pallor

loss of color, anemia or lack of blood flow

cyanosis

bluish, hypoxia or impaired venous return

jaundice

yellow-orange skin,sclera and mucous membranes, liver dysfunction , rbc

destruction

erythema

redness inflammation

edema

presence of fluid in the tissues causing swollen tight and shiny skin surfaces

macule

nonpapable, skin color change,freckle

papule,

palpable circumscribed,elevated nevi <.5 cm

nodule/tumor

palpable wart 5cm or>

vesicle

serous fluid filled, <1cm, blister

pustule

pus filled acne

wheal

palpable,irregular borders, edematous, mosquito bite

erosion

lost epidermis, moist surface, no bleeding, ruptured vesicle

crust

dried blood,serum or pus

scale

flakes of skin that exfoliate, dandruff or psoriasis

fissure

linear crack,tinea pedis

ulcer

loss of epidermis and dermis with possible bleeding and scarring, venous
stasis ulcer

spider

red center with radiating legs that are red, up to 2 cm and can be raised

angioma

cherry

red, 1-3 cm round and can be raised

angioma

spider vein

bluish, spider shaped or may be linear with up to several inches in size

petechia

deep reddish purple, flat=1-3 mm,

purpura

deep reddish purple,>3mm

ecchymosis

purple fading to green or yellow over time,variable in size and flat

hematoma

raised ecchymosis

Stage I

Skin is unbroken but appears red; no blanching when pressed.

Pressure Ulcer

Stage II

Skin is broken, and there is superficial skin loss involving the epidermis

Pressure Ulcer

alone or also the dermis. The lesion resembles a vesicle, erosion, or blister.

Stage III

Pressure are involves epidermis, dermis, and subcutaneous tissue. The

Pressure Ulcer

ulcer resembles a crater. Hidden areas of damage may extend through the
subcutaneous tissue beyond the borders of the external lesion but not
through the underlying fascia.

Stage IV

Pressure are involves epidermis, dermis, subcutaneous tissue, bone, and

Pressure Ulcer

other support tissue. The ulcer resembles a massive crater with hidden
areas of damage in adjacent tissue.

Macule

Flat, non-palpable skin color change. Circumscribed border. This particular

lesion is LESS than 1 cm. (ie: freckles, flat moles)

Patch

Flat, non-palpable skin color change. Irregular border. This particular lesion
is GREATER than 1 cm. (ie: port wine stains, ecchymosis)

Papule

Elevated, palpable, solid mass; circumscribed border. This particular lesion

is LESS than 0.5 cm. (ie: warts)

Plaque

Elevated, palpable, solid mass; circumscribed border. This particular lesion

is GREATER than 0.5 cm. (may be coalesced papule with flat top) {ie:
psoriasis}

Nodule

Elevated, solid, palpable mass; extends deeper into dermis than papule.
This particular lesion is 0.5-2 cm; circumscribed. (ie: squamous cell
carcinoma)

Tumor

Elevated, solid, palpable mass; extends deeper into dermis than papule.
This particular lesion is GREATER than 1-2 cm; does not always have sharp
borders. (carcinoma)

Vesicle

Circumscribed elevated, palpable mass containing serous fluid. This

particular lesion is LESS than 0.5 cm. (ie: herpes zoster, varicella, poison
ivy)

Bulla

Circumscribed elevated, palpable mass containing serous fluid. This

particular lesion is GREATER than 0.5 cm. (ie: contact dermatitis, large burn
blisters)

Wheal

Elevated mass with transient borders, often irregular. Size and color vary.
Caused by movement of serous fluid into the dermis; does NOT contain free
fluid in a cavity. (ie: hives, insect bites)

Pustule

Pus-filled vesicle or bulla. (ie: acne, impetigo, carbuncles, furuncles)

Cyst

Encapsulated fluid-filled or semi-solid mass; located in the subcutaneous

tissue or dermis.

Erosion

Loss of superficial epidermis, but does not extend to dermis. Depressed

moist area. (ie: ruptured vesicles, scratches)

Ulcer

Skin loss extending past epidermis, necrotic tissue loss, bleeding & scarring
possible. (ie: pressure ulcer)

Scar

Skin mark left after healing of wound or lesion, represents replacement by

connective tissue, can be young- red or purple, or mature- white or
glistening (ie: healed wound)

Fissure

Linear crack in the skin, may extend to the dermis. (ie: chapped lips)

Scales

Flakes secondary to desquamated, dead epithelium, may adhere to skin

surface. (ie: dandruff, psoriasis)

Crust

Dried residue of serum, blood, or pus on skin surface, large one maybe a
scab. (ie: residue left after ruptured vesicle)

Keloid

Hypertrophied scar tissue, secondary to excessive collagen formation

during healing, greater incidence in African Americans. (ie: after ear
piercing)

Atrophy

Thin, dry, transparent appearance of epidermis, loss of surface markings,

underlying vessels may be visible. (ie: aged skin)

Lichenification

Thickening & roughening of the skin, accentuated skin markings, may be

secondary to repeated rubbing, irritation, or scratching. (ie: contact
dermatitis)

Petechia

Round red or purple macule, associated with bleeding tendencies or emboli

to skin.

Ecchymosis

Larger than petechia, this lesion is a round or irregular macule with varying
color, and is associated with trauma & bleeding tendencies.

Hematoma

A localized collection of blood creating elevated ecchymosis, associated

with trauma.

Cherry Angioma

Papular and round, red or purple, may blanch with pressure, normal agerelated skin alteration, usually not clinically significant.

Spider Angioma

Red, arteriole lesion, central body with radiating branches, associated with
liver disease, pregnancy, and Vitamin B deficiency.

Telangiectasis

Spider-like or linear, bluish or red in color, does not blanch, associated with
increased venous pressure states.

Hemangioma

bright red, raised lesion about 2 to 10 cms. in diameter; does not blanch
with pressure, present at birth or few months after birth; caused by cluster of
immature capillaries; can appear anywhere on body

Port-Wine Stain

flat, irregularly shpaed lesion ranging from palre red to deep purple red;
deepens in emotional response; present at birth; caused by large, flat mass
of blood vessels on the skin surface, most common on face and head but
may occur other sites

Spider Angioma

flat, bright red dot tiny radiating blood vessels from a pinpoint to 2 cms.;
caused by type of tenalgiectases (vascular dilation) by elevated estrogen
levels, pregnancy, estrogen therapy, vitamin B deficiency or liver disease;
more common on upper half of the body

Venous Lake

flat blue lesion, radiating, cascading linear veins extending from the center 3
to 25cms.; caused by type of tenalgiectases (vascular dilation) caused by
increased intravenous pressure in superficial veins; anterior chest and lower
legs near varicose veins

