Skin lesions and shapes

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Nursing skin lesions and shapes of lesions

telangiectasia

Permanant superficial vascular dialation: spider veins, connective tissue diseases, radiation skin damage

macerated

swollen, soft by increase in water content

verrucous

irregular, rough, convoluted surfaces

oozing

breakdown of small vesicles with serum over skin surface. acute dermititis

petechiae

minute hemorrhagic spots that cannot be blanched

koebner phenomenon

new lesion after trauma/ psoriasis

auspitz's sign

pinpoint bleeding after a scale is removed

nikolsky's sign

pushing a blister causes further separation of the dermis

herpetiform

vesicular lesions clustered on a erythematous base

disseminated

scattered lesions, diffusely arranged

zosteriform

unilateral arrangement of lesions in the cutaneous distribution of a nerve route/dermatome. (e.g. Herpes zoster)

annular

round to oval with a center clearing

coalescing

lesions merge into each other

linear

Scratch, line, or stripe.

macule

(<1cm dia.) flat primary lesion. circumscribed. e.g. Freckles flat nevi, petechiae, measles. (top right pic is a macule, bottom right is a patch)

patch

(a macule that is >1 cm dia.) flat primary lesion. Circumscribed.

papule

( <1cm dia.) something you can feel (elevation, solid, circumscribed). solid or cystic. primary lesion. e.g. Elevated nevus(mole), wart (verruca)

nodule

(>1cm and <2cm dia.) solid or cystic. primary. Deeper than papule. e.g. Xanthoma, fibroma, intradermal nevi.<pic _0147_2p.jpg>

tumor

(nodule >2cm dia.) solid or cystic. primary. Deeper into dermis. e.g. Hemangioma, lipoma

plaque

(papules coalesce to >1cm dia.) plateau, sometimes crusted. primary. e.g. Psoriasis (pic), lichen planus.

erythema, purpura

examples of macules

cafe au lait spot

Large round or oval patch of light brown pigmentation, usually normal. >6 macules >1.5cm diameter indicate neurofibromatosis

dermatofibroma

example of nodule

cyst

Encapsulated, fluid-filled cavity in dermis or subcutaneous layer. Tense, elevated skin. |e.g. Sebaceous (follicular) cyst

psoriasis

example of plaque

scale

extremely dry areas of thin plates of cornified epidermal cells that form flakes on the skin; secondary.

eczema

example of scale

wheal

Superficial, raised, transient, erythematous; slightly irregular due to edema. e.g. Mosquito bite, allegic reaction, demographism.

urticaria

Coalescing wheals to form extensive reaction. Intensely pruritic.

vesicles

( <1cm in dia.) circumscribed, elevated. primary. serous. "blister". e.g. Herpes simplex, early varicella, herpes zoster (shingles), contact dermatitis.

herpes zoster

example of vesicles

bulla

( >1cm vesicle) large primary vesicle. Superficial in epidermis. Usually single chambered. e.g. Friction blister, burns

pustule

primary lesion; vesicle containing purulent exudate|e.g. Impetigo, acne

atrophic scar

(depression) loss of tissue of skin surface. Thinning of epidermis; secondary. e.g. Striae

ulcer

deep depression into dermis, crater-like, irregular. May bleed, leaves scar. secondary. e.g. pressure sore, chancre

secondary skin lesions

result of external forces: scratching, picking, healing of primary lesions

lichenification

dry, leathery thickening of skin as a result of repeated rubbing or scratching area; secondary lesion; chronic atopic dermatitis, neurodermatitis

fissures

erosions, linear cracks w/ abrupt edges, extends into dermis; secondary lesion

scar

Healed wound, replaced by collagen. secondary.

crust

dried exudate of serum, sebum, purulent material on skin surface; secondary. e.g. Impetigo, scab after abrasion, weeping eczema

Confluent

Lesions run together [hives]

Discrete

Distict, individual lesions that remain separate

Gyrate

Twisted, coil spiral, snakelike

Grouped

Cluster of lesions (e.g. Vesicles of contact dermatitis)

Target

Iris, resembles iris of eye, concentric rings of color in the lesions (e.g. Erythema multiforme)

Mongolian spot

Hyperpigmentation in Black, Asian, American Indian, and Hispanic newborns. careful not to interpret this as child abuse.

Vitiligo

Patchy absences of melanin pigment

ABCDE

Asymmetry, Border irregularity, Color variation, Diameter >6cm, Elevation or Enlargement.

Cherry (Senile) angiomas

(1-5mm) smooth, lightly raised, bright red dots.

Linear pigmentation

Brown-black pigmented areas, or linear bands, or streaks along edge of nail. Normal in dark skinned people, abnormal in light skinned people.

Leukonychia striata

Normal white hairline linear markings from trauma or picking at cuticle.

3 normal erythematous neonatal states

Beefy red flush from vasomotor instability, harlequin color change, erythema toxicum (pic)

Acrocyanosis

Bluish color around lips, fingertips, feet, and toenails. Normal = < few hours. Persistent = cyanotic congenital heart disease.

Cutis marmorata

Transient mottling in trunk and extremities. Persistent/pronounced mottling occurs Down syndrome or prematurity.

Milia

Tiny whit papules on neonate face. Sebum occluded follicle openings. Will resolve spontaneously. Advise parents not to squeeze.

Storkbite

Flat, irregular, red/pink patch on neonate face or neck. Fades naturally.

Lanugo

Neonate fine downy hair

Blackheads

Acne, open comedomes, stems from overactive sebaceous glands usually in adolescents.

Whiteheads

Acne, closed comedomes. Oily buildup from overactive sebaceous glands.

Senile lentigines

Hyperpigmentation, "liver spots", small flat brown macules. Aging adults. Excess sun exposure. No treatment req.

Keratose

Raised, thick, pigmented, look crusty, scaly, warty. |Seborrheic keratosis(pic)

Actinic (senile/solar) keratosis

Red-tan scaly plaques, progress to raised and rough. Premalignant to squamous cell carcinoma.

Acrochordons

"skin tags" polyp like overgrowths of skin. Benign.

Sebaceous hyperplasia

Raised, yellow pebbly looking papules. Common in men.

Tenting

When skin does not readily retract upon turgor test.

Polycyclic

Annular lesions grow together

Erosion

Superficial scooped out shallow depression. Epidermis lost. Most, no bleeding. Heals w/out scarring.

Excoriation

Self/inflicted abrasion. Superficial. Scratches.

Keloid

Hypertrophic scar

Decubitus ulcer (pressure ulcer)

Appear over bony prominences, from impeded blood delivery. Ischemia and cell death. Measured in 4 stages.

Stage 1 decubitus ulcer

Reddened, intact skin of decubitus ulcer stages.

Stage 2 decubitus ulcer

Partial- thickness skin erosion w/ loss of epidermis or also dermis in decubitus ulcer.

Stage 3 decubitus ulcer

Full-thickness pressure ulcer. Resembling crater. Extends into subcutaneous tissue. Can not see muscle, bone, tendon.

Stage 4 decubitus ulcer

Full-thickness pressure ulcer. Involves all skin layers, an supporting tissue. Exposed muscle, tendon, or bone. May show slough or eschar(dark necrotic tissue.

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