with time, may A Skin rebounds and
require surgery in the future does not remain
Edema indented when
With indention
Skin Abnormalities pressure is released
Name Description Image o Diaphoresis – excessive sweating

- Caused by over activity of

Acne
sebaceous gland and an onset
Vulgaris of puberty

- Causes reddish, irregular,

slightly raised lesions that
Actinic have a rough, gritty surface
Keratosis - Very itchy; don’t expose them
to the sun
Eczema/ - Causes redness, pruritus,
itchy, can cause skin irritation 3 most commonly detected skin cancer
Atomic and it has red to red brown,
Dermatitis Name Description Image
slightly scaly lesions
- An epidermoid cancer,
- Localized skin irritation, one of the most common
inflammation, and pruritus malignant skin diseases
Pruritus Basal cell
from contact with an irritating - Typically has pearly,
substance carcinoma flesh colored or
Herpes - contagious disease transparent “rolled”
- Recurrent clusters of small border
simplex vesicles on erythematous base
virus - Parang bulla; nakakahawa
- An invasive, cancerous
- has genetic causes and may
skin tumor with strong
begin at any age
Melanoma potential for metastasis
- Silvery scales on bright red
to both regional and
Dermatitis papules,
distant sites and organs
- Scales generally thick,
- Area beneath bleeds if scale is
removed - A form of skin cancer
occurring mainly in the
Squamous squamous cells Based of
Cell lesions may be Inflamed
Carcinoma - Typically, on sun-
exposed surfaces (scalp,
hands, lips, ears)

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 HEALTH ASSESSMENT LECTURE: WEEK 8-9 - SKIN, HAIR, NAILS, HEAD AND NECK

The ABCDE of Lesions - useful for assessment of skin cancers Hair

 Asymmetry - formed from keratin produced by matrix cells in the dermal
 Border Irregularity layer of the skin. Each hair lies in a hair follicle.
 Color Variations Function of Hear
 Diameter  Protection
 Elevation  Regulation of body temperature
 Facilitation of evaporation of perspiration
Physical Assessment of the Skin  Sense organ
1. Greet and identify the client Types of Hair
2. Explain the procedure 1. Vellus
3. Wash hands - Short, pale, and fine hair is located over all of the body.
4. Provide for client privacy 2. Terminal
5. Position client appropriately and comfortably - Dark and coarse and found on the scalp, and brows.
6. Inquire if the client has any history of skin allergies and skin - After puberty, on the legs, axillae and perineum.
problems
7. Inspect for the skin color and uniformity of skin color
8. Assess edema if present. Note location, color, temperature,
shape and degree to which the skin remains indented or pitted
when pressed by a finger
9. Inspect, palpate and describe skin lesions
10. Observe and palpate skin moisture
11. Palpate skin temperature
12. Note skin turgor
13. Position the client comfortably
14. Inform the client findings if necessary
15. Wash hands
16. Document findings and report significant deviation to the
physician
Assessment Findings - Inspection
Questions to Be Asked from The Client
Inspection Normal Abnormal
History of client
 Have you noticed any change in your ability to feel pain, Color Natural hair color patchy gray hair
pressure, light touch or temperature variations?  Excessive scaliness
Moisture Shiny
 Are you experiencing any pain, itching, tingling, or  Poor hygiene
numbness? Presence of dandruff
Scalp Clean
 Are taking any medications (prescribed/over the counter) do and parasites Alopecia
you use any ointments, creams, herbal and nutritional  Brittle hair
supplements or vitamins? How long have you been taking Texture Thick and fine  Split ends
each of these?  Dry
 Do you have any trouble controlling body odor? Do you Hair Changes:
perspire a lot?  Anagen – The active growth phase of hair follicles during
 Have you had any recent hospitalizations or surgeries? which the root of the hair is growing rapidly. During this
 Have you ever had any allergic reactions to food medications, phase the hair grows about 1 cm every 28 days.
plants or other environmental substances?  Telogen – Resting stage of the growth cycle.
 Has anyone in your family had a recent illness, rash, or other Alopecia:
skin problem or allergy? - Probably the most distressing change in hair that can occur
because of its cosmetic effect not only refers to scalp hair
 Has anyone in your family had skin cancer?
but also to body hair.
 Do you have any history of keloids?
- Classification:
a) Non – Cicatricial
 Nonscarring
 Hormonal changes
 Medications
 Infectious diseases / Thyroid
 Follicles may remain intact and may reverse
process