Petechiae

flat red or purple rounded "freckles" 1 to 3 mm in diameter; caused by

minute hemorrhages resulting from fragile capillaries, septicemias, liver
disease, vitamin c or K deficiency, also anticoagulant therapy; common
dependent surfaces of body (back, buttocks) dark skin difficult to see may be
seen in oral mucosa and conjunctivae

Pupura

flat, reddish blue irregularly shaped extensive patches of varying size;

caused by bleeding disorders, scurby, and capillary fragility in the odler adult
(senile purpura); appear anywhere on body, noticeably on legs, arms, backs
of hands

Ecchymosis

flat, irregularly shaped lesion of varying size with no pulsation; light skin
bluish purpilish mark greenish yellow; caused by release of blood from
superficial vessels into surrounding tissue to to trauma, hamephilia, liver
disease, or deficiency vitamin C or K; occurs anywhere on body at the site of
trauma or pressure

Hematoma

raised, irregularly shaped lesion similar to ecchymosis elevates skin and

looks like a swelling; caused by leakage of blood into skin and
subcutaneous tissue as a result of trauma or surgical incision; anywhere at
point of trauma, pressure, or surgical incision

Macule, Patch

nonpalpable change in skin color smaller than 1 cm. examples freckles,

measles, and petechiae; mongolian spots, port-wine stains, vitiligo, and
chloasma

Papule, Plaque

elevated, solid palpable mass with circumscribed border, smaller than 0.5
cm.; examples moles, warts, psoriasis

Nodule, Tumor

elevated, solid, hard, or soft palpable mass extending deeper into dermis
than a papule; examples nodules squamous cell carcinoma, fibroma,
intradermal nevi, Tumors: large lipoma, carcinoma, hemangioma

Vesicle Bulla

elevated fluid-filled round or oval shaped palpable mass with thiin,

translucent walls and circumscribed borders, smaller than 0.5 cm; herpes
simplex, chickenpox, poison ivy, small burn blisters; bullae: contact
dermatitis, friction blisters, large burn blisters

Wheal

elevated, often reddish are with irregular border caused by fluid in tissues
rather than free fluid; examples insect bites, and hives

Pustule

elevated pus-filled vesicle or bulla with circumscribed borders examples:

acne, impetigo and carbuncles (large boils)

Cyst

elevated, encapsulated, fluid-filled or semisolid mass in the subcutaneous

tissue or dermis, usually 1 cm. or larger examples: sebaceous cysts,
epidermoid cysts

Atrophy

translucent, dry paperlike, wrinkled skin surface from thinning or wasting of

the skin due to loss of collagen and elastin; examples striae, aged skin

Erosion

wearing awa of the superficial epidermis moist, shallow depression; heal

without scarring examples: scratch marks, ruptured vesicles

Lichenification

rough, thickened, hardened area of epidermis resulting from chronic

irritation such as scratching or rubbing examples: chronic dermatitis

Scales

shedding flakes of greasy, kertanizied skin tissue color may be white, gray
or silver; examples: dry skin, dandruff, psoriases, and eczema

Crust

dry, blood serum or pus left on the skin surface when vesicles or pustules
burst, red-brown, orange, yellow; eczema, impetigo, herpes, scabs

Ulcer

deep, irregularly shaped area of skin loss extending into dermis or

subcutaneous tissue, may bleed or leave a scar; examples decubitus ulcer,
stasis ulcers

Fissure

linear crack with sharp edges, extending into the dermis; examples include
corners of the mouth or in the hands, athlete's foot

scar

flat, irregular are of connective tissue left after a lesion or wound has
healed; new scars red, or purple older scars silver or white examples:
healed surgica wound or injury, healed acne

keloid

elevated, irregularly, darkened area of excess scar tissue caused by

excessive collage formation during healing; extends beyond original site on
injury; example from ear-piercing or surgery

annular

lesions with a circular shape examples: tinea corporis, pityriasis rosea

confluent

lesions that run together examples: urticaria

Discrete

lesions taht separate and discrete examples: malluscum

Grouped

lesions that appear in clusters examples: purpural lesion

Gyrate

coiled or twisted

Target

lesions with concentric circles of color; erythema multiforme

Linear

appear as a line examples: scratches

Polycyclic

lesions that circular but united examples: psoriasis

Zosteriform

arranged in linear manner along a nerve route examples: herpes zoster

Tinea

fungual infection affecting the body the scalp and feet secondary bacterial
infection may also be present appearance of the lesions varices, and they
present as papules, vesicles or scales

Measles

highly contagious viral disease red tp purple macules or papules; begins on

(Rubeola)

the face then progresses over the neck, trunk, arms and legs, tiny whhite
spots look like grains of salt; mostly in children

German

german measles highly contagious disease pink, papular rash begins on the

Measles

face, then spreads over the body; accompanied by swollen glands; occurs

(Rubella)

mostly in children

Chickenpox

mild infection disease caused by herpes zoster virus; begins a groups of

(Varicella)

small, red, fluid-filled vesicles on the trunk; progresses to the face, arms,
and legs. May cause intense itching, occurs mostly in children

Herpes Simplex

viral infection lesions on lips and oral mucosa; progress from vesicles to
pustules, then crusts; occurs in genitals

Herpes zoster

eruption of dormant herpes zoster virus, typically invade the body during an
attack of chickenpox; clusters of vesicles along the route of sensory nerves;
intense pain ant itching; more common and more sever in older adults

Psoriasis

thickening of skin silver, white scalr patches occurs with overproudction of

skin cells resulting in buildup of cells faster than they can be shed; scalp,
elbows, knees, lower pack and perianal area

Contact

Inflammation of skin an allergy to a substance that comes into contact with

dermatitis

the skin i.e. clothing, jewerly, plants, chemical, or cosmetics; location of

lesions aid in discovery of allergy usually accompained by intense itching

Eczema

inflammation of the skin reddened papules and vesicles that ooze, weep
and progress to form crusts; scalp, face, knees, forearms, torso, and wrists;
causes intense itching

Impetigo

bacterial skin infection appears ont he skin around the nose and mouth;
contagious and common in children begins as patch of blisters that break
exposing red, weeping area beneath, crust soon forms over the are infection
may spread

Basal cell

most common least malignant type of skin cancer; proliferation of the cells

carcinoma

of the stratum basale into the dermis and subcutaneous tissue; begin as
shiny papules tha tdevelop central ulcers with rounded pearly edges; occur
on skin exposed to the sun

Squamous cell

arises from cells of the statum spinosum; begins as reddend, scaly papule

carcinoma

then formas a shallow ulcer with clearly delineated elevated border; appears
on scalp, ears, back of hands, lower lip, caused by exposure to the sun grow
rapidly

