Midterm- Skin/Hair/Nails Flashcards
(167 cards)
1
Q
epidermis
A
outer layer. thin. tough.
DEPENDS on the DERMIS for nourishment
stratified into zones
major ingredient= KERATIN
MELANOCYTES- gives our skin the color
the epidermis is made from dead keratinized cells
we shed ONE POUND of skin/year
the entire epidermis is replaced every 4 weeks
2
Q
dermis
A
vascular, inner supportive layer
consists mostly of CONNECTIVE TISSUE AND COLLAGEN
dermis is tough, fibrous protein that allows the skin to RESIST TEARING
dermis is resilient!! elastic tissue that allows stretching with movement
the dermis is home to nerves, blood vessels, sensory receptors, and lymphatics
includes hair follicles, sebaceous glands, and sweat glands that are embedded into the dermis
3
Q
subcutaneous layer
A
this is ADIPOSE tissue!
subq layer anchors the dermis to the muscle and bones
consists of lobules and fat cells. stores fat for energy!!
provides insulation (temperature control), cushioning
4
Q
hair follicles
A
embedded in dermis layer
the growth is cyclic, and each follicle functions independently
hormones can influence growth of hair (pregnancy- shiny and soft, postpartum- hair loss, thinning…)
5
Q
2 types of hair
A
VELLUS hair: short, fine, light, covers most of the body. think arms and abdomen…
TERMINAL hair: course, thicker, and pigmented. on head, eyebrows, pubic area, axillae (face and chest on males)
6
Q
nails
A
GREAT indication of overall health!! (especially nutrition)
if nails are growing= getting enough protein!
hard plates of keratin, found on dorsal edge of fingers and toes
growth inhibited by illness or to the elderly
average growth=1 mm/week
takes 3 months to restore a fingernail (3x as long for toenails)
lateral nail fold- where ingrown nails occur
nail matrix and nail bed (where nail arises from)
7
Q
sebaceous glands
A
lubricates the skin and hair
produces lipid substance sebum, secreted thru hair follicles
found everywhere BUT the palms and soles
most abundant in the scalp, forehead, face, and chin (why you have more acne in these places)
8
Q
sweat glands
A
- ECCRINE
2. APOCRINE
9
Q
eccrine sweat glands
A
coiled tubes that open directly onto the skin, produce a dilute saline solution: SWEAT
aid in temperature control (via evaporation)
children and the elderly can easily become overheated
10
Q
apocrine sweat glands
A
produce thick, milky secretions, open directly into hair follicle
11
Q
locations of apocrine sweat glands
A
axilla, anogenital, nipples, and the navel
become active with puberty
when bacterial flora reacts with apocrine sweat, you have BODY ODOR!
12
Q
variations in skin color
A
pallor (fear, anxiety, anemia, shock)
erythema (high emotion, CO poisoning, polycythemia)
cyanosis (decreased perfusion, hypoxemia, congenital heart disease)
jaundice (hepatitis, cirrhosis, sickle cell disease)
13
Q
dysplastic melanocyte
A
atypical mole
14
Q
congenital giant nevus
A
lot of different sizes/darkness/shapes of moles
they are concerning because they can become dysplastic
15
Q
normal physiologic jaundice in infants
A
1/2 of all newborns, appears on 2/3rd day
peaks at day 5
**disappears within one week of birth
16
Q
pathologic jaundice in infants
A
appears within first 24 hours
related to hemolytic disease of the newborn
**JAUNDICE THAT PERSISTS BEYOND 2-3 WEEKS SHOULD BE OF CONCERN
17
Q
miliara rubra in infants
A
scattered vesicles on an erythematous base- sweat gland obstruction, disappears within one week
18
Q
erythema toxicum in infants
A
looks like flea bites!