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 HEALTH ASSESSMENT LECTURE: WEEK 8-9 - SKIN, HAIR, NAILS, HEAD AND NECK

b) Cicatricial Common Nail Disorders

 Scarring Name Description Image
 Burns - Spoon shaped nails that may
be seen with trauma to
 Radiation
cuticles or nail folds or in
 Traction Koilonychia iron deficiency anemia,
 Irreversible damage to hair follicles endocrine or cardiac disease.
- Nagiging bluish pag may
Nail sakit sa puso
Yellow - Yellow nails grow slow and
- are formed when epidermal cells are converted into hard plates
are curved.
of keratin. Nail - May be seen in AIDS and
Cuticle Syndrome respiratory syndromes.
- a layer of keratin at the nail fold, attaches the nail plate to - Caused by local infection.
the soft tissue of the nail fold - develops around the edges of
Paronychia the nail at the bottom or
Nail Body
sides.
- translucent, and the pinkish hue reflects a rich blood supply - parallel ridges running
beneath the nail surface lengthwise.
Lunula Longitudinal
- May be seen in the elderly
ridging and some young people with
- nail plate which is slightly hypopigmented than nail.
- contains stem cells and nail plate matrix which helps the no known etiology.
- that are half white on the
growth of the nail. If it gets damaged your nail can’t grow well. upper proximal half and pink
Half-and-
on the distal half.
Half Nails - May be seen in chronic renal
disease.

Pitting - Seen with psoriasis client

Head
Assessment Findings - Inspection Assessment Findings – Inspection
Inspection Normal Abnormal Inspection Normal Abnormal

Colorless and a convex curve Concave Head: Symmetric, Round,

Size, Shape, Facial and skull bones
Clubbed fingernails Erect and in
Angle between nail and nail Symmetry are larger and thicker
(>180°) due to chronic Midline
bed usually, 160°
tissue hypoxia
Highly vascular and pink in Face:
Bluish or purplish
light skinned; dark skinned
tinges; Pale Symmetry,  Asymmetrical face
Nails may be brown or black Symmetric, Round,
Features,  Mask like face
Oval, Elongated,
Perform blanch test/ Movement,  Sunken eyes
Capillary refill test is a quick A CRT longer than 2
Square appearance
Expression,  Moon shaped face
test done on the nail beds. It seconds suggests poor Skin condition
is used to monitor perfusion due to
dehydration and the amount peripheral
of blood flow to tissue. vasoconstriction.
Assessment Findings – Palpation
Normal 1-2secs Palpation Normal Abnormal
Normally hard and
Scamroth Sign/ Schamroth window: Head
smooth without Elastic and not tender
- Clubbed nails – difficulty of breathing or low level of oxygen Consistency
deviation
Hard, Thick, and
Temporal Elastic and not
tender with
Artery tender
inflammation
No swelling,
Limited ROM,
Temporomandibular tenderness, and
Joint (TMJ) swelling, tenderness,
crepitation with
Crepitation
movement

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 HEALTH ASSESSMENT LECTURE: WEEK 8-9 - SKIN, HAIR, NAILS, HEAD AND NECK

