173 terms

PE ch 6; skin

STUDY
PLAY

Terms in this set (...)

Tinea Versicolor
Common superficial fungal infection of the skin, causing hypopigmented, slightly scaly macules on the trunk, neck, and upper arms (short-sleeved shirt distribution). They are easier to see in darker skin and in some are more obvious after tanning. In lighter skin, macules may look reddish or tan instead of pale.
Vitiligo
In vitiligo, depigmented macules appear on the face, hands, feet, extensor surfaces, and other regions and may coalesce into extensive areas that lack melanin. The brown pigment is normal skin color; the pale areas are vitiligo. The condition may be hereditary. These changes may be distressing to the patient.
Cyanosis
Cyanosis is the somewhat bluish color that is visible in these toenails and toes. Compare this color with the normally pink fingernails and fingers of the same patient. Impaired venous return in the leg caused this example of peripheral cyanosis. Cyanosis, especially when slight, may be hard to distinguish from normal skin color.
Jaundice
Jaundice makes the skin diffusely yellow. Contrast this patient's skin color with the examiner's hand. Jaundice is seen most easily and reliably in the sclera, as shown here. It may also be visible in mucous membranes. Causes include liver disease and hemolysis of red blood cells.
Carotenemia
The yellowish palm of carotenemia is compared with a normally pink palm, sometimes a subtle finding. Unlike jaundice, carotenemia does not affect the sclera, which remains white. The cause is a diet high in carrots and other yellow vegetables or fruits. Carotenemia is not harmful but indicates the need for assessing dietary intake.
Erythema
Red hue, increased blood flow, seen here as the "slapped cheeks" of erythema infectiosum ("fifth disease").
Heliotrope
Violaceous eruption over the eyelids in the collagen vascular disease dermatomyositis.
Psoriasis
Silvery scaly lesions, mainly on the extensor surfaces
Pityriasis Rosea
Reddish oval ringworm-like lesions
Atopic Eczema
Appears mainly on flexor surfaces
causes of itching
dry skin, aging, pregnancy, uremia, jaundice, lymphomas and leukemia, drug reaction, and lice.
Basal cell carcinoma
in the lowest, or basal, level of the epidermis, accounts for approximately 80% of skin cancers. These cancers arise in sun-exposed areas, usually on the head and neck. They are pearly white and translucent, tend to grow slowly, and rarely metastasize
Squamous cell carcinoma
in the upper layer of the epidermis, accounts for approximately 16% of skin cancers. These cancers are often crusted and scaly with a red inflamed or ulcerated appearance; they can metastasize.
Melanoma
arising from the pigment-producing melanocytes in the epidermis that give the skin its color, accounts for approximately 4% of skin cancers and is the most lethal type. Although rare, melanomas are the most rapidly increasing U.S. malignancy. Lifetime risk for melanoma in men is 1 in 49, and in women is 1 in 73.4 Melanomas can spread rapidly to the lymph system and internal organs, and they cause 80% of deaths from skin cancer.5 Mortality rates are highest in white men, approximately 3.6% per year, possibly because of lower "skin awareness" and lower rates of self-examination
causes of generalized pallor (white color)
Pallor results from decreased redness in anemia and decreased blood flow, as occurs in fainting or arterial insufficiency; albinism
causes of central cyanosis
advanced lung disease, congenital heart disease, and hemoglobinopathies (it is best ID-ed in the lips, oral mucosa and tongue; the lips may turn blue in the cold and melanin in the lips may stimulate cyanosis in darker-skinned people)
causes of peripheral cyanosis
hypoxia; CHF (reflects decresed BF), PE (could be central too), venous obstruction
where to inspect for jaundice
sclera, palpebral conjuctiva, lips, hard palate, undersurface of the tongue, tympanic membrane and skin; to see more easily in the lips, blanch out the red color by pressure
what does jaundice suggest?
hyperbilirubinemia; liver disease or excessive hemolysis of RBCs
Carotenemia
excessive levels of carotene (seen in palms, soles, face)
decreased motility of skin indicates what?
edema; scleroderma
decreased turgor of skin indicates?
dehydration
ecrine sweat glands
widely distributed; control body temp
apocrine sweat glands
axillary and genital regions; responsible for BO
melain pigment
brown color
oxyhemoglobin pigment
red from arteries with oxygenated blood
deoxyhemoglobin pigment
blue from veins carrying deoxygenated blood
what does generalized hyperpigmentation (brown coloring of skin) indicate?
