From the pictures at the end of Skin, Hair, Nails Chapter
Quiz yourself by thinking what should be in
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| Patch | Primary lesion. Flat, circumscribed, discolored, >1 cm diameter. Ex. Vitiligo, melasma
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| Papule | Primary lesion. Raised, defined, any color, <1 cm diameter. Ex. wart, insect bite
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| Plaque | Primary lesion. Raised, defined, any color, >1 cm diameter. Ex. Psoriasis
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| Wheal | Primary lesion. Raised, flesh-colored or red edematous papules or plaques, vary in size and shape Ex. Urticaria
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| Nodule | Primary lesion. Solid, palpable, >1 cm diameter, often with some depth. Ex. Basal cell carcinoma
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| Tumor | Primary lesion. Large nodule. Ex. Large nevus, basal cell carcinoma
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| Vesicle | Primary lesion. Fluid-filled, <1 cm diameter. Ex. Herpes simplex, chicken pox
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| Bulla | Primary lesion. Fluid-filled, >1 cm diameter. Ex. Second-degree burns, bullous impetigo
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| Pustule | Primary lesion. Purulent, fluid-filled, raised of any size. Ex. pustular acne, folliculitis (inflammation of follicles)
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| Cyst | Primary lesion. Distinct and walled-off, containing fluid or semi-solid material, varied in size. Ex. Epidermal cysts, cystic acne
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| Tinea versicolor | A fungus infection of the skin producing yellow or fawn-colored branny patches. Example of a patch
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| Mollum contagiosum | A rash, caused by pox virus, composed of small dome-shaped papules with a central crater that is belly button-shaped. Cheesy (caseous) material fills the core.
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| Lichen sclerosus | A chronic, atrophic skin disorder marked by the appearance of discrete, flat-topped white papules. Skin affected by rash is often thin, shiny and scarred
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| Atrophy | Secondary lesion. Thinning of skin from loss of skin structures.
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| Scar | Secondary lesion. Fibrous replacement of lost skin structure
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| Keloid | Secondary lesion. Excessive fibrous tissue replacement resulting in enlarged scar and deformity
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| Crust | Secondary lesion. Dried secretions from primary lesion. Ex. Impetigo
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| Scale | Secondary lesion. Rapid turnover of epidermal layer resulting in accumulation of and delayed shedding of outermost epidermis Ex. Psoriasis, tinea corporis
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| Lichenification | Secondary lesion. Accentuation of normal skin lines resembling tree bark and commonly caused by excessive scratching. Ex. Psoriasis, chronic contact dermatitis
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| Excoriation | Lesion resulting from scratching or excessive rubbing of skin (secondary lesion)
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| Erosion | Secondary lesion. Loss of epidermal layer. Ex. varicella
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| Fissure | Secondary lesion. Linear break in skin surface, not related to trauma. Ex. Cheilitis
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| Ulcer | Loss of skin surface, extending into dermis, subcutaneous, fascia, muscle, bone or all (secondary lesion)
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| Scleroderma | A chronic manisfestation of progressive systemic sclerosis in which skin is taut, firm and edematous, limiting movement. Example of atrophy
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| Lichen simplex chronicus | An itching papular eruption that is circumscribed and located on skin that has become thickened and pigmented due to scratching. An example of Lichenification
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| Annular | Ring-like, circular. Ex. Tinea corporis
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| Iris | Bull's eye. Ex. Lyme disease
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| Erythema nodosum | A tender, red, nodular rash on the shins that typically arises in conjunction with another illness. Example of an iris
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| Linear | Line shape. Ex. Contact dermatitis
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| Polymorphous | Several different shapes. Ex. Urticaria, tinea corporis
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| Punctuate | Small, marked with points or dots. Ex. Petechiae, vasculitis
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| Meningococcemia | Meningococci in the blood, an illness that may cause a disseminated rash (an example of punctuate lesion configuration)
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| Serpiginous | Curving, snake-like. Ex. scabies
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| Cutaneous larva migrans | A skin lesion characterized by a tortuous elevated red line that progresses at one while fading out at the other. Example of a serpiginous lesion configuration
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| Nummular/Discoid | Coin-shaped. Ex. Nummular psoriasis, nummular eczema
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| Umbilicated | Central depression. Ex. Herpes zoster, basal cell carcinoma
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| Filiform | Papilla-like or finger-like projections. Ex. warts
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| Verrucaform | Circumscribed, papular with rough surface. Ex. warts
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| Macule | Flat, circumscribed, discolored, <1 cm diameter. Ex. freckles, tattoo
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| Asymmetric | Distributed solely on side of the body. Ex. contact dermatitis, herpes zoster
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| Confluent | With enlargement or multiplication, begin to coalesce to form a larger lesion. Ex. urticaria, tinea versicolor
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| Diffuse | Distributed widely across affected area without any pattern. Ex. drug reaction, rubella
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| Discrete | Single, separated, well-defined borders. Ex. malignant melanoma, wart
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| Generalized | Distributed over large body area. Ex. Psoriasis, acne vulgaris
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| Grouped | Clustered. Ex. Herpes simplex
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| Localized | Located at distinct area. Ex. giant nevus, contact dermatitis, vitiligo
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| Satellite | Single lesion(s) in close proximity to larger lesion, "orbiting." Ex. Cutaneous candidiasis
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| Candidiasis | Fungal infection of the skin or mucous membrane with any species of Candida, but mainly Candida albicans
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| Symmetric | Distributed equally on both sides of the body. Ex. freckles
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| Zosteriform | Distributed along dermatome. Ex. Herpes zoster
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| Cellulitis | Bacterial infection of deep skin tissues. Characterized by swelling, redness, warmth and tenderness or pain
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| Herpes Simplex (cold sores) | Characterized by grouped vesicles on an erythematous base
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| Measles (rubeola) | Characterized by pinkish, erythematous macules and papules first on the face and then spreading. Rash eventually becomes brownish in color
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| Pityriasis rosea | Viral infection initially characterized by a large oval hyperpigmented lesion with a fine scale (known as "herald patch") on the chest or back. Later, more similar, but smaller lesions develop on the torso and extremities
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| German measles (rubella) | Viral illness that presents as a pinkish discrete macular and papular rash covering the entire body.