Malignant

least common most serious; spreads rapidly to lymph nodes and blood

Melanoma

vessels; lesion contains areas of varied pigmentation, black to brown to blue

or red edges are often irregular; notched borders diamter greater than 6 mm

Kaposi's

malignant tumor of the epidermis and internal epithelial tissues; soft, blue to

Sacrcoma

purple and painless; macular or papular resemble keloids or bruises;

common HIV+ patients

Seborrheic

common in infants; appears as eczema yellow-white greasy scales on the

dermatitis

scale and forehead also known as cradle cap

Timea capitis

patchy hair loss on the head with pustules on the skin; highly contagious
fungal disease transmitted fromthe soil, from animals or from person to
person

Alopecia Areata

no known cause for the sudden loss of hair in round balding patches on the
scalp

Folliculitis

iinfections of the hair follicles; appears as pustules with underlying erythema

Furuncle

infected hair follicles give rise to furuncle hard, erythematous pus-filled

Abscess

lesions abscesses are cause dby bacteria entering hte skin larger lesions
are furuncles

Hirsutism

excess body hair in females face, chest, abdmonen, arms and legs,
following male pattern excessive hair on the female chin; typically due ot
endocrine or metablolic dysfunction though it may be idiopathic

Spoon nails

concavity and thinning of the nails congenital conformity

Paronychia

infection of the skin adjacent to the nail, usually caused by bacteria or fungi;
affected area becomes red, swollen, and painful, and pus may ooze from it

Beau's line

trauma or illness affecting the nail formation; linear depression develops at

the base and moves distally as the nail grows

Splinter

result of trauma in endocarditis; appears as reddish-brown spots in the nail

Hemorrhage

Clubbing

more convex than wide ange is greater than 160 degrees occurs in chronic
respiratory and cardiac conditions which oxygenation is compromised

Onycholysis

the nail plate loosens from the distal nail and proceeds to the proximal
portion

Flat

sound is heard over solid tissue where there is the least amount of
trapped air. i.e.: Normally heard over muscles of the arms or legs.

dull

sound is elicited over relatively airless structures. These too are

solid tissues. i.e. Normally heard over the heart, spleen, liver.

Resonance

is the sound heard over normal lung tissue.

Hyperresonanc

This sound is heard over excessively air filled lungs. i.e.

emphysema, COPD

Tympany

This sound is elicited when air is present in a closed structure. With

percussion, the air vibrates with the surrounding tissues. i.e. Normally
heard over air-filled stomach, intestine.

-Stratum Corneum

outer horny layer of dead epithelial cells

-Protects against invasion and evasion -Regulates heat through
conduction

-Stratum Mucosum

inner cellular layer, living epithelial cells

-Stratum Mucosum

Contains melanocytes (skin pigment) which protects against ultra violet

radiation -Forms keratin-tough protein substance
found in hair and nails

Dermis

True Skin"-living epithelial cells highly vascular connective tissue

Dermis

True Skin"-living epithelial cells highly vascular connective tissue

Dermis

Contains peripheral vascular supply -Contains peripheral nerve supply

Dermis

Contains connective tissue, sebaceous glands,and hair follicles

Hypodermis

loose connective tissue interspersed Subcutaneous Fat

Subcutaneous

living epithelial cells

tissue

Subcutaneous

Stores body fat

tissue

-Foundation for the dermis

Subcutaneous

Regulates heat through insulation -Contains lower portion of hair follicle-

tissue

the
root and the bulb

Eccrine sweat

-Secrete into the hair follicles

glands

Apocrine sweat

-Secrete into the hair follicles -Non-functioning until puberty

glands

-Responsible for body odor

Sebaceous oil

-Secrete sebum into the hair follicle -Provide lubrication to skin surface

glands

and hair

Hair

-Cornified horny thin shaft of thread-like epithelial cells -Provides

protection of the scalp, esthetic function -Color determined by the
concentration of melanin

Nails "Onychoid"

Show structure of nail

Plate

horny epithelial cells forming rectangular convex firm plates

Body

exposed portion of nail

-Root

hidden portion at the proximal end of nail

Lunula

crescent shaped whitish area near the

root due to a greater concentration of cells in
the matrix

Matrix

inter-cellular material from which nail

is formed

-Nail

highly vascular portion of the finger and toe covered by the nail

Mantle

dermal lip which forms the cuticle

carotenemia

increase in carotene, does

not involve sclera

Jaundice

abnormal increase in bilirubin, also involves sclera and mucous

membranes

-Reddish blue

increase in total hemoglobin with capillary stasis involving face, mouth,

-Polycythemia

hands, feet, conjunctiva

Pink or Silver lines

-Stretch Marks (striae

brown skin

Genetic natural color due to generalized melanin

brown skin

Pregnancy: increased pigmentation of face, nipples, vulva and the linea

nigra

brown skin

-Addison's disease: Increased pigmentation, especially in areas of

pressure or trauma such as knuckles, elbows and scars

brown skin

Suntan: increased pigmentation in areas

20
exposed to sunlight

blue skin

Cyanosis-decrease in oxygenated hemoglobin especially nail beds, lips,

mucous membranes.

pallor or pale

May be due to decrease in hemoglobin, edema or vasoconstriction,

generalized pallor: anemia

-Vitiligo or pale

Acquired loss of pigmentation, specific to patch areas of involvement

Albinism or pale

Congenital lack of pigmentation, generalized including hair and eyes

Superficial

Determine the presence or absence of a venous pattern. A fine network

Vascularity

is normal
in young children and those with a thin dermis skin layer.

Cyanosis

Ashen-gray color most easily seen in conjunctiva

of eye, oral mucosa, & nail beds in blacks

Ecchymosis

Deeper bluish or black tone, difficult to see unless it occurs in area of

light pigmentation in blacks

erythema

Deeper brown or purple skin tone with evidence of increased skin

temperature secondary to
inflammation in blacks

Jaundice

Yellowish-green color most obviously seen in

sclera of eye, palms of hands, & soles of feet of blacks

Pallor

Skin tone appears lighter than normal. Light skinned

African Americans may have yellowish brown skin; dark skinned African
Americans may appear ashen. Specifically evident is loss of underlying
healthy red tones to skin.

Petechiae

Difficult to see; may be evident in buccal mucosa or sclera

Rash

Not easily visualized but may be felt with light palpation

scar

Frequently has keloid development, resulting in thickened, raised scar

21

Prominent venous

over the abdomen may be

pattern

secondary to venous obstruction (patients with liver problems)

Capillary fragility

around eyes secondary to coughing

Cherry Angioma

Small, slightly raised red areas on

trunk, usually in older adults

Strawberry

Slightly raised, reddened areas with sharp demarcation line. May be 2-3

Hemangioma

cm in diameter & usually disappear by 5 years of age. Strawberry

appearance.

-Spider

red on face, neck, arms and upper trunk, blanching arteriole

nevus/angioma

Telangiectasia

permanent dilation of superficial capillaries.

