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112 Cards in this Set
- Front
- Back
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Pallor in light skin |
- Generalized Pallor |
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Pallor in dark skin |
- Ashen gray; dull brown; yellow-brown |
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Cyanosis in light skin |
- Dusky blue |
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Cyanosis in dark skin |
- Dark, dull; only severe cyanosis is apparent |
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Erythema in light skin |
- Red, bright pink |
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Erythema in dark skin |
- Purplish tinge but difficult to see |
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Jaundice in light skin |
- Yellow in sclera, mucous membranes, then over skin |
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Jaundice in dark skin |
- Yellow in sclera; do not mistake yellowish fatty deposits under lids as this is normal |
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Cherry (Senile) Angiomas |
- Small, smooth, bulging bright red dots that line the surface of the trunk in adults over 30 years old - Occur normally with aging |
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Leukonychia Striata |
- White hairline linear markings on the nail plate from trauma or picking at the cuticle - Is normal and not a cause for concern |
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Mongolian Spots |
- Common variation of hyperpigmentation in Black, Asian, Indian, Hispanic newborns - Blue-black to purple macular area at sacrum or buttocks but sometimes on abdomen, thighs, shoulders, arms - Caused by deep dermal melanocytes and fades during first year - By adulthood, spots are lighter but still visible and should not be confused with bruises, which suggest child abuse - Affects 90% Blacks, 80% Asians & Indians, 9% Whites |
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Physiologic Jaundice |
- Common variation is half of all newborns - Yellowing of skin, sclera, mucous membranes develop after 3rd or 4th day of life because of an increased number of RBCs that go through hemolysis after birth - Hemoglobin of ruptured RBCs is metabolized by the liver and spleen and converted to bilirubin |
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Cafe au lait spot |
- Large round or oval patch of light brown pigmentation - Usually present at birth - Usually these patches are normal |
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Stork Bite |
- Flat, irregularly shaped red or pink patch found on the forehead, eyelid, upper lip but most commonly at the back of the neck (Nuchal area) - Present at birth and usually fades during the first year |
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Lanugo |
- Fine, soft hairs that cover the body and limbs of a newborn - Dark-skinned newborns have more lanugo than light-skinned newborns - Scalp hair may be lost, especially at temples or occiput, but they grow back slowly |
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Diaper Dermatitis |
- Patchwork of inflamed, bright red skin on the buttocks - Linked to wet or infrequently changed diapers, diarrhea, ammonia, heat, and moisture |
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Impetigo |
- Common skin lesion in children - Moist, thin-roofed vesicles with thin, erythematous bases rupture to form thick, honey-colored crusts - Highly contagious bacterial infection of skin most common in infants and children - Infection can spread to other body areas, and to other people by direct contact |
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Atopic Dermatitis (Eczema) |
- Common skin lesion in children - Erythematous papules and vesicles, with weeping, oozing, and crusts - Lesions usually develop on scalp, forehead, cheeks, forearms and wrists, elbows, backs of knees - Is paroxysmal and includes severe pruritus - Higher incidence with family history of allergies |
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Varicella (Chickenpox) |
- Common skin lesion in children - Small, tight vesicles first appear on trunk and spread to face, arms, and legs (not palms or soles) - Shiny vesicles with erythematous base, described as "Dewdrop on a rose petal" - Vesicles erupt in succeeding crops over several days; they become pustules and then crusts; they are intensely pruritic |
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Senile Lentigines |
- Common variation of hyperpigmentation in older adults - Are small, flat, brown macules - Clusters of melanocytes that appear after extensive sun exposure - Appear on forearms and dorsa of hands - Require no treatment |
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Papule |
- Can be felt - Thickening of epidermis - IE Elevated nevus (mole), warts |
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Macule |
- Solely a color change - Flat on the skin - Diameter less than 1cm - IE freckles, flat nevi, hypopigmentation, petechiae, measles, scarlet fever |
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Wheal |
- Transient - Irregular shape due to edema - Raised, erythematous - IE mosquito bite, allergic reaction, dermographism |
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Vesicle "Blister" |
- Elevated, containing fluid