pituitary, adrenal or liver disfunction
what does generalized red coloring skin (erythema) indicate?
polycythemia, carbon monoxide, drug reactions, exanthem (rash caused by viruses)
what does red localized skin indicate?
inflammation; hemangioma (plethora of blood vessels)
what does brown localized skin suggest?
nevi, café au lait (hyperpigmentation - opposite of vitiligo), melanoma
macule
small, flat spot, up to 1.0 cm
patch
flat spot, 1.0 cm or larger
plaque
elevated superficial lesion 1.0 cm or larger, often formed by coalescence of plaques
papules
Up to 1.0 cm
cyst
Nodule filled with expressible material, either liquid or semisolid
vesicle
Up to 1.0 cm; filled with serous fluid
nodule
Marble-like lesion larger than 0.5 cm, often deeper and firmer than a papule
wheal
A somewhat irregular, relatively transient, superficial area of localized skin edema
bulla
1.0 cm or larger; filled with serous fluid
pustule
Filled with pus
burrow
(scabies)—A minute, slightly raised tunnel in the epidermis, commonly found on the finger webs and on the sides of the fingers. It looks like a short (5-15 mm), linear or curved gray line and may end in a tiny vesicle. Skin lesions include small papules, pustules, lichenified areas, and excoriations. With a magnifying lens, look for the burrow of the mite that causes scabies.
scale
A thin flake of dead exfoliated epidermis.
crust
The dried residue of skin exudates such as serum, pus, or blood
scar
Connective tissue that arises from injury or disease
erosion
Nonscarring loss of the superficial epidermis; surface is moist but does not bleed
excoriation
Linear or punctate erosions caused by scratching
fissure
A linear crack in the skin, often resulting from excessive dryness
ulcer
A deeper loss of epidermis and dermis; may bleed and scar
nevi
mole
comedo
pimple
vellus hair
short, fine, inconspicuous hair
terminal hair
coarse, thick, pigmented hair (eyebrows, hair a-top a head)
Addison's disease
Hyperpigmentation of skin and mucous membranes
AIDS
Hairy leukoplakia, Kaposi's sarcoma, herpes simplex virus (HSV), human papillomavirus (HPV), cytomegalovirus (CMV), molluscum contagiosum, mycobacterial skin infections, candidiasis and other cutaneous fungal infections, oral and anal squamous cell carcinoma, acquired ichthyosis, bacterial abscesses, psoriasis (often severe), erythroderma, seborrheic dermatitis (often severe)
Chronic renal disease
Pallor, xerosis, pruritus, hyperpigmentation, uremic frost, metastatic calcification in the skin, calciphylaxis, "half and half" nails, hemodialysis-related skin disease
CREST syndrome
Calcinosis, Raynaud's phenomenon, sclerodactyly, telangiectasias
Crohn's disease
Erythema nodosum, pyoderma gangrenosum, enterocutaneous fistulas, aphthous ulcers
Cushing's disease
Striae, skin atrophy, purpura, ecchymoses, telangiectasias, acne, moon facies, buffalo hump, hypertrichosis
Dermatomyositis
Heliotrope rash, Gottron's papules, periungual telangiectasias, alopecia, poikiloderma in sun-exposed areas, Raynaud's phenomenon
Diabetes
Necrobiosis lipoidica diabeticorum, diabetic bullae, diabetic dermopathy, granuloma annulare, acanthosis nigricans, candidiasis, neuropathic ulcers, eruptive xanthomas, peripheral vascular disease
Disseminated intravascular coagulation
Skin necrosis, petechiae, ecchymoses, hemorrhagic bullae, purpura fulminans
Dyslipidemias
Xanthomas (tendon, eruptive, and tuberous), xanthelasma (may occur in healthy people)
Gonococcemia
Erythematous macules to hemorrhagic pustules; lesions in acral distribution that can involve palms and soles
Hemochromatosis
Skin bronzing and hyperpigmentation
Hypothyroidism
Dry, rough, and pale skin; coarse and brittle hair; myxedema; alopecia (lateral third of the eyebrows to diffuse); skin cool to touch; thin and brittle nails
Hyperthyroidism
Warm, moist, soft, and velvety skin; thin and fine hair; alopecia; vitiligo; pretibial myxedema (in Graves' disease); hyperpigmentation (local or generalized)
Infective endocarditis
Janeway lesions, Osler nodes, splinter hemorrhages, petechiae
Liver disease