Storkbite

red spots seen on back of infant neck, go away by 5 years

-Port wine

large flat bluish purple capillaries over face, do not disappear

spontaneously

Senile lentigo

age or liver spots) irregular shape, flat pigmented macules

-Seborrheic

pigmented raised wart appearing lesions

keratoses

-Skin Tags-

neck and upper chest sebaceous hyperplasia, yellowish, flattened

acrochordon

papules with central depression.

Nevi

moles

increased

Systemic infection-generalized Local infection-specific to area of

temperature

infection Sun burn-specific to exposed areas Dehydration-generalized

decrease

Raynaulds disease-digits Shock-generalized

temperature

increased

Hyperthyroidism-generalized Obesity-generalized Edema-specific to

smoothness of skin

area of edema

Increase in

Hypothyroidism-generalized Excessive exposure to water, wind,

roughness

chemicals, sun
-specific to exposed areas

decreased skin

se in turgor

turger

Aging Rapid weight loss Dehydration

increased skin

Edema-specific to affected areas Obesity-generalized

turger

fingertips

determine the presence or absence of moisture, if present the amount

and location with ________

Primary Lesions

Appear as immediate result of cause

Macule

Flat non-substantive change in color less than 1 cm

Patch

Macule which is greater than 1 cm

Papule

Elevated substantive lesion of any color less than 1 cm

Plaque-

Elevated, firm, rough lesion which is greater than 1 cm

Vesicle

Elevated lesion filled with clear fluid less than 1 cm

Bulla

vesicle which is greater than 1 cm

Wheal

elevated, edematous elevation, white to pink to skin color

Comedones

Plug of keratinous debris filling the pilosebaceous opening (Blackhead)

Secondary Lesions

Alterations in the primary lesions, never appear originall

Scale

Desquamation of surface cells

Excoriation

Scratch, scrape, superficial abrasion

Crust

Dried serum, pus, or blood overlaying skin surface

Erosion

Superficial loss of a portion of the epidermis

Ulcer

Loss of entire epidermis, may involve portion of dermis

Fissure

Linear versicle separation through epidermis and dermis

Lichenification

thickening of skin due to chronic rubbing or scratching

Scar

Dense collection of connective tissue replacing lost tissue

Olfaction

Determine general body odor, characteristic body odor non- existent

prior to puberty when the apocrine sweat glands begin to function, odor
is an index of activity, anxiety, and hygiene habits and agents, and
health status,

Epidermis

outer protective layer of the skin. Replaced every 4 weeks

Dermis

collagen, blood vessels, and lymph containing. Tough and resists skin
tearing.

Subcutaneous

contains fat cells for energy, temp control, cushioning

Sebaceous Glands

oil glands (lipdd substance that emulses with water to prevent water
loss)

Eccrine Glands

Sweat glands that produce odorless sweat

Apocrine Glands

sweat glands in underarms, genitals, breast areas that respond to

emotional/sexual stimulation.

Jaundiced

Yellow

Cyanotic

blue

Ruddy

red

6 General

1) Color 2) Texture 3) Turgor 4) Temp 5) Moisture 6) Edema

observations of the
Skin:

6 Functions of the

1) Protection 2) Prevention against water/electrolyte loss 3) Sensory

Skin

perception 4) Repair 5) Absorption/Secretion 6) Temp regulation

Linear

lesions that appear in a straight or curved line

Generalized

located all over the body

Localized

located to a specific body region

Discrete

individually separate

Dermatomal

follows the dermatomes on the abdomen/back

Mongolian Spots

appear on dark skinned newborns. Irregular, flat areas over the

sacrum that look like bruising

Contact Dermatitis

acute reaction to a substance. May produce diffuse vesicles.

Tinea pedis

Athlete's Foot. A fungal infection that produces vesicular, abraided

fissures.

Herpies Simples I and

I= mouth II= genitals. Chronic viral infection that produces vesicular,

II

crusty, red, painful lesions on lips and genitalia

Herpes zosters

Shingles. Results from latent virus of chicken pox. Produced vesicular

to pustular rash that follows a nerve dermatome. Extremely painful.

Actinic Keratosis

Flesh colored/pink slightly scaly raised lesions. Dry and rough.

Appear on sun exposed areas. Precancerous.

Basal Cell Carcinoma

a nodular ucerative red/pink lesion with raised pearly margins. It is

local invasive and usually slow growing.

Squamous Cell

arise from actinic keratosis as indurated red papules, plaques, or

Carcinoma

nodules. They are ulcerative and crusted. May metastasize.

Melanoma

have irregular borders and colors and readily metastasize.

THE ABCDEs of

Assymetry; Border; Color; Diameter; Evolving

Melanoma

Turgor

the tenting test. Check above clavicle. Reflective on the elasticity of

the skin.

Nails

Spoon shape = iron deficiency anemia

Clubbing = Oxygen deficiency
Thick = age, fungal infections
Thin = nutritional anemia, decreased peripheral vascularization

Beau lines

transverse indentations on the nail; associated with trauma,

malnutrition, acute severe illness.

Capillary Refill

Press down on nail. Nail bed should turn white. Upon release, should
return to pink color instantly or in less than 3 seconds

Annular

a lesion that forms a ring around a clear center of normal skin.

Atrophy

decrease in size or wasting

Bulla

an elevated, circumscribed, fluid filled lesion greater than 1 cm in diameter

Congruen

describes lesions that run together

Contusio

Bruising

Diffuse

Spread out, widely distributed

Fissure

a linear crack in the skin

Induration

hardening of the skin, usually caused by edema

Keloid

hypertrophic scar tissue, prevalent in people who have dark skin

Macule

flat circumscribed lesion 1 cm or less in diameter on skin or mucous membrane

Nevus

a congenital, pigmented area on the skin

Nodule

solid skin elevation 1 cm or more in diameter that extends into the dermal layer

Papule

a solid, elevated circumscribed, superficial lesion, 1 cm or less in diameter

Petechiae

flat red/purple spots on the surface of the skin or mucous membranes resulting in
minute hemorrhage

Plaque

a solid, elevated circumscribed lesion greater than 1 cm in diameter

Pustule

vesicle or bulla that contains pus

Ulcer

circumscribed crater on the surface of the skin or mucous membrane

Urticaria

Hives, pruritic wheals often transient and allergic in origin

Vesicle

Fluid filled, elevated superficial lesion 1 cm or less in diameter

Wheal

elevated, solid transient lesion, often irregularly shaped, an edematous response

Epidermis, Dermis,

What are the layers of the Integumentary System?

Hypodermis
(subcutaneous tissue)

20 square feet

How much skin covers the average adult?

Sebaceous

What are sebum producing glands found everywhere in the dermis

except for the palmar and plantar surfaces?

Apocrine

What are sweat glands associated with hair?

Eccrine

What are sweat glands not associated with hair follicles?