- Clear serum flows if wall is ruptured - IE herpes zoster, early varicella - Up to 1 cm diameter |
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Bulla |
- Larger than 1 cm diameter - Basically a larger vesicle - IE friction blister, burns |
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Cyst |
- Encapsulated fluid-filled cavity in dermis or subcutaneous layer - Elevated skin - IE sebaceous cyst, wen |
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Pustule |
- Pus in the cavity - Elevated skin - IE impetigo, acne |
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Scale |
- Compact, desiccated flakes of skin - From shedding of dead excess keratin cells - IE Eczema, psoriasis, dry skin, after scarlet fever or drug reaction |
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Fissure |
- Linear crack with abrupt edges - Extends into dermis - IE cheilosis at corners of mouth caused by excess exposure, athlete's foot |
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Erosion |
- Scooped out but shallow depression - Heals without scar because erosion does not extend into dermis |
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Ulcer |
- Extends deeper than erosions into the dermis - Irregular shape - Scarring when healing - IE stasis ulcer, pressure sore, chancre (Ulcer on genitals) |
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Excoriation |
- Self-inflicted abrasion - Sometimes crusted - IE insect bites, scabies, dermatitis, varicella |
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Scar |
- After skin lesion is repaired, normal tissue is lost and replaced with connective tissue (collagen) - IE healed area of surgery or injury, acne |
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Atrophic Scar |
- Skin level is depressed with loss of tissue - Thinning of the epidermis - IE striae |
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Keloid |
- Hypertrophic scar - Smooth, rubbery, shiny, "clawlike" - Found in earlobes, back of neck, scalp, chest, back - 10-30 yrs old, higher incidence in blacks, hispanics, asians - Results after surgery, acne, ear piercing, tattoos, infections, burns |
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Pressure ulcers |
- Appear over bony prominence when circulation is impaired - Common sites are back and side - Risk factors: Impaired mobility, thin fragile skin, decreased sensory perception, impaired consciousness, moisture from urine or stool, excessive perspiration or wound drainage, shearing injury, poor nutrition, infection |
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Stage I Pressure Ulcer |
- Skin red but unbroken |
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Stage II Pressure Ulcer |
- Partial erosion of epidermis, maybe dermis |
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Stage III Pressure Ulcer |
- Ulcer extends to subcutaneous layer, resembles crater |
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Stage IV Pressure Ulcer |
- Exposes muscle, tendon, bone - May be slough or eschar |
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Basal Cell Carcinoma |
- Most common form of skin cancer - Slow growth - Occur on sun-exposed areas of face, ears, scalp, shoulders - Begins as skin-colored papule, then develops central red ulcer with rounded borders |
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Squamous Cell Carcinoma |
- Less common than basal cell carcinoma - Grows rapidly - Erythematous scaly patch with sharp margins - Develops central ulcer and surrounding erythema - Usually on hands or head, areas exposed to UV radiation |
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Malignant Melanoma |
- Usually brown, but can have mixed pigmentation - Irregular borders - Scaling, flaking, oozing texture - Risk factors: UV radiation from sun exposure or indoor tanning, family history - Most common cancer in women 25-29 years old |
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Vitiligo |
- Patches of skin throughout the body experience an absence of melanin production and become white - Much more apparent and damaging to the image within dark-skinned people |
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Junctional Nevus |
- Macular only - Occurs in children and adolescents |
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Compound Nevus |
- Macular and papular - Present in young adults |
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What conditions accompany pallor? |
- Anemia, shock, arterial insufficiency - Pallor of shock presents with rapid pulse, oliguria, apprehension, restlessness |
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What causes "spoon nails"? |
- Iron deficiency anemia |
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What conditions accompany erythema? |
- Venous stasis, carbon monoxide poisoning, and polycythemia - Extravascular conditions of blood like petechiae (1-3mm), purpura (>3mm), ecchymoses (>3mm) |
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What conditions accompany cyanosis? |
- Shock, cardiac arrest, heart failure, chronic bronchitis, congenital heart disease - Indicates hypoxemia |
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What conditions accompany jaundice? |
- Hepatitis, cirrhosis, sickle cell disease, transfusion reactions, hemolytic disease of the newborn - Light or clay colored stools, dark golden urine appear in both light and dark-skinned people |