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| Roseola | Viral illness. Rash appears as fever resolves. The rashes are discrete macules and papules about 1-5 mm in diameter and with an area of pallor surrounding each lesion
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| Tinea corporis | Dermatophyte skin infection resulting in an erythematous, commonly pruritic annular lesion with a raised border and central clearing. Commonly called ringworm
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| Tinea versicolor | Dermatophyte infection that results in hypopigmented patchy lesions generally on the upper chest, upper back, proximal extremities.
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| Psoriasis | Chronic skin disorder characterized by reddish-pink lesions covered with silvery scales
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| Eczema | Aka atopic dermatitis. Characterized by itchy, pink macules or papules
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| Contact dermatitis | Inflammatory response to an antigen resulting in erythematous and pruritic lesions
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| Urticaria | Hives. Accumulation of fluid in the dermal layer of the skin
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| Seborrhea | Aka seborrehic dermatitis. Inflammatory skin disorder characterized by macular pink, red, or orange-yellow lesions. Distribution is generally on the face, scalp and ears
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| Scabies | Caused by a mite that burrows into the epidermis. Results in hypersensitivity reaction of erythema and pruritis
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| Ticks | Characterized by an erythematous target lesion that appears at the site of the bite
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| Congenital nevi | Exists from birth. "Birth marks"
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| Acquired nevi | Occur most commonly in childhood and adolescence
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| Skin tags | Normal papules that are generally <1 cm. Common in pregnancy and in aging skin.
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| Lipoma | Tumor comprised of fat cells and commonly located on the back of the neck, torso, arms, and legs. Occur singly and multiply
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| Lentigo | Bening, acquired, circumscribed, pigmented macules found generally on sun-exposed skin
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| Actinic Keratosis | Usually found on sun-exposed skin. Macular or papular lesions are discrete, with a rough or scaly surface. Commonly called solar keratosis
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| Basal cell carcinoma | Nodular or popular lesion that appears shiny with a rolled pearly border and typically has small spider veins (telangiectases) on its surface. Grows slowly. Rarely metastasizes.
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| Pediculosis capitis | pediculosis (lice) infestation of the head
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| Pediculosis corporis | Pediculosis (lice) infestation of the body
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| Phthirus pubis | Pediculosis (lice) infestation of the genitals
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| Squamous cell carcinoma | Lesions are typically papular, nodular or plaques located on sun-exposed skin surfaces
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| Kaposi's sarcoma | Opportunistic skin infection. Due to impaired immune system. Lesions usually on the nose, penis, and extremities
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| Hemangioma | Vascular lesions that are present at birth. Develop and grow but spontaneously resolve by age 9. Filled with blood an blanch with pressure
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| Nevus Flammeus (Port wine stain) | Malformation of superficial dermal blood vessels
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| Spider or Star Angioma | Vascular lesion that arises from a central dermal arteriole with multiple extensions. Commonly on the face, arms, torso
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| Venous Lake | Papular bluish to purple lesion. Blanches with pressure, is benign and often associated with sun exposure. Generally on face, esp. lips or ears
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| Petechiae | Small reddish to purple macules or papules
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| Purpura | Purplish macules or papules resulting from bleeding under the skin secondary to inadequate clotting mechanisms
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| Ecchymosis | Physical trauma to the skin damages capillaries and blood seeps into surround tissues
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| Hematoma | Collection of blood under the skin usually from blunt-force trauma. Palpable lesions
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| Abrasion | Removal of the skin layers and exposing the dermis. Caused by shear force or friction
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| Suspected deep tissue injury | Purple or maroon localized area of discolored intact skin or blood-filled blister from damage to underlying soft tissue as a result of pressure, shearing or both
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| Stage I pressure ulcer | Intact skin with nonblanchable redness of an area
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| Stage II pressure ulcer | Partial thickness loss of dermis presenting as a shallow open ulcer with a red pink wound bed, without slough or bruising
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| Stage III pressure ulcer | Full thickness tissue loss. Subcutaneous fat may be visible, but bone, tendon or muscle is not. Slough may be present. May include Undermining and tunneling.