Karotine

What are Nails made of?

Cyanosis

What color is Lack of O2 to the skin called?

Petechiae

Bleeding under the skin

Ecchymosis

Bruising

Macule

Freckle

Macule and Patch

What are Non palpable lesions?

Solid Lesion (wart)

What is an example of a papule lesion?

Eczema, psoriasis

What is an example of Plaque Lesions?

Lipoma

What is an example of a Nodule Lesion?

Carcinoma

What are Tumor lesions called?

Lichenification

What are Layers of thickened and rough skin as a result of rubbing

over a prolonged period of time called?

Excoriation

What is it called when the Outer layer of skin is rubbed off?

Stage 2 Pressure Ulcer

What stage of pressure ulcer is characterized by which Epidermal

and dermal layers are injured

Stage 3 Pressure Ulcer

What stage of pressure ulcer is characterized by which

Subcutaneous tissues are injured

Stage 4 Pressure Ulcer

What stage of pressure ulcer is characterized by which Muscle and

perhaps bone are injured

First Degree Burn

What type of burn is characterized by: Epidermis is injured or

destroyed; skin is red, dry, painful

Second Degree Burn

What type of burn is characterized by: Epidermis and upper layers

of dermis are destroyed; skin is red,blistery,painful; Also called
partial thickness burn

Third Degree Burn

What type of burn is characterized by: Epidermis and dermis are

destroyed, subcutaneous tissue is injured; hair follicles, sweat
glands and nerve endings are destroyed; skin is white, red, black;
Also called full thickness burn

Alopecia

What is Losing Hair called?

Hirsutism

What is having too much hair called?

Skin

Largest organ that covers 20 square feet in the average person

Function of Skin

~Protection - prevents injury, impermeable to bacteria, stops water

and electrolyte loss
~Temperature regulation - sweat glands
~Communication - blush, blanch
~Wound Repair - replaces itself
~Excretion of waste thru sweat
~Production of Vitamin D - converts cholesterol into Vitamin D

Epidermis

Outer layer; Contains melanocytes (produces our pigment)

Dermis

Supportive layer of connective tissue or collagen; Contains the skin

appendages (hair follicles and sweat glands)

Subcutaneous Tissue

Adipose tissue (where fat is stored and gives us insulation)

Hair

Vestigial (no longer needed for protection); Made of keratin

Appendages of Skin

Sebacious Glands

SEBUM or oil; Responsible for LUBRICATING our skin

Appendages of Skin

Ecrine Glands

SWEAT glands; Open directly unto the skin

Appendages of Skin

Apocrine Glands

Open into hair follicles; Gland produces milky substance (found in

AXILLA and ANOGENITAL area; responsible for BODY ODOR)

Appendages of Skin

Nails

Plates of keratin

Appendages of Skin

Infants and Children

~more PERMEABLE to water (don't put sun block or topical

medications)
~sebacious glands (require lotion)
~temperature regulation is IMMATURE (don't shiver)
~pigment system is NOT developed

Puberty

~Epidermis thickens
~Glands function (eccrine, apocrine, sebacious)

Pregnancy

~hormone levels
~ skin pigmentation, chloasma, linea nigra
~ connective tissue is fragile (striae)
~ sweat gland production

Aging

~epidermis thins
~dermis thins and wrinkles
~ muscle tone
~ collagen and elasticity
~sweat glands
~vascular fragility

History

~Previous history of skin disease

~Change in pigmentation
~Change in a mole
~Excessive dryness (xerosis)
~Excessive oiliness (seborrhea)
~Excessive moisture (diaphoresis)

~Pruritis (itching), very common

History

~Excessive bruising
~Rash or lesions: location, spread, appearance, duration,
exposure, self care
~Medications
~Hair loss (alopecia)
~Excess hair (hirsutism)
~Change in nails (brittleness - vitamin deficiency)
~Environmental hazards
~Self care behavior (use of sun screen, soaps, lotions, use of
artificial nails)

Preparation

~Strong direct light

~Small centimeter ruler
~Penlight: tangential to assess contour of the skin
~Gloves

Inspection: Color

General pigmentation; widespread color changes

~Pallor: fear, peripheral vasoconstriction, smoking, shock, anemia

~Erythema: fever, inflammation, polycythemia
~Cyanosis: hypoxia, shock, heart failure
~Jaundice: liver problems (seen in 1st junction of hard and soft
pallet)

Lesions

~Color
~Elevation: flat, raised, pendunculated (sac - like)
~Pattern: annular, grouped, confluent, linear
~Shape: regular or irregular
~Primary vs Secondary
~Size

Annular

Lesions that are Circular (ringworm)

Confluent

Lesions that run together (hives)

Discrete

Dinstinct (pimples)

Grouped

Clustered (contact dermatitis)

Gyrate

Twisted (poison ivy)

Target

Lesion within a lesion (erythema multiforme)

Linear

Scratch or streak (poison ivy)

Zosteriform

Linear, along nerve route

Macule

~Flat, circumscribed area of COLOR CHANGE only; ( < 1 cm)

~i.e. mole or nevus (nevi), freckle

Primary Lesion

Patch

Macule that is (> 1 cm )

~i.e. caf au lait spot or vitiligo

Primary Lesion

Papule

Solid, circumscribed and elevated (< 1 cm)

~i.e. elevated mole, wart

Primary Lesion

Plaque

Papules that coalesce to form an elevation (> 1 cm)

~i.e. xerosis

Primary Lesion

Nodule

Solid, elevated, hard or soft (> 1 cm); DEEPER into the dermis
~i.e. fibroma

Primary Lesion

Tumor

(> 2 cm) and can be firm or soft

~i.e. lipoma

Primary Lesion

Wheal

Superficial, raised, transient, erythematous, 2 edema

~i.e. mosquito bite

Primary Lesion

Uriticaria

Wheals that coalesce, intensily PRURITIC (itchy)

~i.e. hives

Primary Lesion

Vessicle

Elevated lesion containing FLUID (< 1 cm)

~i.e. early stages of chicken pox

Primary Lesion

Bulla

Vessicle that is (>1 cm)

i.e. burn or blister

Primary Lesion

Cyst

Encapsulated fluid filled cavity in dermis or SQ layer

i.e. sebaceous_____
Primary Lesion

Pustule

Vesicle that contains PUS

~i.e. impetigo, acne
Primary Lesion

Crusts

Dried exudate (serum, pus, blood) when vessicle or pustules burst

Secondary Lesion

Scales

Flakes of skin, sheds excess keratin

Secondary Lesion

Fissure

Linear crack, extends into the dermis

Secondary Lesion

Erosion

Scooped out shallow depression, superficial epidermis loss

Secondary Lesion

Ulcer

Deeper depression; extends into the dermis

Secondary Lesion

Excoriation

Scratch marks

Secondary Lesion

Lichenification

Thickening of the skin, happens with prolonged scratching or

rubbing

Secondary Lesion

Angiomas

~(1 - 5 mm) smooth; slightly raised, BRIGHT RED, will BLANC

(Capillary that becomes DESCENDED)

Vascularity and Bruising

Telangiectasis

FIERY RED STAR shaped lesion with a red body, will BLANCH
with pressure (common w/ liver disease or pregnancy)

Vascularity and Bruising

Echymosis

Bruising (should be consistent with normal living)

Vascularity and Bruising

Portwine Stain

Benign proliferation or blood vessels; Macular patch

Hemangiomas

Strawberry Mark

A macular plaque covering the scalp or face; Immature capillaries

(Will resolve between 5 and 7 years old)

Hemangiomas

Danger Signs of Lesions

Asymmetry (not round? oval?)