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Which conditions does general hypothermia accompany? |
- Shock, cardiac arrest |
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In which conditions do localized hypothermia occur? |
- Peripheral arterial insufficiency, Raynaud disease |
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What are symptoms of hyperthyroidism? |
- Hyperthyroidism increases the metabolic rate, which causes warm, moist skin in patients - Accompanies general hyperthermia, a state of increased heat in the body which can be induced by such factors as fever and heavy exercise |
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What are some conditions that local hyperthermia accompanies? |
- Trauma, infection, and sunburn |
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Upon touching the patient's skin, it is rough, dry, and flaky. What condition does this indicate? |
- Hypothyroidism |
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Upon touching the patient's skin, it is smooth, soft, and moist. What condition may this indicate? |
- Hyperthyroidism |
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Upon inspecting the thickness of the patient's skin, you notice it is very thin and shiny. What condition may this indicate? |
- Arterial insufficiency - Not enough blood is reaching the extremities, resulting in hypoxemia and disintegration of the epidermis |
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What causes unilateral edema? |
- Localized causes IE venous insufficiency |
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What causes bilateral edema?
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- Systemic, central causes IE heart failure |
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Scleroderma |
- AKA "hard skin" - The mobility of the skin is insufficient |
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What conditions accompany poor mobility and turgor? |
- Poor mobility is caused by edema - Poor turgor is caused by dehydration, the skin "tents" instead of returning to place; however, this is a natural occurrence of aging |
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What is a primary lesion? |
- A lesion that has formed on previously unaltered skin |
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What is a secondary lesion? |
- A lesion that has changed over time due to infection or scratching |
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Upon inspecting a lesion with a wood's light, you notice it bears a blue-green fluorescence. What does this indicate? |
- Fungal infection |
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Upon inspecting a patient's hair, you notice a region that is gray and scaly with broken hairs. What condition does this indicate? |
- Tinea Capitis, a ringworm infection in school-age children |
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A patient presents with clubbing nails, what conditions may this accompany? |
- Heart of lung disease due to the insufficient flow of blood to the ends of the fingers or toes - The nails feel spongy upon palpation |
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A patient presents with jagged, broken nails. What would this lead you to suspect about the patient. |
- They have nervous picking habits |
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A light-skinned patient presents with dark brown, linear streaks on nail surfaces. What condition does this indicate? |
- Melanoma - Dark brown, linear streaks on nail surfaces are normal only in dark-skinned people |
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What are the three common erythematous states in the neonate? |
1. Beefy red flush from vasomotor instability 2. Harlequin Color Change 3. Erythema Toxicum |
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What is Harlequin Color Change? |
- The baby is rolled onto it's side - The lower half becomes erythematous, while the top half becomes blanched |
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What is Erythema Toxicum? |
- A series of red macules and papules are scattered throughout the baby's body - Occurs during first 3-4 of life then resolves on its own - AKA "flea bite" or "newborn rash" |
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What are the 2 temporary cyanotic conditions of the neonate? |
1. Acrocyanosis 2. Cutis Marmorata |
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What is Acrocyanosis? |
- Cyanosis that appears around the lips, hands and fingernails, and feet and toenails - Resolves in warmer temperatures |
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What is Cutis Marmorata? |
- Mottling of the skin due to cooler room temperatures - Reticulated red or blue pattern of the skin |
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What is Carotenemia? |
- A yellow - orange pigment in light-skinned infants - Results from ingesting excess Carotene, a Vitamin A precursor |
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What is Milia? |
- Tiny white papules scattered about the cheeks, nose, forehead - Caused by sebum occluding the opening of the follicles |
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What are acrochordons? |
- Overgrowths of normal skin that are polyp-like - Occur in aging adults - Occur on trunk, axillae, cheeks, neck, eyelids |
