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97 Cards in this Set
- Front
- Back
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Macule |
Primary lesion. Less than 1cm. Flat.
** Common lesion |
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Patch |
Primary lesion. Greater than 1cm. Flat.
Larger macule. |
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Papule |
Primary lesion. Less than 1cm. Raised.
Ex : wart, insect bite, mole, milia.
** Common lesion |
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Plaque |
Primary lesion. Greater than 1 cm. Raised.
Large papule. |
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Nodule |
Primary lesion. Greater than 1cm. Raised.
Extends into dermis. Deep plaque. HCP can palpate and feel the inside of the dermis |
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Tumor |
Primary lesion. Greater than 2cm. Raised.
"Mass" |
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Wheal |
Primary lesion. All sizes. Both raised and flat. |
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Urticaria |
Primary lesion. All sizes. Both raised and flat.
Grouping of wheals. Ex : hives. |
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Vesicle |
Primary lesions Less than 1cm. Raised. Fluid filled.
Ex. blisters, zoster (herpes), chicken pox
** Common lesion |
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Bulla |
Primary lesions Greater than 1cm. Raised. Fluid filled.
Larger vesicles. Common in second degree burns. |
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Cyst |
Primary lesion. All sizes. Raised. Fluid filled.
Cavity that extends deep into dermis. May be hard to differentiate from nodule unless opened. |
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Pustule |
Primary lesion. All sizes. Raised. Fluid-filled.
Filled with pus. Ex : acne (whiteheads)
** Common lesion. |
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Primary lesions |
Lesions that have first appeared on the skin |
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Secondary lesions |
Primary lesions that have since changed form/ characteristics to a new kind of lesion. |
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Crust |
Secondary lesion.
Scab or dried exudate |
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Scale |
Secondary lesion.
Plaque with scales and/or flaky skin. Ex : Psoriasis |
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Fissue |
Secondary lession.
Linear crack that is pink or red in appearance. |
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Erosion |
Secondary lesion.
Shallow depression. Superficial only. |
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Ulcer |
Secondary lesion.
Depression that goes deep to the dermis layer (and beyond). |
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Excoriation |
Secondary lesion.
Reddened area from scratches. Self-inflicted. May have crusting. |
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Scar |
Secondary lesion.
Healed lesion with mark (most permanent) |
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Atrophic Scar |
Secondary lesion.
Purple/red or clear in color. Also called "Stretch marks" or "Striate"
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Lichenification |
Secondary lesion.
Thickened area that often builds up from damage Also called a "callus". |
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Keloid |
Secondary lesion.
Elevated scar that is often colored. Certain areas of the body and ethnic backgrounds are more prone to it. |
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Vascular lesions |
Lesions involving the vessels underneath the skin.
Often red or purple in appearance. |
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Petechiae |
Vascular lesion. Less than 1cm. Flat.
Pinpoint dots (macular lesions). Often red in color.
** Can be a sign of clotting issues or toxicity |
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Ecchymosis |
Vascular lesion. Any size. Flat.
Also known as a "bruise" |
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Purpura |
Vascular lesion. Greater than 1cm. Flat
Can look like bruising (purple, red, etc.)
** Can be a sign of toxicity |
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Hemangioma |
Bening vessel mass. |
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Areas Prone to Bruising . . . |
- Upper chest - Back - Face - Neck |
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Functions of the Skin |
- Protection - Barrier - Temperature regulation - Wound repair - Absorption/ excretion - Production of Vitamin D - Perception / sensation (touch, pain, temperature, pressure) - Identification - Communication (nonverbal) |
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Epidermis |
Outermost layer of skin. Tough but thin.
Replaced every 4 weeks.
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Keratin |
Tough, fibrous protein |
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Melanin |
Brown tones to the skin and hair.
All individuals have the same amount of melanocytes. The amount of melanin secreted is what varies -- this is genetically, hormonally or environmentally determined. |
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Carotene |
Influences orange tones |
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Dermis |
Inner, supportive layer of skin
Consists of connective tissue (collagen), nerves, sensory receptors, blood vessels, lymphatics, hair follicles, sebaceous glands and sweat glands |
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Subcutaneous Layer |
Layer beneath the dermis/epidermis.
Contains the adipose (fat) tissue to protect and insulate the body |
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Sebaceous Glands |
Produces sebum (lubricating) |
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Eccrine Sweat Glands |
All-over glands that produce sweat. No smell. |
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Apocrine Sweat Glands. |
Produces thick, milk secretions. Located in the armpit and groin regions. Activated at puberty. |
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Nails |
Hard plates of keratin. |
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Pallor |
Pale or white |
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Erythema / erythemic |
Redness or pink-colouring |
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Cyanosis / cyanotic |
Bluish or mottled color |
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Jaundice |
Yellow color.
"Icteric" |
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Subjective Data / History for Skin Assessment |
- Previous history - Changes (pigment, lesions, texture) - Pruritis - Excessive bruising - Rash / lesions - Medications - Hair loss - Nail changes - Environmental/ occupational exposure - Self-care behaviors |
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"Previous History of Skin Disease" |
- treatment - skin allergies - birthmark - tattoos - piercings |
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Change in Skin Color |
What's the change?
General or localized? |
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Change in Lesions |
Include moles, freckles, sores, etc. |
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Change in Skin Textue |
Dryness? Moisture? |
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Pruritis |
Itching |
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Excessive Bruising |
More than 20-30 bruises.