Jaundice, spider angiomas and other telangiectasias, palmar erythema, Terry's nails, pruritus, purpura, caput medusae
Meningococcemia
Pink macules and papules, petechiae, hemorrhagic petechiae, hemorrhagic bullae, purpura fulminans
Neurofibromatoses 1 (von Recklinghausen's syndrome)
Neurofibromas , café au lait, freckling in the axillary and inguinal areas, plexiform neurofibroma
Pancreatitis (hemorrhagic)
Grey Turner sign (bruising of the flanks), Cullen's sign (superficial edema and bruising in the subcutaneous fatty tissue around the umbilicus), panniculitis (group of diseases- inflammation of subcutaneous adipose tissue)
Pancreatic carcinoma
Panniculitis, migratory thrombophlebitis (phlebitis=vein inflammation; related to a thrombus (blood clot))
Peripheral vascular disease
Dry, scaly, shiny atrophic skin; dystrophic, brittle toenails; cool skin; hairless shins; ulcers; pallor; cyanosis; gangrene
Pregnancy (physiologic changes)
Melasma, increased pigmentation of areolae, linea nigra, palmar erythema, varicose veins, striae, spider angiomas,hirsutism, pyogenic granuloma
Reiter's syndrome
Psoriasis-like skin and mucous membrane lesions, keratoderma blennorrhagicum, balanitis circinata
Rheumatoid arthritis
Vasculitis, Raynaud's phenomenon, rheumatoid nodules, pyoderma gangrenosum, rheumatoid papules, erythematous to salmon-colored rashes
Rocky Mountain spotted fever
Erythematous rash that begins on wrists and ankles, then spreads to palms and soles; becomes more purpuric as it generalizes
Scleroderma
Thickened, taut, and shiny skin; ulcerations and pitted scars on fingertips; sclerodactyly; telangiectasias; Raynaud's phenomenon
Sickle cell
Jaundice, leg ulcers (malleolar regions), pallor
Syphilis
1°: Chancre (painless) (see p. 516)
2°: Rash ("the great imitator")—ham- to bronze-colored, generalized, maculopapular rash that involves the palms and soles, pustules, condylomata lata, alopecia ("motheaten"), white plaques on oral and genital mucosa
3°: Gummas, granulomas
Systemic lupus erythematosus
Photosensitivity, malar (butterfly) rash, discoid rash, alopecia, vasculitis, oral ulcers, Raynaud's phenomenon
Thrombocytopenic purpura
Petechiae, ecchymoses
Tuberous sclerosis
Adenoma sebaceum (angiofibromas), ash-leaf spots, shagreen patch, perungual fibromas
Ulcerative colitis
Erythema nodosum, pyoderma gangrenosum
Roseola infantum (HSV 6)
Erythematous, maculopapular, discrete rash (often fever present) that begins on head and spreads to involve trunk and extremities, petechiae on soft palate
Rubella (German measles)
Erythematous, maculopapular, discrete rash (often fever present) that begins on head and spreads to involve trunk and extremities, petechiae on soft palate
Rubeola (measles)
Erythematous, maculopapular rash that begins on head and spreads to involve trunk and extremities (lesions become confluent on face and trunk, but are discrete on extremities), Koplik spots on buccal mucosa
Varicella (chickenpox)
Generalized, pruritic, vesicular (vesicles on an erythematous base, "dewdrop on a rose petal") rash begins on trunk and spreads peripherally, lesions appear in crops and are in different stages of healing
Herpes zoster (shingles)
Pruritic, vesicular rash (vesicles on an erythematous base) in a dermatomal distributio
cafe-au-lait
A slightly but uniformly pigmented macule or patch with a somewhat irregular border, usually 0.5 to 1.5 cm in diameter; benign. Six or more such spots, each with a diameter of >1.5 cm, however, suggest neurofibromatosis (p. 188). (The small, darker macules are unrelated.)
causes of itching
dry skin, aging, pregnancy, uremia, jaundice, lymphomas and leukemia, drug reaction, and lice.
Basal cell carcinoma
in the lowest, or basal, level of the epidermis, accounts for approximately 80% of skin cancers. These cancers arise in sun-exposed areas, usually on the head and neck. They are pearly white and translucent, tend to grow slowly, and rarely metastasize
Squamous cell carcinoma
in the upper layer of the epidermis, accounts for approximately 16% of skin cancers. These cancers are often crusted and scaly with a red inflamed or ulcerated appearance; they can metastasize.