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How does Herpes Zoster manifest? |
- Typically as an itching, tingling, painful rash encompassing the right or left flank |
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How does Polycythemia look in light-skinned people? |
- Ruddy blue in face |
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How does Polycythemia look in dark-skinned people? |
- Well concealed; look for redness in lips |
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How does carbon monoxide poisoning look in light-skinned people? |
- Bright cherry red in face, upper torso |
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How does carbon monoxide poisoning look in dark-skinned people? |
- Cherry-red color in nail beds, lips, oral mucosa |
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How does venous stasis look in light-skinned people? |
- Dusky rubor |
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How does venous stasis look in dark-skinned people? |
- Easily masked, palpate for warmth or edema |
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How does albinism look in light-skinned people? |
- Whitish pink |
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How does albinism look in dark-skinned people? |
- Tan, cream, white |
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How does uremia look in light-skinned people? |
- Orange-green |
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How does uremia look in dark-skinned people? |
- Masked; rely on laboratory and clinical findings |
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How does Addison Disease look in light-skinned people? |
- Bronze, "eternal tan" - Cortisol deficiency stimulates melanin production |
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How does Addison Disease look in dark-skinned people? |
- Easily masked; rely on laboratory and clinical findings |
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Annular pattern of lesions? |
- Begins in center then spreads to periphery
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Confluent pattern of lesions? |
- Lesions run together |
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Discrete pattern of lesions? |
- Distinct, individual lesions that remain separate |
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Gyrate pattern of lesions? |
- Twisted, coiled spiral, snakelike |
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Grouped pattern of lesions? |
- Clusters of lesions |
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Linear pattern of lesions? |
- Scratch, streak, line, stripe |
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Target pattern of lesions? |
- Concentric rings, resembles iris of eye |
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Zosteriform pattern of lesions? |
- Linear arrangement along a nerve route |
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Polycyclic pattern of lesions? |
- Annular lesions grow together |
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How does a bruise appear in a light-skinned person? |
- Red-blue to purple then progresses to blue-green, yellow, and brown to fading - Putting pressure on a bruise does not not cause it to blanch |
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How does a bruise appear in a dark-skinned person? |
- Deep, dark purple |
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How does Measles manifest on the skin? |
- Looks "coppery" and does not blanch - Koplik spots in mouth (Bluish white, red elevations of 1-3 mm) |
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How is German measles differentiated from Measles? |
- Swollen lymph nodes
- Absent Koplik spots |
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A patient presents with ulcers on the upper lip. What does this indicate? |
- Herpes Simplex (Cold Sores) |
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A patient presents with unilateral linear lesions dotted along the route of a cutaneous sensory nerve. What condition does this indicate? |
- Herpes Zoster (Shingles) |
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A patient with lyme disease presents with red macular rashes on the back of the knee and on the axillae. The rashes resemble bull's eyes with some clearing in the center. What is this phenomenon called? |
- Erythema Migrans |
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A patient presents with dry erythematous patches containing silvery scales on the scalp. What condition does this indicate? |
- Psoriasis |
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A patient has patchy, asymmetric balding from chemotherapy. What is this condition called? |
- Toxic Alopecia |
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A young black girl has partial balding along the hairline. What is this called? |
- Traumatic Alopecia - Caused by hair rollers and braiding |
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An infant presents with yellow-to-white greasy, adherent scales on the scalp and forehead. What is this called? |
- Seborrheic Dermatitis (Cradle Cap) |
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What is Trichotillomania? |
- Self-induced loss of hair from compulsive twisting, plucking - Indicates a personality disorder |