Neck  Submental – tip of the chin

- Composed of muscles ligaments and the cervical vertebrae.  Submandibular – under the mandible
Assessment Findings – Inspection  Jugulodigastric – also known as subdigastric lymph nodes;
Inspection Normal Abnormal located below the posterior belly of the digastric muscle and
Position, Neck is symmetric anterior to the internal jugular vein.
symmetry, with head centered and With swelling, enlarged  Superficial cervical – upper portion of the sternocleidomastoid
lumps and without bulging masses or nodules muscle
masses masses  Deep cervical chain – sternocleidomastoid muscle
Movement of  Posterior cervical – posterior triangle behind the
the neck Thyroid cartilage, sternocleidomastoid muscle
cricoid cartilage, Asymmetric movement  Supraclavicular – above the clavicle or collarbone, toward the
Structure
thyroid gland moves or generalized
(thyroid gland upward symmetrically enlargement hollow of the neck
and thyroid as the client swallows
cartilage)
Cervical C7 is usually visible
Prominence/ swelling
vertebrae and palpable
Range of Stiffness, rigidity,
Smooth and controlled
motion (ROM) limited mobility

Assessment Findings – Palpation

Palpation Normal Abnormal
Trachea
Midline Pulled to one side
(position)

Thyroid Gland:
-Hyoid bone Deviated from midline
Midline
-Thyroid cartilage maybe because of masses
-Cricoid cartilage OTHERS (FROM CANVAS)
Pain
No swelling,
Cervical
enlargement and
Swelling, enlargement  is an unpleasant sensory and emotional experience associated
Lymph nodes and tenderness
tenderness with actual or potential tissue damage, or described in terms of
Auscultate the such damage
thyroid gland if Nature of Pain
No bruits are A soft, blowing, swishing
there is enlargement
during inspection
auscultated sound  Pain is subjective and highly individualized
and palpation  Its stimulus is physical and/or mental in nature
 It interferes with personal relationships and influences the
Palpating the thyroid gland meaning of life
- You’ll need to stand behind the client.  Only the patient knows whether pain is present and how the
- Give the client a cup of water and have him extend his neck experience feels
slightly.
 May not be directly proportional to amount of tissue injury
- Place the fingers of both hand on the client’s neck, just below
Signs and Symptoms of Pain
the cricoid cartilage and just lateral to the trachea.
 Increased RR
- Tell the client to take a sip of water and swallow.
- Thyroid gland should rise as he swallows.  Increased HR
- Use your fingers to palpate laterally and downward to feel the  Peripheral vasoconstriction
whole thyroid gland.  Pallor
- Palpate over the midline to feel the isthmus of the thyroid.  Elevated BP
 Diaphoresis
Neck Lump Nodes  Moaning
 Preauricular – located in front of your ears. They drain lymph  Guarding behavior
fluid from the eyes, cheeks, and the scalp near your temples.
 Restlessness
 Posterior auricular - located beneath the ear.
 Irritability
 Occipital – located in the back of the head, near the occipital
bone of the skull.