Melanoma
arising from the pigment-producing melanocytes in the epidermis that give the skin its color, accounts for approximately 4% of skin cancers and is the most lethal type. Although rare, melanomas are the most rapidly increasing U.S. malignancy. Lifetime risk for melanoma in men is 1 in 49, and in women is 1 in 73.4 Melanomas can spread rapidly to the lymph system and internal organs, and they cause 80% of deaths from skin cancer.5 Mortality rates are highest in white men, approximately 3.6% per year, possibly because of lower "skin awareness" and lower rates of self-examination
causes of generalized pallor (white color)
Pallor results from decreased redness in anemia and decreased blood flow, as occurs in fainting or arterial insufficiency; albinism
causes of central cyanosis
advanced lung disease, congenital heart disease, and hemoglobinopathies (it is best ID-ed in the lips, oral mucosa and tongue; the lips may turn blue in the cold and melanin in the lips may stimulate cyanosis in darker-skinned people)
causes of peripheral cyanosis
hypoxia; CHF (reflects decresed BF), PE (could be central too), venous obstruction
where to inspect for jaundice
sclera, palpebral conjuctiva, lips, hard palate, undersurface of the tongue, tympanic membrane and skin; to see more easily in the lips, blanch out the red color by pressure
what does jaundice suggest?
hyperbilirubinemia; liver disease or excessive hemolysis of RBCs
Carotenemia
excessive levels of carotene (seen in palms, soles, face)
decreased motility of skin indicates what?
edema; scleroderma
decreased turgor of skin indicates?
dehydration
ecrine sweat glands
widely distributed; control body temp
apocrine sweat glands
axillary and genital regions; responsible for BO
melain pigment
brown color
oxyhemoglobin pigment
red from arteries with oxygenated blood
deoxyhemoglobin pigment
blue from veins carrying deoxygenated blood
what does generalized hyperpigmentation (brown coloring of skin) indicate?
pituitary, adrenal or liver disfunction
what does generalized red coloring skin (erythema) indicate?
polycythemia, carbon monoxide, drug reactions, exanthem (rash caused by viruses)
what does red localized skin indicate?
inflammation; hemangioma (plethora of blood vessels)
what does brown localized skin suggest?
nevi, café au lait (hyperpigmentation - opposite of vitiligo), melanoma
nevi
mole
comedo
pimple
keloid
Hypertrophic scarring that extends beyond the borders of the initiating injury
vellus hair
short, fine, inconspicuous hair
terminal hair
coarse, thick, pigmented hair (eyebrows, hair a-top a head)
Addison's disease
Hyperpigmentation of skin and mucous membranes
AIDS
Hairy leukoplakia, Kaposi's sarcoma, herpes simplex virus (HSV), human papillomavirus (HPV), cytomegalovirus (CMV), molluscum contagiosum, mycobacterial skin infections, candidiasis and other cutaneous fungal infections, oral and anal squamous cell carcinoma, acquired ichthyosis, bacterial abscesses, psoriasis (often severe), erythroderma, seborrheic dermatitis (often severe)
Chronic renal disease
Pallor, xerosis, pruritus, hyperpigmentation, uremic frost, metastatic calcification in the skin, calciphylaxis, "half and half" nails, hemodialysis-related skin disease
CREST syndrome
Calcinosis, Raynaud's phenomenon, sclerodactyly, telangiectasias
Crohn's disease
Erythema nodosum, pyoderma gangrenosum, enterocutaneous fistulas, aphthous ulcers
Cushing's disease
Striae, skin atrophy, purpura, ecchymoses, telangiectasias, acne, moon facies, buffalo hump, hypertrichosis
Dermatomyositis
Heliotrope rash, Gottron's papules, periungual telangiectasias, alopecia, poikiloderma in sun-exposed areas, Raynaud's phenomenon
Diabetes
Necrobiosis lipoidica diabeticorum, diabetic bullae, diabetic dermopathy, granuloma annulare, acanthosis nigricans, candidiasis, neuropathic ulcers, eruptive xanthomas, peripheral vascular disease
Disseminated intravascular coagulation
Skin necrosis, petechiae, ecchymoses, hemorrhagic bullae, purpura fulminans
Dyslipidemias
Xanthomas (tendon, eruptive, and tuberous), xanthelasma (may occur in healthy people)
Gonococcemia