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| Stage IV pressure ulcer | Full thickness tissue loss with exposed bone, tendon or muscle. Slough or eschar may be present. Often include undermining and tunneling
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| Unstageable pressure ulcer | Full thickness tissue loss in which the base of the ulcer is covered by slough, eschar or both
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| Neuropathic ulcer | Ulcers resulting from loss of sensation in an extremity, impairing a person's ability to detect pressure
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| Venous ulcer | Develop from chronic pooling of blood in an extremity. Usually occur between the ankle and knee. Wound edges irregular with large exudate. Base beefy red with granulation tissue. Surround tissue hyperpigmented. Generally painless.
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| Arterial ulcer | Result from chronic ischemia due to impaired arterial circulation to an extremity. Usually located distally. Wound edges defined. Base is pale. Minimal granulation tissue.
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| Longitudinal ridging (of nails) | Normal variation, esp. in elderly. Commonly due to aging.
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| Onycholysis | Separation of a part of the nail plate from the nail bed. Common causes are trauma, fungal infections, topical irritants, psoriasis and subungal neoplasms or warts
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| Koilonychia (spoon nails) | Transverse and longitudinal concavity of the nail. Causes are trauma, iron-deficiency anemia and hemochromatosis
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| Hemochromatosis | Genetic disease marked by excessive absorption and accumulation of iron in the body
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| Pitted nails | Lesions from psoriasis
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| Beau's lines | Results from slowed or halted nail growth in response to illness, physical trauma or poisoning
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| Clubbing | results from chronic hypoxia to distal fingers, such as with CHF
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| Yellow Nails | Slow growing, without cuticle, and onycholysis resulting in thickening of nail and yellow color. Causes include lung disorder and lymphedema
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| Half-and-half nails | Color changes associated with chronic renal failure. Proximal portion of nails is white, distal portion is pink or brown
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| Dark longitudinal streaks | Often a normal variant in dark-skinned patients.
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| Splinter hemorrhages | Brownish red longitudinal lines in direction of nail growth that result from damage to capillaries (ex. vasculitis)
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| Alopecia Areata | Autoimmune disorder resulting in noninflammatory loss of hair
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| Hirsutism | Excessive androgenic hormones in a female patient causing masculine changes including hair in male distribution patterns (ex. beard)
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| Traction alopecia | hair loss due to tight hair braiding practices
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| Trichotillomania | Compulsive hair pulling causing breaking of hair and thinned/balding areas on the scalp
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| Sjorgen's syndrome | An autoimmune disorder marked by decreased lacrimal and salivary secretions, resulting in dry eyes and dry mouth. Annular erythema found on skin
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| Polycythemia | An excess of RBCs. An integument finding with this is pruritus
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| Mastocytosis | A term for a variety of rare disorders in which there is proliferation of excessive numbers of normal mast cells systemically or in the skin. Integument findings - pruritus
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| Malar rash | red macular lesions distributed over forehead, cheeks, and chin, resembling a butterfly
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| Systemic lupus erythematosus | Any of a group of deep fungus infections involving various bodily systems or regions
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| Hypothyroidism | Causes thick, coarse hair, dry skin, and cool skin temp
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| Hyperthyroidism | Causes smooth skin, thin, silky hair and brittle nails
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| Cushing's syndrome | Symptoms from prolonged exposure to excessive glucocorticoid hormones. Side effect of the pharmacological use of steroids in the management of inflammatory illnesses. Integument finding - straie
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| Addison's disease | Rare illness marked by gradual and progressive failure of the adrenal glands and insufficient production of steroid hormones. Integument finding - hyperpigmentation of skin and mucous membranes, nevi
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| Androgen disorders | Cause excessive hair growth or thinning, worsening acne
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| Diabetes mellitus | Causes decreased sweating (hypohidrosis), frequent cutaneous yeast infections, hair loss on distal extremities and hyperpigmentation (acanthosis nigricans)
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| Herpes labialis | lesions from herpes simplex virus on or around the mouth
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| Herpes genitalis | lesions form herpes simplex virus in genital regions
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| Cutaneous herpes | lesions form herpes simplex virus elsewhere in the body
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