Health Assessment Chapter 12
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| Macule | Solely a color change, flat and circumscribed, of less than 1 cm. examples include Freckles, flat nevi, hypopigmentation, petechiae, measles, scarlet fever
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| Papule | something you can feel (solid, elevated, circumscribed, less than 1 cm) caused by superficial thickening in the epidermis. ex. include elevated nemus (mole), lichen planus, wart, molluscum
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| patch | macules that are larger than 1 cm. ex. include mongolian spot, vitiligo, cafe au lait spot, chloasma, measles, rash
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| nodule | solid, elevated, hard or soft, larger than 1 cm. may extend deeper into dermis than a papule. examples include xanthoma, fibroma, intradermal nevi
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| tumor | larger than a few centimeters in diameter, form or soft, deeper into dermis; may be benign or malignant, although it usually implies cancer to most people. examples include lipoma, hemangioma
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| plaque | papules coalesce to form surface elevation wider than 1 cm. a plateaulike, disk-shaped lesion. ex. include psoriasis, lichen planus
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| wheal | superficial, raised, transient, and erythematous; slightly irregular shape from edema (fluid held diffusely in the tissues). examples include mosquito bite, allergic reaction, dermographism
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| urticaria | wheals coalesce to form extensive reaction, intensely pruritic
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| vesicle | elevated cavity containing free fluid, up to 1 cm; a "blister." clear serum flows if wall is ruptured. examples include herpes simplex, early varicella (chicken pox), herpes zoster (shingles), contact dermatitis
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| bulla | larger than 1 cm diameter; usually sing;e chambered (unilocular); superficial in epidermis; thin walled and ruptures easily. examples include friction blister, pemphigus, burns , contact dermatitis
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| cyst | encapsulated fluid- filled cavity in dermis or subcutaneous layer, tensely elevating skin. examples include sebacous cyst, wen
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| pustule | turbid fluid (pus) in the cavity. circumscribed and elevated. examples include acne, impetigo
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| crust | the thickened, dried out exudate left when vesicles/ pustules burst or dry out. color can be red brown honey or yellow depending on fluid ingredients. examples include impetigo, weeping eczematous, dermatitis, and scabs after abrasions
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| scale | compact, desiccated flakes of skin, dry, or greasy silvery or white, from shedding of dead excess keratin cells. examples include scarlet fever, drug reaction, dry skin
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| fissure | linear crack with abrupt edges; extends into dermis; dry or moist. examples include cheilosis and athletes foot
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| erosion | scooped out but shallow depression. superficial; epidermis lsot; moist but no bleeding; heals without scar because erosion does not extend to dermis
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| ulcer | deeper depression extending into dermis, irregular shape; may bleed; leaves scar when heals. examples include stasis ulcer, pressure sore, chancre
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| excoriation | self-inflicted abrasion; superficial; sometimes crusted; scratched from intense itching. examples include insect bites, scabies, dermatitis, and varicella
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| scar | after the skin lesion is repaired, normal tissue is lost and replaced with collective tissue (collagen). this is a permanent fibrotic change. examples are healed areas of surgery or injury, acne
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| atrophic scar | the resulting skin level is depressed with loss of tissue; a thinning of the epidermis. examples include straie
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| lichenification | prolonged, intense scratching eventually thickens skin and produces tightly packed sets of papules; looks like the surface of moss (or lichen).
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| keloid | a benign excess of scar tissue beyond sites of original injury: surgery, acne, ear piercing, tattoos, infections, burns. look smooth, rubbery, shiny, and "clawlike"; feels smooth and firm. found in ear lobes, back of the neck, scalp, chest, and back
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| port wine stain | a large, flat, macular patch covering the scalp or face, the color is dark red or blueish and intensifies with crying, exertion, or exposure to heat or cold. the marking consists of mature capillaries. present at birth and doesnt fade.
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| strawberry mark | raised bright red area with well defined borders about 2-3 cm in diameter. does not blanch with pressure. consists of immature capillaries and usually fades as person gets older.
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| cavernous hemangioma | a redish irregular shaped solid and spongy mass of blood vessels. does not involute spontaneously.
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| spider or star angioma | a fiery red star shaped marking with a solid circular center. capillary radiations extend from the central arterial body. note the central pulsating body and blanching of extended legs when pressure is given.
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| telangiectasia | caused by vascular dilation; permanently enlarged and dilated blood vessels that are visible on the skin surface.
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| venous lake | a blue purple dilation of venules and capillaries in the star shaped linear or flaring pattern. pressure causes them to empty or disappear.
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| petechiae | tiny punctate hemorrhages 1 to 3 mm round. caused by bleeding from superficial capillaries; will not blanch. some diseases that cause bleeding are: thrombocytopenia, subacute bacterial endocarditis, and other septemias
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| ecchymosis | purplish patch resulting from extravasation of blood into the skin
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| purpura | confluent and extensive patch of petechiae and ecchymosis. occurs in old age as blood leaks from capillaries in response to minor trauma and diffuses through dermis
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| primary contact dermatitis | local inflammatory reaction to an irritant in the environment or an allergy. often erythema shows first, followed by swelling wheals
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| allergic drug reaction | erythematous and symmetric rash, usually generalized
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| tinea corporis | scales- hyperpigmented in whites, depigmented in dark skinned people
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| tinea pedis | athletes foot, a fungal infection first appears in the small vesicles between toes etc.
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| labial herpes simplex | herpes simplex virus infection has a prodrome of skin tingling and sensitivity. lesion then erupts with tight vesicles followed by pustules and produces acute gingivostomatitis
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| tinea versicolor | fine, scaling, round patches of pink, tan, or white caused by a superficial fungal infection
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| herpes zoster | small, grouped vesicles emerge along route of cutaneous sensory nerve then pustules then crusts. caused by the varciella zoster virus, a reactivation of the dormant virus of chickenpox
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| erythema migrans of lyme disease | not fatal but may have neurological, cardiac, or arthritic problems. caused by the spirochete bacterium carried by the black or dark brown deer tick. first stage has a bull's eye
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| psoriasis | scaly, erythematous patch with silvery scales on top (usually on the scalp)
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| basal cell carcinoma | starts with skin colored papule then develops rounded, pearly borders with central red ulcer or looks like large open pore with central yellowing
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| squamous cell carcinoma | arise from actinic ketatoses or de novo. scaly patch with sharp margins with a central ulcer and surrounding erythema
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| malignant melanoma | lethal lesions that are malignant, transformation of malanocytes. irregular or notched borders. UV radiation is a risk factor
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