Border irregularity (notching? ragged?)
Color Variation (combos of color in one mole?)
Diameter (>6 mm) pencil eraser size?
Elevation and enlargement (has it gotten bigger?)

Burns or bleeds?

Malignant Melanoma

~Caused by exposure to UV
~People at risk: blond, red hair, blue eyes (1: 65)
~Lesions look like mixed pigmentation
~Common locations: trunk, legs, back (most sun exposure)
~Black population - under fingernail, palms, soles of feet

Basal Cell Carcinoma

~Most COMMON skin cancer

~Exposure to UV
~Presents with NON HEALING sore
~Lesions look like papule and inside becomes like an ulcer
~Common locations: head and back

Seborrheic Keratosis

Raised thickened areas of pigmentation (develop on trunk, head,

hands)

Skin Lesion of Aging

Acrochordons

Overgrowth of normal skin, polyp, skin tags (develop on eyelids,

cheek, back)

Skin Lesion of Aging

Palpation

Temperature
~Hypothermia (circulatory problems)
~Hyperthemia (increased metabolism)
Moisture (diaphoresis)
Texture
~Hyperthyroidism (smooth silky skin)
~Hypothyroidism (dry scaly skin)
Thickness (uniformly thick, paper thin - old age and PVD pts)

Purpuric Lesions

Caused by blood flowing out of breaks in the blood vessels. RBCs

are deposited in the tissues

Petechiae

Very small, tiny hemorrhages, round and very discrete (WILL NOT
BLANCH)

Purpura

Extensive patches of petechiae (look like bruising)

Mobility and Turgor

~where to test: anterior chest under clavicle in adults; abdomen in

children
~tenting: indicates dehydration

Edema

Fluid that accumulates in the tissues; Check ankly maleolus and

tibia
1+ = Mild Pitting
2+ = Moderate Pitting (subsides quickly)
3+ = Deep Pitting (indentation stays for a short period of time)
4+ = Very Deep Pitting (indentation lasts alot longer)

Inspection and Palpation

~Color: melanin production (grey hair is a loss of melanin)

of the Hair

~Texture: fine, thick, curly, straight

~Distribution: appropriate to gender
~Lesions: check scalp

Tinea Capitis

Fungal infection (ringworm)

Alopecia areata

Sudden appearance of bald spots

Trichotillomania

Self-induced hair loss

Pediculosis Capitis

Lice

Hirsutism

Excessive hair

Furuncle

Infected hair follicle

Inspection and Palpation

~Shape

of the Nails

~Contour
~Consistency (without ridges, grooves or thickening)
~Color (pallor, cyanosis)
~Profile test or Schamroth technique

Capillary Refill

~Depress nail edge

~Normal return < 3 sec
~Sluggish return (problems with peripheral circulation)

Koilonychias

Spoon nails; Genetic

Beau's Lines

Transverse grooves in the nails (trauma or illness)

Paronychia

Inflammation of the nail folds

Onycholysis (fungal)

Loosening of the nail plate

Onchodystrophy

YELLOW hard nails 2 lack of O

Clubbing

Normal <160
Abnormal >180

Nursing Diagnoses

~Risk for impaired skin integrity

~Impaired skin integrity
~Risk for infection
~Impaired physical mobility
~Body image disturbance

Macule

a primary skin lesion that is typically less than one centimeter in diameter,
nonpalpable and flat, an example being freckles or moles. (Primary skin
lesions arise from normal skin, and they result from anatomic changes in the
epidermis, dermis, or subcutaneous tissue, they are the most common
lesions of the skin.)

Melanocyte

Cells located in the bottom layer of the skin's epidermis. Melanocytes

produce melanin, which produces pigment. They are also located in the eye,
ear, meninges, bone and heart. Skin color is not determined by the number of
melanocytes, but rather by the activity level of the cells.

Nodule

A nodule is considered a primary skin lesion that is 1-2 centimeters in

diameter, and is a palpable, solid mass. An example is erythema nodosum.

Oncolysis

the reduction of a tumor, or neoplastic cells. Also, the reduction of any

swelling or mass.

Papule

a primary skin lesion that is smaller than 1 centimeter in diameter and is a

papule, solid mass that may sometime vary in color. An example is a nevus,
or a wart.

Paronychia

Often a bacterial or fungal infection that affects the hands and feet in the
area where the finger or toenail meets the skin. The infection is sometimes
tender and can be acute or gradual with onset.

Petechiae

vascular skin lesions, sometimes caused by capillary leakage which allows

the red blood cells out of the blood vessels (nonblanching). Petechiae is
usually smaller than 0.5 cm.

Platyonychia

flattening of the nail bed (many times among the elderly)

Plaque

a plaque is an elevated area of skin with a relatively broad, flat surface that is
greater than 0.5 cm in diameter.

Pruritis

itching which can be caused by skin disease or and internal disorder

Purpura

red or purple discolorations of the skin (which are greater than 0.5 cm in
diameter) and are caused by internal bleeding

Pustule

a primary skin lesion that is palpable and filled with pus, an example is acne
or impetigo

Scale

a secondary skin lesion (secondary skin lesions result from changes in a

primary lesion, developing during the course of a cutaneous disease) which
is characterized by "heaped-up" keratinized cells. An example is dandruff, or
psoriasis

Seborrhea

a common skin problem that causes red, itchy rash with white scales. It can
be present in any area of the body, and is commonly called dandruff when it
is present on the scalp.

Serpiginous

a skin lesion that is characterized as "snake-like" or "creeping", and many

times leaves scar tissue in one area while it spreads to the next area. An
example is cutaneous larva migrans

Splinter

small areas of bleeding (hemorrhage) under the finger or toenails. They run

Hemorrhages

in the direction of nail growth. Splinter hemorrhages are common and are
many times an indication of underlying disease.