unknown etiology
disappears within one week after birth
19
Q
pustular melanosis in infants
A
seen in AA infants
can last several months
small vesiculopustular over a brown macular base
20
Q
milia in infants
A
pinhead, smooth, white raised areas without surrounding erythema
on nose, chin, forehead
retention of sebum in sebaceous gland
21
Q
abnormal texture of skin
A
rough- hypothyroid
velvet- hyperthyroid
22
Q
cherry angiomas
A
small, smooth, slightly raised red dots
commonly appear on trunk of adults
this is not significant
think red mole
23
Q
ecchymosis
A
should be CONSISTENT with trauma
bruising above the knee or below the elbow is SUSPICIOUS
bruising
24
Q
bruising cycle
A
0-5 days: red, blue, purple, and tender
5-10 days: greenish yellow
> 10 days: brown
2-4 weeks: healed
25
salmon patch in infants
nervus simplex
40% of all newborns have this
flat, irregular, light pink patches
nape of neck: stork bite
almost all disappear by age 1
26
darkish purple lesions on face/extremities in infants
port wine stains
does not fade
laser removal to help reduce
27
elevation of lesions
pedunculated
rises off a stalk, think skin tags
28
pattern and shape of lesions
annular- ring shape
grouped- all together with no outliers
confluent- throughout
linear- line
discrete- couple of small areas
gyrate- serpentine
iris
polycyclic- round
zosteriform- follows a dermatome (herpes zoster)
29
fitzpatricks sign
positive when dimpling and retraction of the skin lesion beneath the skin with lateral compression
seen with DERMATOFIBROMAS
ex: when you squeeze a pimple, it sinks down
nodules derived from mesodermal and dermal cells
FIRM, RAISED PAPULES, PLAQUES, OR NODULES that very in size (3-10 mm in diameter)
color- brown, purple, red, yellow, pink...
multiple (>15) on a person may be associated with an autoimmune disorder
usually asymptomatic
**NEEDS TO BE INVESTIGATED! TO MAKE SURE ITS NOT MELANOMA**
30
abnormal hair distribution can be related to what things?
aging, PCOS, thyroid (hypo/hyper)
31
abnormal inspection of nails:
spoon nails- anemia
dirty- poor self care, job
bitten- anxiety
clubbing- O2 insufficiency
paronychia- red, swollen nail folds, VERY tender
32
paronychia
red, swollen nail folds, VERY tender
acute- bacterial infection (manicure with not sterile tools)
chronic- fungal infection (think someone who works as a dishwasher)
33
onycholysis
separation of nail plate from nail bed
yellow nails
white nail syndrome (leukonychia)
koilonychia
34
yellow nails
can indicate lung disorders
35
white nail syndrome (leukonychia)
arsenic poisoning
chronic renal failure
heart disease
36
koilonychia
iron deficiency
spooning
thin
37
indications of pits, grooves, lines in nails
nutritional deficiency
38
brown linear nail streaks in light skinned people
melanoma
39
splinter hemorrhages of nails
occur with endocarditis
working with hands
40
beau's lines in nails
visible line on nail due to nail stop growing
can happen during serious illness
think ICU patient
body trying to preserve its work- stops producing nail
can be traced to high fever, infection, ICU stay
41
macule
primary lesion
flat, circumscribed, nonpalpable
small (up to 1 cm)
color change
42
examples of a macule
freckles, measles, nevus, solar lentigos
solar lentigos (sunspots)- sun induced, well circumscribed
43
patch
primary skin lesion
this is a macule that is >1cm
example: mongolian spot
44
vitiligo
a type of patch (primary skin lesion)
absence of melanocytes
autoimmune
M=F
cafe au lait
45
with vitiligo, you are at increased risk of...
thyroid disease
DM
pernicious anemia
46
papule
a type of primary skin lesion
solid, elevated, circumscribed
>1cm!!
example: elevated nevus (mole)
47
elevated nevus (mole)
a type of papule (primary skin lesion)
molluscum
wart (verruca)
48
molluscum
a type of elevated nevus (mole) (which is a papule)
solid skin-colored papules with central umbilication
self-limited vital infection
49
wart (verruca)
a type of elevated nevus (mole) (which is a papule)
anal
plantar
50
plaque
a type of primary lesion
papules that are >1cm
plateau like, disc shaped
confined to superficial dermis
may result from confluence of papules
51
lichen planus
a type of plaque
acute/chronic inflammatory dermatosis
salmon colored base
small amount of scale
52
nodule
solid, elevated, hard/soft
>1cm
extends deeper into the dermis than a papule
53
examples of a nodule
xanthoma, fibroma, carcinoma
54
tumor
solid, elevated, hard/soft
>2cm!