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 HEALTH ASSESSMENT LECTURE: WEEK 8-9 - SKIN, HAIR, NAILS, HEAD AND NECK
TYPES OF PAIN
Acute Pain
 Lasts only through the expected recovery period
 Of short duration, has limited tissue damage and emotional
response
 Eventually resolves with or without treatment, after and
injured area heals
 Complete pain relief is not always achievable, but reducing
pain to a tolerable level is realistic
 Unrelieved acute pain can progress to chronic pain
Chronic Pain
 Pain that lasts longer than 6 months and is constant or
recurring with a mild-to- severe intensity
 Leads to great personal suffering
 Associate symptoms of chronic pain include fatigue, insomnia,
anorexia, weight loss, hopelessness and anger
Pain Concepts
Radiating Pain
 perceived at the source of the pain and extends to the
nearby tissues
Referred Pain
 felt in a part of the body that is considerably removed or
farll from the tissues causing the pain
Persistent Pain
 a pain that contributes insomnia, weight gain,
constipation, etc.
Severe Pain
 an emergency situation deserving attention and
professional treatment
Hyperalgesia
 excessive sensitivity to pain
Pain Threshold / Sensation
 the amount of pain stimulation a person requires before
feeling pain
 least level of pain that the patient is able to detect
Pain Tolerance
 maximum amount and duration of pain that an individual
is willing to endure
Pain Perception
 the point which the person becomes aware of the pain
Allodynia
 pain due to a stimulus that does not normally provoke
pain
Dysesthesia
 unpleasant abnormal sensation, imitates the pathology of
central neuropathic pain disorder
Nociceptive Pain
 pain directly related to tissue damage and may be somatic
Sensitization
 an increased sensitivity of a receptor after repeated
activation by noxious stimuli or nociceptor
Breakthrough Pain
 a transitory increase in pain that occurs on a background of
otherwise controlled persistent pain
Bradykinin
 universal stimulus for pain
Comfort
 implies renewal amplification of power
COMMON ABNORMALITIES OF THE SKIN
Contact Dermatitis
 Localized skin irritation, inflammation, and pruritus from
contact with an irritating substance
 Can occur as an additive effect of multiple irritants (soaps,
detergents, or chemicals) or allergy to a specific agent (topical
to a specific agent, topical medication, plant oils, or metals)
 Secondary infections may occur at the site
 Edema may occur, with development of vesicles and bullae
 Vesicles or bullae may rupture, causing crusting
 Edema may be very significant, particularly when face or
genitalia are involved
 Person may have history of previous reaction to agent and
recent exposure
Intertrigo
 A superficial dermatitis in the skinfolds
 Caused by heat, moisture, and friction, and is most common in
obese people
 Pink to reddened skin in body folds (between and beneath
buttocks, beneath fatty abdominal pad, or beneath pendulous
breasts)
 Areas in folds develop erythema, fissures, and denudation
 Lesions may itch, burn, or sting
Pityriasis Rosea
 A common, mild, acute inflammatory skin disease
 Often described as “Christmas tree” rash because of shape
 Rash may last 4 to 8 weeks
 Can be intensely pruritic
 Believed to be caused by viral infection
Psoriasis
 A common dermatitis that has genetic causes and may begin at
any age
 Silvery scales on bright red papules
 Scales generally thick
 Area beneath bleeds if scale is removed
 Usually occurs on extensor surfaces of knees, elbows, and
scalp
 Itching may be mild or severe
 A genetic predisposition is suggested by family history
Rosacea
 A chronic disorder of unknown cause that occurs mainly on
the face
 Acne component with papules, pustules, and seborrhea
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 HEALTH ASSESSMENT LECTURE: WEEK 8-9 - SKIN, HAIR, NAILS, HEAD AND NECK

 May be aggravated by alcohol, caffeine, chocolate, heat, and Tinea Pedis

spicy foods, as well as by situations that promote flushing  A fungal skin disease occurring in the foot
Seborrhea  Athlete's foot
 A disorder of the sebaceous glands that causes an increase in  Exfoliating, fissuring, macerated area of erythema
the amount of sebaceous secretion  Sites itch, burn, and / or sting
 Typical sites include scalp, face (between brows, along sides
of nose, at mustache / beard areas) and on presternal,
interscapular, and umbilical regions
 Itching may be present
 Fissuring is possible with secondary infections
 “Super dandruff” is common term because it occurs along sites
with greater hair distribution
Seborrheic Keratosis
 A benign skin lesion that may be pigmented
 Sharply demarcated lesions
 Brown to black pigmentation
 Rough, dry surface
 Elevation
 Surrounding skin generally normal
 Incidence increases with age
 Generally found on trunk, although potentially can occur
anywhere
Stasis Dermatitis
 Eczema of the legs with pigmentation, edema and chronic
inflammation resulting from venous insufficiency
 Stasis ulcer is associated with stasis dermatitis and develops
from venous insufficiency
 Red, scaly patch often initial sign
 Site develops vesicles and crusts
 Ulcer may develop as a result of trauma, edema, or infection
 Caused by poor circulation, which can be related to peripheral
vascular diseases, obesity, or poor nutrition
Tinea Capitis
 A fungal infection of the scalp
 Well-demarcated, reddened area
 Scaling, itching
 Dry, brittle hair
Tinea Corporis
 a fungal skin disease occurring anywhere on the body
 Ringworm
 Ring-shaped erythematous lesions on body
 Advancing border with small vesicles
 Pruritic
 Most often on exposed surfaces
Tinea Cruris
 a fungal skin disease occurring in the genital and anal areas in
males
 Sharply demarcated, reddened areas
 Severe pruritus

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