Telangiectasis

fine, relatively permanent dilation of superficial blood vessels (many times

capillaries)

Tumor

characterized by a primary skin lesion that is a palpable, solid mass and is

greater than 2 cm. A tumor can also be called a neoplasm in which the cells
are neoplastic (having abnormal growth)

Tzanck Test

scraping of an ulcer base to look for certain cells, such as Tzanck cells,
which are degenerated epithelial cells from the keratin layer of the skin.

Urticaria

The trigger to cause an urticaric lesion can either be allergic, or non-allergic.

It is a skin rash with dark, red, raised bumps that are often ithcy. It presents in
the form of a wheal or hive. The epidermis is not affected while the dermis
shows edema.

Varicella

commonly known as chickenpox, varicella is a virus that is extremely

contagious and produces a head-to-toe rash with red, raised, itchy lesions or
blisters that appear in waves over the course of the virus.

Vesicle

a primary skin lesion that is smaller than 1 cm in diameter, palpable and filled
with serous fluid. (ex blister, herpes simplex)

Wheal

a primary skin lesion that is characterized by a superficial area of cutaneous

edema that is caused by hives or insect bites

Zosteriform

A skin lesion that is characterized by a linear arrangement along a nerve

distribution (like in herpes zoster)

Seborrhea

Oily

Xerosis

Abnormal dryness of the skin

Pruritis

itching

Alopecia

Hair loss

Hirsutism

excessive hairiness

Mongolian spot

common variation of hyperpigmentation; blue-black to purple macular area

Cafe au lait spot

large round or oval patch of light-brown pigmentation, usually present at

birth

Harlequin color

lower half of body turns red and upper half blanches with a distinct

change

demarcation line down the midline

Erythema

common rash that appears in the first 3 to 4 days of life

toxicum

Acrocyanosis

bluish color around the lips, hands and fingernails, and feet and toenails

Cutis

transient mottling in the trunk and extremeties in response to cooler room

marmorata

temperature

Physiological

yellowing of the skin, sclera, and mucous membranes develops after 3rd or

jaundice

4th day of life

Carotenemia

produces yellow-orange color in light-skinned persons but no yellowing in

sclera or mucous membranes; comes from ingesting large amounts of foods
containing carotene

Millia

tiny white papules on cheeks, forehead, and across the nose and chin;
caused by sebum that occludes the opening of the follicles

Striae

jagged linear "stretch marks" of silver to pink color that appear during the
second trimester on abdomen, breasts, and sometimes thighs

Linea nigra

brownish black line down the midline

Cholasma

an irregular brown patch of hyperpigmentation on the face

Vascular spiders

tiny red centers with radiating branches and occur on face, neck, upper

chest, and arms

Senile lentigines

small, flat, brown macules; "liver spots"

Seborrheic

develop mostly on the trunk but also on the face and hands; looks dark,

keratosis

greasy, and "stuck on"

Actinic keratosis

lesions that are red-tan, scaly plaques that increase over the years to
become raised and roughened

sebaceous glands

produce sebum, which is forms an emulsion to retard water loss. Are

verywhere except palms and soles

exocrine glands

produce sweat

apocrine glands

produce milky secretion

Sebacous and

two glands that decrease production with age

apocrine

melanocytes

decrease in theses causes greying of hair

senile purpura

minor trauma produces dark red discolored areas due to decrease

vascularity of skin with aging

8 critical

...

characteristics

5 suspicious

asymmetry, border irreg, color variation diameter >6 (pencil eraser),

characteristics of

elevation/enlargement as an adult (abcde)

nevi

primary lesions

development as the immediate result of specific causative factors and

develop in ualtered skin.

secondary lesions

lesion develpment secondary to time, changes, scratches or infection.

Macule

a category of primary lesions - flat, color change, <1 cm and include

petechia, meales, scarlet fever, ephelides,

ephelides

a primary lesion, macule resulting from sun exposure

petechia

primary lesion, macule, which will not blanch, is tiny red or brown and
may indicate a disesae of abnormal ABNORMAL CLOTING FACTORS /
BLEEDING as seen in thrombocytopenia, sepsis, subacute endocartitis.

Papule

solid palpatable <1 cm. caused by supercial thickening of skin. Ex.:

NEVUS, MART. can coalesce to plaque

Nevus

mole

Patch

a category of primary lesions, >1 cm. Ex.- mongolian spot, cafe au lait
spot

cafe au lait spot

oval light pigmented area superior to gluteus maximus, genetic, normal.

Six or more of .1.5 cm are indicative of neurofibromatosis. p239

Plaque p 252

a category of primary lesions, disk shaped. They are papules which

have coalesced p 252Ex psoriasis, ??lichen planus- thickening litchen

like appearance 2 to scratching (p 255)

Nodule

Solid, elevated, >1 cm

Tumor

primary lesion category which is > few cm, firms, soft, deeper in dermis

Wheal

Ex MOSQUITO BITE, allergic rxn. which are superficial, raised and irreg
due to edema, transient and erythematous. Rx benedryl

Uticaria

primary lesion category in which wheels coalesce to from extensive

reaction - hives

Cyst

primary lesions category - elevated fluid filled cavity in dermis or

subdermis, (as opposed to a bullaa which is superficial or a pustule
which is pus filled)

Vescicle

primary lesion category elevated clear fluid filled cavity up 1 cm Ex:

HERPES SIMPLEX, early varicella( chicken pox), HERPES ZOSTER,
contact dermititis .

Bulla

primary lesion category >1 cm Ex: friction BLISTER, burn, THIN walled
chamber which rupurtures easily and is SUPERFICIALin dermis

Pustule

primary lesion category Ex: ACNE impetigo. Turbid PUS filled cavity

Late clubbing

nail elevation > 180 degrees indicative of COPD, Chrons

erythema

intense skin redenning 2 to excedd blood in dialated superficial

capillaries

vitiligo

patchy white spots from destruction of melanocytes

Urticara (Hives)

Coalesced wheels which ire intensely pruitic

Plaque

Papules coalesce to form _____

Hives/Urticara

Wheels coalesce to form _______

chloasma

facial hyperpigentation with pregnancy

keloid

secondary lesion, hypertrpohic scar. More common in AA, smooth,

rubbery, clawlike

pediculosis capitis

head lice. esp areound occipital area/ears

diaphoresis

profuse prespiration secondary to increased metabolic rate

Ecxema

atopic dermititis

Seborrheic

cradle cap - "greasy yellow pink lesions," absense of puritius

dermatitis

Herpes zoster

small grouped vescicles caused by varicella zoster virus common in

abdominal area of 50 yr old

Tinea pedis

ringworm of the foot

submental lymph

lymph node behind the mandible

node

superficial cervical

lymph node overlying the sternomastoid muslce

Supraclavicular

enlargement of this lymph node is bhind the clavicle is indicative of

Hotchkins

proximal

When nodes are enlarged, check the area they drain, which is ___ to
the node

epidermis

Outer layer of skin. Major ingredient is keratin. Contains melanin.

dermis

Inner supportive layer consisting mostly of connective tissue. Contains

nerves, sensory receptors, blood vessels, lymphatics, hair follicles,
sebaceous glands, and sweat glands.

subcutaneous

Adipose tissue. Stores fat, provides insulation for temperature control, aids

layer

in protection by its soft cushioning effect.

sebum

Oils and lubricates the skin and hair and forms an emulsion with water that
retards water loss from the skin.

eccrine glands

Coiled tubules that open directly onto the skin surface and produce sweat.
Mature in the 2-month-old infant.

apocrine glands

Open into the hair follicles and produce a thick, milky secretion when
emotionally or sexually stimulated. Mature in puberty.

