Assessing the skin
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The document discusses different types of primary and secondary skin lesions. It describes macules, vesicles, pustules, papules, nodules, wheals, telangiectasias, plaques, and cysts as examples of primary skin lesions. Secondary skin lesions result from trauma or infection and include scales, crusts, fissures, erosions, excoriations, atrophy, and scars. The document also discusses abnormalities of the nails including paronychia, koilonychia, onycholysis, white nail syndrome, yellow nail syndrome, and clubbing.
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Assessing the skin
- 1. Assessing the SKIN Mr. Jhessie L. Abella, RN, RM, MAN
- 2. PRIMARY SKIN LESION Pr i ma r y l e s i o n s a r e t h o s e o b j e c t i v e l e s i o n s wi t h wh i c h c o e t a n e o u s o r s k i n d i s e a s e s b e g i n . Th i s t y p e o f s k i n l e s i o n ma y c o n t i n u e a s s u c h o r ma y u n d e r g o mo d i f i c a t i o n , p a s s i n g i n t o t h e s e c o n d a r y o r c o n s e c u t i v e s k i n l e s i o n s .
- 3. MACULE The lesion appears circular small and flat spot that is less than in (1mm to 1 cm) in diameter and with the color not the same as that of nearby skin. It has in different shapes usually red, brown, and white. Flat moles, measles, petechiae and freckles are the examples of macule. Macule that is more than in (1 cm) in diameter is called a patch; it has an irregular in shape.
- 4. VESICLE A raised lesion that is less than in (0.5 cm) across. Lesions are round or oval in shape with thin mass filled with serous blood or clear fluid. Herpes simplex, burn blister and early chicken pox are examples of vesicle. Bullae are another example of vesicle that is more than in (5 mm) across. Lesions are cause by chemical burn, exposure to sunlight, insect bites or viral infection.
- 5. PUSTULE A raised vesicle or bulla lesion filled with pus. Infection is the primary cause. Acne vulgaris, impetigo and boils are examples.
- 6. PAPULE A solid elevated skin lesion less than in (1 cm) across. Lesions are rough in texture and usually color pink, red and brown. This lesion is associated with psoriasis, skin cancer, actinic keratosis, and syphilis. Warts, acne, pimples and elevated moles are examples.
- 7. NODULE A solid elevated lesion that has edges and area 0.5 to 2 cm. Physician describes this as "palpable," where hard mass is felt from the tissue surrounding it. The size of the nodule is more than 2 cm in diameter. The other term is tumor which is associated with lipomas, and keratinous. malignant melanoma and hemangioma are examples.
- 8. WHEAL A red swelling skin itchy lesion and localized edema. Lesion is usually cause by an allergic reaction, insect bites or reaction from drugs. Hives, urticaria and mosquito bites are examples.
- 9. TELANGLECTASIA A dilated small blood vessels in the surface of the skin. It is often manifestation of certain diseases such scleroderma or rosacea.
- 10. PLAQUE A patch of closely grouped papules more than in (1 cm) across. Lesions are rough in texture and color brown, red, or pink. The size is larger than 1 cm. Rubeola and psoriasis are examples.
- 11. CYST Elevated skin lesion and encapsulated filled with fluid. The size is 1 cm or larger. Epidermoid and sebaceous cyst and chalazion of the eyelid or meibomian gland lipogranuloma are examples.
- 12. SECONDARY SKIN LESION Skin lesion is an alteration in the integumentary system or skin. There are in two forms, the primary skin lesion and secondary skin lesion. Secondary skin lesions are not initially appears; usually result from a trauma or chronic infection.
- 13. SCALE Thickened epidermal cell that flake off
- 14. CRUST Dried serum or pus on the skin surface.
- 16. EROSION Loss of all or part of the epidermis
- 17. EXCORIATION Linear or hollowed out crusted area exposing dermis
- 18. ATROPHY A decreased in the volume of the epidermis
- 19. SCAR A formation of connective tissue
- 20. ULCER An excavation extending into the dermis or below
- 21. KELOID
- 22. LICHENIFICATION A distinctive thickening of skin that is characterized by accenuated skin- fold markings.
- 24. THE NAILS
- 25. A Paronychia is an infection around the nail. Many organisms can cause a paronychia. This particular case is caused by the yeast-like organism Candida. Note the inflammation (red, swollen area) at the base of the nail and the changes that are apparent in the nail itself.
- 26. Nails may exhibit many different abnormalities. In the condition known as Koilonychia, the nails are flattened and have concavities. This condition may be associated with iron deficiency.
- 27. In Onycholysis the nails become loose. They may even detach from the nail bed. When not held firmly in place, the nails are rapidly damaged and debris collects beneath them.
- 28. White nail syndrome may also be called leukonychia. Leukonychia can occur with arsenic poisoning, heart disease, renal failure, pneumonia, or hypoalbuminemia.
- 29. Yellow nail syndrome is characterized by yellow nails that lack a cuticle, grow slowly, and are loose or detached (onycholysis). Yellow nail syndrome is most commonly associated with lung disorders, and with lymphedema.
- 30. Half and Half Nails
- 31. Yellow nail syndrome is characterized by yellow nails that lack a cuticle, grow slowly, and are loose or detached (onycholysis). Yellow nail syndrome is most commonly associated with lung disorders, and with lymphedema.
- 32. CLUBBING is a condition in which the angle between the nails and the nail bed is 180 degree or greater.