Erythematous macules to hemorrhagic pustules; lesions in acral distribution that can involve palms and soles
Hemochromatosis
Skin bronzing and hyperpigmentation
Hypothyroidism
Dry, rough, and pale skin; coarse and brittle hair; myxedema; alopecia (lateral third of the eyebrows to diffuse); skin cool to touch; thin and brittle nails
Hyperthyroidism
Warm, moist, soft, and velvety skin; thin and fine hair; alopecia; vitiligo; pretibial myxedema (in Graves' disease); hyperpigmentation (local or generalized)
Infective endocarditis
Janeway lesions, Osler nodes, splinter hemorrhages, petechiae
Kawasaki disease
Mucosal erythema (lips, tongue, and pharynx), strawberry tongue, cherry red lips, polymorphous rash (primarily on trunk), erythema of palms and soles with later desquamation of fingertips
Liver disease
Jaundice, spider angiomas and other telangiectasias, palmar erythema, Terry's nails, pruritus, purpura, caput medusae
Leukemia/lymphoma
Pallor, exfoliative erythroderma, nodules, petechiae, ecchymoses, pruritus, vasculitis, pyoderma gangrenosum, bullous diseases
Meningococcemia
Pink macules and papules, petechiae, hemorrhagic petechiae, hemorrhagic bullae, purpura fulminans
Neurofibromatoses 1 (von Recklinghausen's syndrome)
Neurofibromas, café au lait, freckling in the axillary and inguinal areas, plexiform neurofibroma
Pancreatitis (hemorrhagic)
Grey Turner sign, Cullen's sign, panniculitis
Pancreatic carcinoma
Panniculitis, migratory thrombophlebitis
Peripheral vascular disease
Dry, scaly, shiny atrophic skin; dystrophic, brittle toenails; cool skin; hairless shins; ulcers; pallor; cyanosis; gangrene
Pregnancy (physiologic changes)
Melasma, increased pigmentation of areolae, linea nigra, palmar erythema, varicose veins, striae, spider angiomas,hirsutism, pyogenic granuloma
Reiter's syndrome
Psoriasis-like skin and mucous membrane lesions, keratoderma blennorrhagicum, balanitis circinata
Rheumatoid arthritis
Vasculitis, Raynaud's phenomenon, rheumatoid nodules, pyoderma gangrenosum, rheumatoid papules, erythematous to salmon-colored rashes
Rocky Mountain spotted fever
Erythematous rash that begins on wrists and ankles, then spreads to palms and soles; becomes more purpuric as it generalizes
Scleroderma
Thickened, taut, and shiny skin; ulcerations and pitted scars on fingertips; sclerodactyly; telangiectasias; Raynaud's phenomenon
Sickle cell
Jaundice, leg ulcers (malleolar regions), pallor
Syphilis
1°: Chancre (painless) (see p. 516)
2°: Rash ("the great imitator")—ham- to bronze-colored, generalized, maculopapular rash that involves the palms and soles, pustules, condylomata lata, alopecia ("motheaten"), white plaques on oral and genital mucosa
3°: Gummas, granulomas
Systemic lupus erythematosus
Photosensitivity, malar (butterfly) rash, discoid rash, alopecia, vasculitis, oral ulcers, Raynaud's phenomenon
Thrombocytopenic purpura
Petechiae, ecchymoses
Tuberous sclerosis
Adenoma sebaceum (angiofibromas), ash-leaf spots, shagreen patch, perungual fibromas
Ulcerative colitis
Erythema nodosum, pyoderma gangrenosum
Roseola infantum (HSV 6)
Erythematous, maculopapular, discrete rash (often fever present) that begins on head and spreads to involve trunk and extremities, petechiae on soft palate
Rubella (German measles)
Erythematous, maculopapular, discrete rash (often fever present) that begins on head and spreads to involve trunk and extremities, petechiae on soft palate
Rubeola (measles)
Erythematous, maculopapular rash that begins on head and spreads to involve trunk and extremities (lesions become confluent on face and trunk, but are discrete on extremities), Koplik spots on buccal mucosa
Varicella (chickenpox)
Generalized, pruritic, vesicular (vesicles on an erythematous base, "dewdrop on a rose petal") rash begins on trunk and spreads peripherally, lesions appear in crops and are in different stages of healing
Herpes zoster (shingles)
Pruritic, vesicular rash (vesicles on an erythematous base) in a dermatomal distributio
Trichotillomania
Hair loss from pulling, plucking, or twisting hair. Hair shafts are broken and of varying lengths. More common in children, often in settings of family or psychosocial stress.