9 functions of

protection, prevents penetration, perception, temperature regulation,

skin

identification, communication, wound repair, absorption and excretion, and

production of vitamin D.

lanugo

Fine downy hair of the newborn infant.

vernix caseosa

Thick, cheesy substance made up of sebum and shed epithelial cells on

some newborns.

chloasma

Increased pigment in the face during pregnancy.

striae

stretch marks

senile purpura

dark red discolored areas resulting from minor trauma in older adults.

ephelides

freckles

nevus

mole

junctional nevus

mole- macular only- in children and adolescents

compound nevi

mole- macular and papular. Found in young adults

cherry angiomas

small smooth slightly raised bright red dots that commonly appear on the
trunk in all adults over 30 years old.

early clubbing

angle straightens out to 180 degrees and nail base feels spongy to
palpation.

linear

dark streaks/ linear bands in the nail of dark-skinned people.

pigmentation
leukonychia

white hairline linear markings from trauma or picking at the cuticle

striata
mongolian spot

Common variation of hyperpigmentation in black, asian, american indian,

and hispanic newborns. Blue-black to purple macular area at the sacrum or
buttocks.

harlequin color

Occurs when the baby is in a side-lying position. The lower half of the body

change

turns red and the upper half blanches with a distinct demarcation line down
the midline.

erythema

common newborn rash consisting of tiny punctate, red macules and

toxicum

papules on the cheeks, trunk, chest, back, and buttocks.

caf au lait spot

Large round or oval patch of light brown pigmentation. Usually normal- but
six or more at 1.5 cm or larger are indicative of neurofibromatosis.

acrocyanosis

bluish color around the lips, hands, fingernails, feet, and toenails.

cutis marmorata

transient mottling in the trunk and extremities in response to cooler room

temperatures.

storkbite

salmon patch- flat irregularly shaped red or pink patch found on the
forehead, eyelid, or upper lip- but most commonly at the back of the neck.

milia

tiny white papules on the cheeks, forehead, and across the nose and chin
cause by sebum that occludes the opening of the follicles.

senile lentigines

liver spots- small, flat, brown macules. Clusters of melanocytes that appear
after extensive sun exposure.

keratoses

raised, thickened areas of pigmentation that look crusted, scaly, and warty.

seborrheic

look dark, greasy, and stuck on

keratosis
actinic keratosis

red-tan scaly plaques that increase over years to become raised and
roughened. Silvery white scale possible. Directly related to sun exposure.
Premalignant.

xerosis

dry skin

acrochordons

skin tags

sebaceous

raised yellow papules with a central depression

hyperplasia
annular

circular- begins in center and spreads to periphery

confluent

lesions run together

discrete

distinct individual lesions that remain separate

grouped

clusters of lesions

gyrate

twisted, coiled, spiral, snakelike

target

iris, resembles the iris of the eye... concentric rings of color in the lesions.

linear

a scratch, streak, line, or stripe

polycyclic

annular lesions grow together

zosteriform

linear arrangement along a nerve route

macule

solely a color change, flat and curcumscribed, of less than 1 cm.

papule

something you can feel- caused by superficial thickening in epidermis. < 1

cm

patch

macules larger than 1 cm

plaque

papules coalesce to form surface elevation wider than 1 cm. A plateaulike,

disk-shaped lesion

nodule

solid, elevated, hard or soft, larger than 1 cm.

wheal

superficial, raised, transient, erythematous, slightly irregular shape due to

edema

tumor

> a few centimeters in diameter. firm or soft, deeper into dermis. benign or
malignant

urticaria

hives

vesicle

elevated cavity containing free fluid up to 1 cm. Blister. clear serum flows if
ruptured

bulla

> 1 cm. Usually single chambered (unilocular). Superficial in epidermis.

Thin walled. Ruptures easily.

cyst

encapsulated fluid-filled cavity in dermis or subcutaneous layer, tensely

elevating skin.

pustule

turbid fluid (pus) in cavity. circumscribed and elevated.

crust

thickened dried out exudate

scale

compact desiccated flakes of skin

fissure

linear crack with abrupt edges. Extends into dermis. dry or moist.

erosion

scooped out but shallow depression. superficial.

ulcer

deeper depression extending into dermis. may bleed.

excoriation

self-inflicted abrasion. superficial. sometimes crusted.

atrophic scar

resulting skin level depressed with loss of tissue. a thinning of the

epidermis.

lichenification

prolonged intense scratching eventually thickens the skin and produces

tightly packed sets of papules. looks like surface of moss.

keloid

hypertrophic scar. skin level elevated by excess scar tissue.

hematoma

a bruise you can feel

contusion

bruise

port-wine stain

large, flat macular patch covering scalp or face, frequently along the
distribution of cranial nerve V.

strawberry mark

raised bright red area with well-defined borders about 2 to 3 cm in

diameter. Non-blanching.

cavernous

reddish-blue irregularly shaped solid and spongy mass of blood vessels.

hemangioma
petechiae

tiny punctate hemorrhages, 1 to 3 mm. round and discrete. dk red, purple,

or brown in color.
purpura

confluent and extensive patch of petechiae and ecchymoses >3 mm flat,

red to purple, macular hemorrhage.

tinea capitis

scalp ringworm

toxic alopecia

balding from illness or chemo

trichotillomania

traumatic self-induced hair loss- usually resulting from compulsive twisting

or plucking.

pediculosis

head lice

capitis
folliculitis

superficial infection of hair follicles

koilonychia

spoon nails

beau's lines

transverse furrow or groove in nail. Occurs with trauma that temporarily

impairs nail formation.

paronychia

red swollen tender inflammation of nail folds. acute- usually bacteria.

Chronic- usually fungal

onycholysis

slow persistant fungal infection of finger/toenails. change in color, texture,

thickness, with nail crumbling or breaking and loosening of nail plate.

habit-tic

depression down middle of nail or multiple horizontal ridges caused by

dystrophy

continuous picking of cuticle by another finger of same hand- injuring nail

base and matrix.

hirsutism

excess body hair in females forming a male sexual pattern. caused by

endocrine or metabolic dysfunction or occasionally idiopathic.