55
examples of a tumor
lipoma (fatty tumor)
hemangioma
56
wheal
superficial, raised, transient
erythematous and irregular
57
examples of a wheal
insect bite
allergic reaction
58
urticaria
wheals coalesce to form extensive reaction- pruritic
59
vesicle
elevated cavity with free fluid
up to 1 cm
clear serum
60
examples of vesicles
herpes simplex
varicella
herpes zoster
61
bulla
elevated cavity with free fluid
>1cm
thin walled
ruptures easily
62
examples of a bulla
friction blister
2nd degree burn
contact dermatitis
63
pustule
circumscribed, elevated
**filled with pus**
64
examples of a pustule
impetigo
folliculitis
acne
65
acne
a type of pustule
closed with comedomes= white head
open comedomes=black heads - oxygen turns it black
66
erosions
a type of secondary lesion
scooped out, shallow depression
superficial epidermis loss
moist, doesn't bleed
heals without a scar
67
fissure
a type of secondary lesion
linear cracks, EXTENDS INTO THE DERMIS**
dry or moist
68
examples of fissures
cheilosis
athletes foot
eczema
69
excoriation
a type of secondary lesion
self-inflicted abrasion
superficial
from intense itching
70
causes of excoriation
insect bite
chicken pox
scabies
71
scabies
ITCHY!
highly contagious
web of hands and feet=classic
mites
72
ulcers
type of secondary lesion
deep depressions, extends into dermis and beyond
irregular shape
may bleed
leaves a scar
73
causes of scar of ulcers
stasis, pressure chancre
74
scar
a type of secondary lesion
connective tissue (collagen) that replaces healed damaged normal tissue
75
lichenification
a type of secondary lesion
prolonged, intense itching THICKENS the skin
increased visibility of skin furrows
leathery-like skin
76
keloid
a type of secondary lesion
hypertrophic scar
elevated, invasive
77
surface debris
scale
crust
atopic dermatitis
seborrhea dermatitis
seborrheic keratosis
78
scale
a type of surface debris
compact desiccated flakes on skin
dry or greasy
from shedding of dead excess keratin cells
79
examples of a scale
psoriasis
sebhorric dermatitis
dry skin
80
crust
a type of surface debris
thickened, dried out exudates LEFT WHEN PUSTULES BURST AND DRY UP, color depends on fluid ingredients
81
examples of crust
impetigo- dry honey colored
weeping eczema
scab after abrasion
82
atopic dermatitis
a type of surface debris
ECZEMA
erythematous papules/plaques
itching!!
weeping and crusting can occur
TRIAD OF A
stress and cold weather are triggers
83
triad of A
atopic dermatitis
asthma
allergies
84
seborrhea dermatitis
a type of surface debris
dandruff
erythematous papules and plaques, greasy appearance
yellow crust and scales
occurs in hair and non-hairy skin
85
seborrheic keratosis
a type of surface debris
MOST COMMON NONCANCEROUS SKIN GROWTH!!!
common in older adults
brown/black/pale growth
face, chest, shoulders, back
round/oval, warty, scaly appearance
single or multiple
"stuck on" look
86
vascular lesions
cherry angioma
spider angioma
petechiae
venous star/spider vein
erysipelas
dermoid cysts
secondary syphilis
rosacea
nikolsky's sign
purpura
MRSA
87
cherry angioma
a type of vascular lesion
bright red- ruby
1-3 mm
round/flat, raised no pulse!!
may blanch
on trunk/extremities
88
what is the significance of a cherry angioma?
none
89
spider angioma
a type of vascular lesion
fiery red, small (<2cm)
central body with radiating legs
may BLANCH (HAS BLOOD FLOW)
face, neck, arms- r/t hepatic disease, pregnancy, vitamin B deficiency, can be benign too
90
the central body with radiating legs of a spider angioma may do what?
may pulse in the spider body
91
petechiae
a type of vascular lesion
deep red/reddish purple
1-2 mm, round, flat, no pulsation, no blanching
variable distribution
**formed by blood escaping from the vessels**
may indicate... BLEEDING TENDENCY
92
venous start/spider vein
a type of vascular lesion
bluish in color (venous)
size is variable
shape may vary (spider, linear, irregular)
NO pulsation- DOES NOT blanch
seen on lower extremities near veins and anterior chest
accompanied by an increase in pressure in superficial veins
93
erysipelas
a type of vascular lesion
infection caused by: BETA HEMOLYTIC STREP
can be caused by staph aureus
spreading infection of dermal and subq tissue differs from cellulitis because it is raised with a clear edge
94
dermoid cysts
a type of vascular lesion
cheese like substance within it
non-cancerous
very common in face/hands
slow growing
95
secondary syphilis
a type of vascular lesion
papulosquamous eruption on the trunk
bigger than cherry angiomas
96
rosacea
a type of vascular lesion
common (but poorly understood) disorder of facial skin
97
nikolsky's sign
a type of vascular lesion
top layers of the skin SLIP away from the lower layers when slightly RUBBED
documented as + or -
area beneath is pink, moist, tender
98
causes of nikolsky's sign
autoimmune condition (pemphigus vulgaris)
bacterial infection (scaled skin syndrome)
toxic drug reaction
99
autoimmune condition (pemphigus vulgaris) that causes nikolsky's sign
immune system produced antibodies and fights bone between skin cells
leads to formation of blister
meds such as PCN and ACE inhibitors can cause
100
purpura
a type of vascular lesion
non-palpable
ecchymosis from trauma or hemorrhage
101
MRSA
a type of vascular lesion
people can be carriers!
