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Skin/Hair/Nails
Assessing the skin, hair & nails
| Question | Answer |
|---|---|
| History of present health concern questions to ask | Dry, itchy skin? Piercings? Tattoos? Scars? Moles? Hair loss? |
| Past history of patient questions to ask? | Skin cancer? surgery? allergies? |
| Family history questions to ask? | Skin cancer? |
| Lifestyle questions to ask? | Tanning booths, sunscreen? work indoors or outdoors? |
| Inspection of skin, look at the | General condition, color variations, skin integrity (intact), lesions, jaundice |
| Palpation of skin, feel for | texture, thickness, moisture, mobility, edema and turgor |
| Skin cancer assessment | A-Asymmetry B-Border C-Color D-Diameter E-Elevated |
| Pallor is | loss of color, seen in arterial insufficiency, decreased blood supply and anemia |
| Cyanosis is | may cause white skin to appear blue-tinged, in nailbed and conjunctival areas |
| Central cyanosis results from______, whereas peripheral cyanosis may be a local problem resulting from ______. | cardiopulmonary problems, vasoconstriction |
| To differentiate between central and peripheral cyanosis, look for central cyanosis in the | oral mucosa |
| Acanthosis nigricans is | the roughening and darkening of skin in localized areas, especially posterior neck. |
| Albinism is a | generalized loss of pigmentation |
| Primary lesions arise from | normal skin due to irritation or disease. |
| Rough, flaky, dry skin is seen in | hypothyroidism |
| Facial hair on females (Hirsutism) is a characteristic of | Cushing syndrome and results from an imbalance of adrenal hormones or it may be a side effect of steroids. |
| Pale or cyanotic nails may indicate | hypoxia or anemia |
| Early and late clubbing of fingers can occur from | |
| History of present health concern questions to ask | Dry, itchy skin? Piercings? Tattoos? Scars? Moles? Hair loss? |
| Past history of patient questions to ask? | Skin cancer? surgery? allergies? |
| Family history questions to ask? | Skin cancer? |
| Lifestyle questions to ask? | Tanning booths, sunscreen? work indoors or outdoors? |
| Inspection of skin, look at the | General condition , color variations, skin integrity (intact), lesions, jaundice |
| Palpation of skin, feel for | texture, thickness, moisture, mobility, edema and turgor |
| Skin cancer assessment | A-Asymmetry B-Border C-Color D-Diameter E-Elevated |
| Pallor is | loss of color, seen in arterial insufficiency, decreased blood supply and anemia |
| Cyanosis is | may cause white skin to appear blue-tinged, in nailbed and conjunctival areas |
| Central cyanosis results from______, whereas peripheral cyanosis may be a local problem resulting from ______. | cardiopulmonary problems, vasoconstriction |
| To differentiate between central and peripheral cyanosis, look for central cyanosis in the | oral mucosa |
| Acanthosis nigricans is | the roughening and darkening of skin in localized areas, especially posterior neck. |
| Albinism is a | generalized loss of pigmentation |
| Primary lesions arise from | normal skin due to irritation or disease. |
| Rough, flaky, dry skin is seen in | hypothyroidism |
| Facial hair on females (Hirsutism) is a characteristic of | Cushing syndrome and results from an imbalance of adrenal hormones or it may be a side effect of steroids. |
| Pale or cyanotic nails may indicate | hypoxia or anemia |
| Early and late clubbing of fingers can occur from | Hypoxia |
| Spoon nails may be present with | iron deficiency anemia |
| Capillary refill normal | < 2 secs |
| A macule is | flat, < 1cm, non-palpable skin color change (may be brown, white, tan, purple or red) Examples: freckles, flat moles, petechiae, rubella, vitiligo, ecchymosis |
| A papule is | elevated, palpable, solid mass, < 0.5cm Examples: elevated nevi, warts, lichen planus |
| A patch is | > 1 cm, may have irregular border |
| A plaque is | > 0.5 cm. Examples: psoriasis, actinic keratosis |
| A nodule is | elevated, solid, palpable mass, extends deeper into dermis than a papule (0.5-2cm) |
| A tumor is | > 1-2cm, does not also have sharp borders |
| A vesicle is | circumscribed elevated palpable mass containing serous fluid, < 0.5 cm. Examples: herpes, varicella, poison ivy, second degree burn |
| A bulla is | > 0.5 cm. Examples: contact dermatitis, large burn blisters, impetigo. |
| Petechia is | round, red or purple macula, associated with bleeding tendencies |
| Ecchymoses | round or irregular macular lesions |
| Hematoma | localized collection of blood created elevated ecchymoses. Associated with trauma |
| Cherry Angioma | Papular and round, red or purple, noted on trunk and extremities, may blanch with pressure |
| Spider Angioma | Red, arteriole lesion, central body with radiating branches, noted on face, neck arms and trunk, associated with liver disease, pregnancy and vitamin B deficiency |
| Telangiectasis (Venous star) | shape varies: spiderlike or linear, color bluish or red, does not blanch with pressure,associated with increased venous pressure states |
| Configuration of skin lesions | Linear-straight lines as in a scratch or streak Annular- circular lesions Zosteriform- linear lesions clustered along a nerve route Discrete-individual and distinct lesions Polycyclic- circular lesions that tend to run together Confluent- run togethe |
| Wheal | elevated mass with transient borders, caused by movement of serous fluid into the dermis |
| Pustule | pus-filled vesicle or bulla |
| Cyst | encapsulated fluid-filled or semisolid mass located in the subcustaneous tissue or dermis |
| Erosion | loss of superficial epidermis, does not extend to the dermis, depressed, moist area (example scratch marks) |
| Ulcer | skin loss extending past epidermis, necrotic tissue loss, bleeding and scarring possible |
| scar | represents replacement by connective tissue of the injured tissue. Young scars are red or purple, mature scars are white or glistening |
| Fissure | linear crack in the skin, may extend to the dermis (example: chapped lips or hands or athletes foot |
| Stage 1 pressure ulcer | nonblanchable redness of a localized area over a bony prominence, may be painful, firm, soft warmer, or cooler as compared to adjacent tissue. May be difficult to detect in dark skin tones |
| Stage 2 pressure ulcer | Partial thickness loss of dermis presenting shallow open ulcer with red-pink wound bed, without slough. May be intact or open/ruptured serum-filled blister. |
| Stage 3 pressure ulcer | full-thickness tissue loss. Subcutaneous fat may be visible but bone, tendon, or muscle is not exposed. may include undermining and tunneling. |
| Stage 4 pressure ulcer | Full thickness tissue loss with exposed bone tendon or muscle. Slough or eschar may be present in some parts of the wound bed. |
| Unstageable pressure ulcer | full-thickness tissue loss in which the base of the ulcer is covered by slough (yellow, tan, green or brown) or eschar (brown, black or tan) in the wound bed. Stable (Dry, adherent, intact without erythema) eschar on the heels should not be removed |
| Conditions that lead to pressure uclers | pressure, shear and friction |
Created by:
Jmariez
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