Tinea Capitis ("Ringworm")
Round scaling patches of alopecia. Hairs are broken off close to the surface of the scalp. Usually caused by fungal infection from tinea tonsurans.Mimics seborrheic dermatitis.
Paronychia
A superficial infection of the proximal and lateral nail folds adjacent to the nail plate. The nail folds are often red, swollen, and tender. Represents the most common infection of the hand, usually from Staphylococcus aureus orStreptococcus species, and may spread until it completely surrounds the nail plate. Creates a felon if it extends into the pulp space of the finger. Arises from local trauma due to nail biting, manicuring, or frequent hand immersion in water.
Clubbing of the Fingers
Clinically a bulbous swelling of the soft tissue at the nail base, with loss of the normal angle between the nail and the proximal nail fold. The angle increases to 180° or more, and the nail bed feels spongy or floating. The mechanism is still unknown but involves vasodilatation with increased blood flow to the distal portion of the digits and changes in connective tissue, possibly from hypoxia, changes in innervation, genetics, or a platelet-derived growth factor from fragments of platelet clumps. Seen in congenital heart disease, interstitial lung disease and lung cancer, inflammatory bowel diseases, and malignancies
Onycholysis
A painless separation of the whitened opaque nail plate from the pinker translucent nail bed. Starts distally and progresses proximally, enlarging the free edge of the nail. Local causes include trauma from excess manicuring, psoriasis, fungal infection, and allergic reactions to nail cosmetics. Systemic causes include diabetes, anemia, photosensitive drug reactions, hyperthyroidism, peripheral ischemia, bronchiectasis, and syphilis.
Terry's Nails
Nail plate turns white with a ground-glass appearance, a distal band of reddish brown, and obliteration of the lunula. Commonly affects all fingers, although may appear in only one finger. Seen in liver disease, usually cirrhosis, congestive heart failure, and diabetes. May arise from decreased vascularity and increased connective tissue in nail bed.
White Spots (Leukonychia)
Trauma to the nails is commonly followed by nonuniform white spots that grow slowly out with the nail. Spots in the pattern illustrated are typical of overly vigorous and repeated manicuring. The curves in this example resemble the curve of the cuticle and proximal nail fold.
Transverse White Bands (Mees' Lines)
Curving transverse white bands that cross the nail parallel to the lunula. Arising from the disrupted matrix of the proximal nail, they vary in width and move distally as the nail grows out. Seen in arsenic poisoning, heart failure, Hodgkin's disease, chemotherapy, carbon monoxide poisoning, and leprosy
Transverse Linear Depressions (Beau's Lines)
Transverse depressions of the nail plates, usually bilateral, resulting from temporary disruption of proximal nail growth from systemic illness. As with Mees' lines, timing of the illness may be estimated by measuring the distance from the line to the nail bed (nails grow approximately 1 mm every 6 to 10 days). Seen in severe illness, trauma, and cold exposure if Raynaud's disease is present
Pitting
Punctate depressions of the nail plate caused by defective layering of the superficial nail plate by the proximal nail matrix. Usually associated with psoriasis but also seen in Reiter's syndrome, sarcoidosis, alopecia areata, and localized atopic or chemical dermatiti
Actinic Keratosis
Superficial, flattened papules covered by a dry scale. Often multiple; can be round or irregular; pink, tan, or grayish. Appear on sun-exposed skin of older, fair-skinned people. Though benign, 1 of every 1000 per year develop into squamous cell carcinoma (suggested by rapid growth, induration, redness at the base, and ulceration). Keratoses on face and hand, typical locations, are shown.
Seborrheic Keratosis
Common, benign, yellowish to brown raised lesions that feel slightly greasy and velvety or warty and have a "stuck on" appearance. Typically multiple and symmetrically distributed on the trunk of older people, but may also appear on the face and elsewhere. In black people, often younger women, may appear as small, deeply pigmented papules on the cheeks and temples (dermatosis papulosa nigra).
linear skin lesion
Example: Linear epidermal nevus
geographic skin lesion
Example: Mycosis fungoides
Serpiginous skin lesion
Example: Tinea corporis
Annular skin lesion
Example: Annular lesion of tinea faciale (ringworm)
ABCDs of melanoma
ASYMMETRY

Irregular BORDERS, especially notching

Variation in COLOR, especially mixtures of black, blue, and red

DIAMETER > 6mm