Cyanosis
This is a bluish mottled color that signifies decreased perfusion the tissues are not adequately perfumed with oxygenated blood
Dusky blue
Brown skin look at conjunctival oral mucosa nail beds
Pallor
When the red pink tone from the oxygenated hemoglobin in the blood are lost, the skin takes on the color of connective tissue (collagen) which is mostly white
Presents as:
Pale, ashen gray dull skin
Brown skin appears yellow-brown dull skin losses healthy glow
Erythema
Intense redness of skin from excess blood hyperemia in the dilated superficial capillaries
presents as: Red bright pink
Dark skin purplish tinge difficult to see palpate for increased warmth with inflammation
Jaundice
Is exhibited by a yellow color, indicating rising amounts of bilirubin in the blood
Presents as
Yellow in the sclera , hard palate, mucous membrane palms of the hand
Conditions that exhibits Pallor
Anemia - decreased hematocrit Shock- decreased perfusion, vasoconstriction Local arterial insufficiency Albinism Vitiligo
Albinism
Total absence of pigment melanin throughout the integument
Vitiligo
Patchy depigmentation from destruction of melanocytes
Conditions that exhibits cyanosis
Increased amount of unoxygenated hemoglobin
Central-chronic heart and lung disease causes arterial desaturation
Peripheral- exposure to cold anxiety
Conditions that exhibits Erythema
carbon monoxide poisoning, polycythemia hyperemia, venous stasis
Hyperemia
Increased blood flow though engorged arterioles , such as in inflammation, fever, alcohol intake, blushing to
An unusual amount of blood in a part; congestion.
Polycythemia
Increased red blood cells capillary stasis
Venous stasis
Decreased blood flow area engorged venules
Conditions that exhibits Jaundice
Increased serum bilirubin from the liver inflammation or hemolytic disease, such as after severe burns, some infections
Carotenemia, uremia
Carotenemia
Increased serum Carotene from ingestion of large amounts of carotene-rich foods
Uremia
Renal failure causes retained Urochrome pigments in the blood
Intoxication caused by the body’s accumulation of metabolic by-products normally excreted by healthy kidneys.
Pustule
Turbid fluid (pus) in the cavity. Circumscribed and elevated examples impetigo , acne
Urticaria
(Hives) wheals coalesce to form extensive reaction, intensely pruritic.
Hematoma
A bruise you can feel it elevates the skin and is seen as swelling
Potassium Hydroxide (KOH) Preparation
Microscopic examination of skin scraping helps diagnose superficial fungal infections
Use a sharp sterile blade lightly Scrape the scale from the edge of scaling lesion place on clean slide add a drop of 10% to 20% KOH to dissolve non-fungal skin debris send to the lab
Lesions recognition Technique
Color
Elevation flat raised
Pattern or shape: grouping annular
Size use a ruler to measure
Location and distribution on body: is it generalized or localized
Any Exudate: note it’s color and any odor
Edema
Fluid accumulating in the intercellular spaces; to check for edema imprint your thumbs firmly against the ankle malleolus or tibia normal skin surface stays smooth if pressure leaves a dent it’s called pitting
Grading Scale for Edema Pitting
1+ Mild pitting, slight indentation, no swelling of the leg
2+ Moderate pitting indentation subside rapidly
3+ Deep pitting indentation remains for a short time leg looks swollen
4+ very deep pitting indentation lasts long time leg is very swollen
Hyperthyroidism
The thyroid gland (in the front of your neck) produces to much thyroid hormone
Skin feels smoother and softer like velvet
Having too much thyroid hormone can make thing in your body speed up. You may lose weight quickly, have a fast heartbeat, sweat a lot, or feel nervous and moody
Hypothyroidism
The thyroid glands does not produce enough thyroid hormone
Skin feels rough, dry, and flaky
Senile purpura
A minor trauma may produce dark red discolored areas
Melasma
The “mask of pregnancy” a patchy tan to dark brown discoloration if the face
Function of the Skin
Protection prevent penetration temperature regulation wound repair absorption and excretion production of vitamin D
Hirsutism
Shaggy or excessive hairs
Braden Scale
A validated assessment tool commonly used to quantify a patient’s degree of risk for developing a pressure ulcer. Each assessment parameter is measured on a scale from high risk of 1 to low risk of 3 or 4. The parameters include sensory perception, moisture, activity, mobility, nutrition, and friction and shear, with a possible total score range of 4 to 23. The lower the total score, the higher the risk for pressure ulcer development. Patients are at risk for developing pressure ulcers if the total score is less than 17. Patients need to be assessed on a regular basis.