COMMUNITY ACQUIRED
clusters of infections among athletes, military recruits, children
prevention
presentation
treatment
102
community acquired MRSA
considered this if you have not been hospitalized/had a procedure within the last year
103
MRSA clusters of infections among athletes, military recruits, children...
pacific islands, alaskan native, native american
homosexual men
prisoners
104
prevention of MRSA
good hand hygiene
keep cuts/scrapes clean, cover with a bandage until healed
avoid contact with others who have wounds or bandages
avoid sharing personal items
105
presentation of MRSA
furuncle (big, deep pimple)
deep-seated folliculitis
impetigo
abscesses
106
treatment of MRSA
1. culture and sensitivity
2. **I&D
3. ABX if needed (such as multiple sites, area difficult to drain, comorbidities)
107
classification of skin lesions
flat, nonpalpable
raised, solid palpable
raised, cystic, palpable
depressed
108
flat, nonpalpable skin lesions
macules, patches, purpura, ecchymosis, spider angioma, venous spider
109
raised, solid palpable skin lesions
papules, plaques, nodules, tumors, wheals, scale, crust
110
raised, cystic, palpable skin lesions
vesicles, pustules, bullae, cysts (have stuff in them!!)
111
depressed skin lesions
atrophy, erosion, ulcer, fissue
112
tinea corporis
ringworm!!
body, feet, head, hands, groin, nails, everywhere!!
they eat keratin to survive, it has a central clearing because they have moved outward to find new keratin to eat
can get from animals
113
other types of tinea (besides corporis)
tinea curis- jock itch
tinea pedis- athlete's foot
tinea scapula- scalp
tinea manus- hand
114
psoriasis
hereditary disorder
silvery white scales
sharply demarcated erythematous pupules and plaques of varying size/shape with white overlaying scales
IF YOU REMOVE A SCALE AND THERE IS A DOT OF BLOOD=AUSPITZ SIGN**
M=F
30% psoriasis patients will develop a related form of arthritis: PSORIATIC ARTHROPATHY
115
trigger and risk factors for psoriasis
weight gain, smoking, stress
meds such as: beta blockers, lithium
116
fifth's disease
"slapped cheek"
mild rash, most common in children
lacey red rash on FACE, TRUNK, AND LIMBS
rash may itch
**low grade fever or a cold a few days before the rash appears**
rash resolves in 7-10 days
117
edema
palpate for accumulation of fluid in the intercellular spaces
firmly imprint thumb against a dependent portion of the body, release pressure
observe for indentation of skin
legs, feet, and ankles are good places to do this
pitting
non-pitting
angioedema
dependent edema
inflammatory
non-inflammatory
lymphedema
118
degrees of edema
0=no pitting
+1= 0-1/2, mild
+2= 1/4-1/2 (moderate)
+3= 1/2-1 (severe)
+4= >1 (severe)
measure circumference
check symmetry
119
pitting edema
indention remains on skin when pressure is applied
"my ankles swell in the evening and are better in the morning"
nocturia
120
non pitting edema
EDEMA THAT IS FIRM WITH DISCOLORATION/THICKENING OF SKIN
lymphedema
121
angioedema
recurring episodes of non-inflammatory swelling of the skin, brain, viscera, MM
onset may be RAPID
r/t reaction of medications
122
dependent edema
localized
dependent limb or area (turn the patient, leave a handprint in the buttocks)
123
inflammatory edema
swelling d/t extracellular fluid effusion surrounding an area of inflammation
ankle sprain is an example
124
non-inflammatory edema
swelling due to mechanical causes
125
lymphedema
obstruction of a lymphatic vessel
126
pressure ulcers
localized damage to the skin and underlying soft tissue
usually over a bony prominence or related to a medical/other device
injury can present as intact skin to open ulcer
may be painful
impacted by microclimate, nutrition, perfusion, comorbidities, and condition of the soft tissue
causes- pressure, friction, shear, maceration
risks- advanced age, high acuity, immobility, incontinence, poor nutrition
127
stage 1 pressure ulcer
PRESSURE INJURY, NON-BLANCHABLE ERYTHEMA OF INTACT SKIN
color changes DO NOT include purple or maroon discoloration
presence of blanchable erythema/change sin sensation, temperature, or firmness may precede visual changes
128
purple or maroon discoloration on a pressure ulcer may indicate what?