Also include bruises in unusual places (behind the ear?) or bruises in the same area but different stages of healing |
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Rash / Lesion |
Any? |
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Medications |
Include ANY medications, supplements, etc. |
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Hair Loss |
Include pattern, location, change in texture and color |
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Nail Change |
Include texture, color or shape |
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Environmental / Occupational Hazards |
Excessive sun exposure? Chemical exposure? Excessive hand-washing? |
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Self-Care Behaviors |
Skin self examinations? What skincare products are used? How is everything cared for? Sunscreen use? |
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ABCDE Assessment for Moles |
Use the ABCDE for HCP/self-exam of moles. . .
Asymmetry → asymmetrical is cause for concern Border → jagged borders are cause for concern Color → multiple/ non-brown colors are cause for concern Diameter → >6 mm/1cm is cause for concern Evolution → any change is cause for concern |
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Skin Examination / Objective Data |
Inspect and palpate . . . 1. Color/ general pigmentation 2. Hair 3. Nails 4. Lesions 5. Temperature 6. Moisture/ dryness 7. Texture 8. Edema 9. Mobility + turgor 10. Vascular lesions or bruising |
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Color / General Pigmentation (exam) |
Ex : "Skintone is dark brown. Consistent with ethnic background." |
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Hair (exam) |
Inspect and palpate. Take note of . . . 1. color 2. texture 3. distribution 4. lesions (or presence of parasites) |
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Nails (exam) |
Inspect and palpate. Take note of . . . 1. texture 2. contour 3. color |
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Lesions (exam) |
Take note of . . . 1. location 2. color 3. size 4. symmetry 5. pattern 6. elevation 7. odor 8. drainage or discharge 9 . pain 10. edges |
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Temperature (exam) |
Ex : "Temperature is warm to touch", "Temperature is cool to touch"
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Moisture / dryness (exam) |
Is skin in tact?
Ex : "Skin feels moist" |
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Edema (exam) |
To check for edema, push with thumb and take note of swelling.
+1 (mild pitting) → slight indent, no swelling +2 (moderate) → indentation subsides rapidly +3 (deep) → indentation remains for short time, swollen appearance +4 (very deep) → indentation lasts for a long time, very swollen |
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Skin Mobility / Skin Turgor (exam) |
Test on back of hand.
Ex : "Turgor returns to baseline in 3 seconds." |
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Vascular Lesions / Bruising (exam) |
Take note where, color, size, etc. |
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Generalized (pattern) |
Spread throughout the body |
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Zosterform (pattern) |
Unilateral. Does NOT cross the midline. |
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Localized (pattern) |
On one area of the body |
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Decubitus Ulcer |
"Pressure ulcer" Undergoes 4 stages leading through each layer (epidermis, dermis, subcutaneous and into muscle) |
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Diaper Dermatitis / Contact Dermatitis |
Macular patch with poorly defined borders. Inflammatory disease caused by skin irritation from ammonia, heat, moisture, diapers, etc. |
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Impetigo |
Moist, thin-roofed vesicles with erythematous base. Ruptures to form a honey-colored crust. Contagious bacterial infection of the skin. |
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Eczema |
Erythematous papules and vesicles with weeping, oozing and crusts. Pruritus. Often associated with family history of allergies. |
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Varicella (Chicken Pox) |
Shiny vesicles on a erythematous base. Often erupts, becomes pustules and then crusts. Intensely pruritic. |
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Allergic Drug Reaction |
Erythematous and symmetrical rash, usually generalized. |
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Tinea Corporis ("ringworm") |
White scales forming multiple circular lesions with clear centers.
Light up in blacklight. |
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Tinea Pedis ("Athlete's Foot") |
Fungal infection.
First appears as vesicles and then grows scaly and hard. |
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Psoriasis |
Scaly, erythematous patch with silvery scales on top. |
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Tinea Versicolor |
Fine, scaling patches of pink, tan or white that is caused by a superficial fungal infection. |
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Candidiasis |
Scalding red moist patches with sharply demarcated borders and some loose scales.
Usually in genital areas. |
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Herpes Zoster / Shingles |
Small, grouped vesicles emerging in a zosterform pattern.
Reactivation of the dormant virus of chickenpox. |
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Melanoma |
Malignant skin tumors.
Identify via the "ABCDE method" |
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Kaposi's Sarcoma |
Vascular tumors presenting as pink papular (patch) lesions scattered.
Common tumor in HIV-infected persons. |
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Seborrheic Dermatitis |
"Cradle Cap" Thick yellow (to white), greasy adherent scaling w/ mild erythema on scalp and forehead. Common in early infancy. |
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Alopecia Areata |
Sudden appearance of sharply circumscribed, round or oval balding patch- usually with smooth, soft skin underneath |
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Pediculosis Capitis |
Infestation manifested by intense itching of the scalp. The nits (eggs) are easier to see- appearing as translucent bodies adherent to shaft. |
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Folliculitis |
Superficial infection of hair follicles. Consists of multiple pustules with visible white heads and an erythemateous base. |
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Nail Clubbing |
Inner nail elevates. Nail bed is greater than 180 degrees. |
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Hirsutism |
Excess body hair in females forming a male sexual pattern; caused by endocrine or metabolic dysfunction. Sometimes idiopathic. |
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"Approximated" |
Close. Use to describe legion edges for an open wound.
Ex : well-approximated |
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Stitches |
Stitches must be noted.
What kind? In tact? How many? |
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"Tender to Palpation" |
Objective data!!
** Do not put in the wrong category. If patient has to report it, it is objective, irregardless if it comes up during the physical exam |
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Heplock / IV |
Any breaks must be noted.
When there is a heplock/IV break in skin, be sure to note the following . . . - Is it hard? - Is it red? - Any pain? - Any drainage? |
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Dressings |
- How big is the dressing? (4x4, 2x2) - Location of dressing? - Odor of drainage? - Type/ color of drainage? - Any other relevant information . . .
Do NOT lift up the dressing to see underneath. Describe only what you see on the dressing. |