deep tissue pressure injury
129
stage 2 pressure ulcer
PARTIAL THICKNESS LOSS OF SKIN WITH EXPOSED DERMIS
wound bed is viable (pink or red, moist)
may also present as an intact or ruptured serum-filled blister
adipose (fat) NOT visible
deeper tissues not visible
granulation tissue, slough, and eschar do not present
injuries commonly result from adverse microclimate and shear in skin over pelvis and shear in the heel
this stage should not be used to describe moisture associated skin damages (MASD)
130
stage 3 pressure ulcer
FULL-THICKNESS SKIN LOSS
ADIPOSE TISSUE VISIBLE
can have granulation tissue (red base)
ROLLED WOUND EDGES
slough (yellow proteins)
eschar (hard, black covering)- keep
deepness varies by location
UNDERMINING AND TUNNELING MAY OCCUR
fascia, muscle, tendon, ligament, cartilage and/or bone are not exposed
IF SLOUGH OR ESCHAR OBSCURES THE EXTENT OF TISSUE LOSS, THIS IS AN UNSTAGEABLE PRESSURE INJURY
131
stage 4 pressure ulcer
FULL THICKNESS SKIN AND TISSUE LOSS
WITH EXPOSED, DIRECTLY PALPABLE FASCIA, MUSCLE, TENDON, LIGAMENT, CARTILAGE OR BONE IN THE ULCER
SLOUGH OR ESCHAR MAY BE VISIBLE
epibole (rolled edges), undermining and/or tunneling often occur
depth varies by anatomical location
IF SLOUGH OR ESCHAR OBSCURES THE EXTENT OF TISSUE LOSS, THIS IS AN UNSTAGEABLE PRESSURE INJURY
132
unstageable pressure injury
obscured full-thickness skin and tissue loss
if too much slough/eschar
stable eschar
133
what is stable eschar?
dry
adherent
intact without erythema or fluctuance
on the hell or ischemic limb
SHOULD NOT BE SOFTENED OR REMOVED
134
deep tissue pressure injury
persistent non-blanchable, deep red or maroon or purple discoloration
intact or non-intact skin
CAN RAPIDLY EVOLVE
pain and temperature change often precede skin color changes
caused by pressure
if any necrotic tissue, subcutaneous tissue, granulation tissue etic, can then stage
135
skin cancer
most common cancer
1/5 americans will develop by age 70
9500 diagnosed every day
incidence rises yearly
more than 2 people die every your from skin cancer (1 of the 2 from melanoma)
most cancers caused by the skin
having 5 or more sunburns doubles your risk for melanoma!!
136
causes of the rise in skin cancer incidence
ozone layer depletion, tanning beds
137
why is important to detect melanoma early
5 year survival rate for melanoma is 99%!
138
importance of geographic location to the equator for skin cancer
closer to equator (sun)
high altitudes with winter skiing
139
tanning bed/sunlamp use
in group 1 with cigarettes, plutonium, solar radiation
DANGER
radiation 10-15x more than the sun
more people develop skin cancer from tanning than develop lung cancer from cigarettes
any history of indoor tanning increases risk of skin cancer (even once)
tan color went from being a sign of lower class to total opposite
140
effect of ethnicity on skin cancer
much higher risk of death in african american
blacks, asian americans, and native hawaiians- can be harder to see changes, melanoma most often occurs in non-exposed skin with less pigment
in non-white, plantar part of the foot the most common place
141
genetics effect on skin cancer
fair-skin, blue/green eyes, red/blonde hair, easily burn or freckle and tan poorly
142
non melanoma
due to exposure to UV
genetic predisposition
immunosuppression
chemical exposure
TOBACCO/ETOH: SCC
143
genetic predisposition for nonmelanoma
fair skin, blue or green eyes, red/blonde hair, easily burn, freckle, tan poorly
personal history of skin cancer, family history of skin cancer
144
chemical exposure for nonmelanoma
arsenic
tar pitch
tar oil
carbon black
crude paraffin and asphalt
145
basal cell carcinoma
most common skin cancer
arises from abnormal and uncontrolled growth of basal cells
malignant, slow growing, but can be invasive and destructive
sore that comes and goes but eventually stays
sun exposure sites such as ear, neck, and head
>40 yo, M>F
146
squamous cell carcinoma
second most common
MAINLY CAUSED BY CUMULATIVE UV EXPOSURE OVER THE COURSE OF A LIFETIME
daily year-round exposure to the sun's UV lights
TANNING BEDS
INTENSE EXPOSURE DURING SUMMER MONTHS
older than 55
men more than women
occupation requiring long outdoor hours
sports
sun exposure sites
147
sports that lead to squamous cell carcinoma
golf and skiing
148
sun exposure sites that lead to squamous cell carcinoma
ERYTHEMATOUS SCALY PATCH WITH SHARP MARGINS 1 CM OR >
develops central ulcer
solar (actinic) keratosis precancerous for SCC
ANY PERSISTENT (>1 MO) NODULE, PLAQUE, OR ULCER IS SUSPICIOUS
149
solar (actinic) keratosis precancerous for SCC
yellow corn looking covering
flat scaly, raised, crusty, rough
actinic cheilitis- variant off lower lip
150
melanoma
EXPOSURE TO UV LIGHT/TANNING BEDS
HARMM
melanoma risk assessment tool
only 1% of skin cancers but 75% of deaths
caucasian men over 50 are at the highest risk
darker patients at less risk but doesn't mean they can't get
2nd most common cancer for young adults
risk factors
151
exposure to uv light/tanning beds that affects melanoma
intense intermittent
H/O 2 OR MORE BLISTERING SUNBURNS BEFORE 20
triggers mutations (genetic defects)
genetic disposition
family history
personal history
NEVI- dysplastic, congenital nevomelanocytic (>1/5mm), numerous acquired nevi
immunosuppression
152
HARMM for melanoma
history
age over 50
no regular dermatology appts
male gender
mole changes
153
risk factors for melanoma
fair
light eyes/hair
MORE THAN 100 MOLES OR 50 IF UNDER AGE 20
154
ABCDEF melanoma assessment
asymmetry in shape- 1/2 unlike others
color is mottled, many shades
diameter is large >6mm (pencil eraser)
elevation is usual- tangential lighting to see
enlargement, evolving- h/o increased size- most important
feeling (presence of sensation, itching, tenderness, pain)
155
melanoma types
superficial spreading
lentigo maligna
acral lentiginous
subungal melanoma
nodular
156
superficial spreading melanoma
grows along top layer before penetrating
grow out of pre-existing nevi
flat irregular in shape and color, with different shades of black/brown
most commonly in caucasians
most common- 70%
157
lentigo maligna melanoma
OFTEN IN SITU- ONE SPOT
sun damaged skin
appear large/flat
tan with areas of brown coloring
found most in the elderly on face/neck/arms
158
acral lentiginous melanoma
lesion is flat with irregular margins and pigmentation, becomes raised and nodular
spreads superficially before penetrating
occurs on nails and is more common in african americans and asians
**50% of diagnosed melanomas in asians/individuals with dark skin
159
subungal melanoma
rare subtype of acral lentiginous
involve thumb/great toe
no truma with mark
160
nodular melanoma
invasive at diagnosis- grows down first
starts as a raised area
dark blackish-blue or bluish red
most aggressive
10-15% of all cases
161
sophie brings in her husband nathan age 72 who is in a wheelchair. on his sacral area he has a deep crater with a full thickness skin loss involving necrosis of subcutaenous tissue that extends down to the underlying muscle. what stage?
stage 4
162
you assess a child with a crusted, weeping lesion...
impetigo
163
what physical exam finding would lead you to suspect hyperlipidemia?
xanthoma of inner canthus
164
you diagnose ms. lime with contact dermatitis. in your description you would most likely note...
multiple bulla on right ring finger
165
your patients presents with an area of itchy dry skin that you describe as thickened, normal in color, without drainage, vesicles, edema, it is most likely...
lichenification (thickened skin from continual rubbing)
166
you are teaching your patient to note changes in her skin lesions.. you tell her to be alert for all of the following EXCEPT...
change in temp.
SHOULD look for change in shape, color, sensation
167
you are describing a lesion noted on mr. smith, a 55 yo male. it is flat, nonpalpable lesion less than 1 cm in size...
macule
