Skin lesions and shapes
Nursing skin lesions and shapes of lesions
Permanant superficial vascular dialation: spider veins, connective tissue diseases, radiation skin damage
swollen, soft by increase in water content
irregular, rough, convoluted surfaces
breakdown of small vesicles with serum over skin surface. acute dermititis
minute hemorrhagic spots that cannot be blanched
new lesion after trauma/ psoriasis
pinpoint bleeding after a scale is removed
pushing a blister causes further separation of the dermis
vesicular lesions clustered on a erythematous base
scattered lesions, diffusely arranged
unilateral arrangement of lesions in the cutaneous distribution of a nerve route/dermatome. (e.g. Herpes zoster)
round to oval with a center clearing
lesions merge into each other
Scratch, line, or stripe.
(<1cm dia.) flat primary lesion. circumscribed. e.g. Freckles flat nevi, petechiae, measles. (top right pic is a macule, bottom right is a patch)
(a macule that is >1 cm dia.) flat primary lesion. Circumscribed.
( <1cm dia.) something you can feel (elevation, solid, circumscribed). solid or cystic. primary lesion. e.g. Elevated nevus(mole), wart (verruca)
(>1cm and <2cm dia.) solid or cystic. primary. Deeper than papule. e.g. Xanthoma, fibroma, intradermal nevi.<pic _0147_2p.jpg>
(nodule >2cm dia.) solid or cystic. primary. Deeper into dermis. e.g. Hemangioma, lipoma
(papules coalesce to >1cm dia.) plateau, sometimes crusted. primary. e.g. Psoriasis (pic), lichen planus.
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
example of nodule
Encapsulated, fluid-filled cavity in dermis or subcutaneous layer. Tense, elevated skin. |e.g. Sebaceous (follicular) cyst
example of plaque
extremely dry areas of thin plates of cornified epidermal cells that form flakes on the skin; secondary.
example of scale
Superficial, raised, transient, erythematous; slightly irregular due to edema. e.g. Mosquito bite, allegic reaction, demographism.
Coalescing wheals to form extensive reaction. Intensely pruritic.
( <1cm in dia.) circumscribed, elevated. primary. serous. "blister". e.g. Herpes simplex, early varicella, herpes zoster (shingles), contact dermatitis.
example of vesicles
( >1cm vesicle) large primary vesicle. Superficial in epidermis. Usually single chambered. e.g. Friction blister, burns
primary lesion; vesicle containing purulent exudate|e.g. Impetigo, acne
(depression) loss of tissue of skin surface. Thinning of epidermis; secondary. e.g. Striae
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
dry, leathery thickening of skin as a result of repeated rubbing or scratching area; secondary lesion; chronic atopic dermatitis, neurodermatitis
erosions, linear cracks w/ abrupt edges, extends into dermis; secondary lesion
Healed wound, replaced by collagen. secondary.
dried exudate of serum, sebum, purulent material on skin surface; secondary. e.g. Impetigo, scab after abrasion, weeping eczema
Lesions run together [hives]
Distict, individual lesions that remain separate
Twisted, coil spiral, snakelike
Cluster of lesions (e.g. Vesicles of contact dermatitis)
Iris, resembles iris of eye, concentric rings of color in the lesions (e.g. Erythema multiforme)
Hyperpigmentation in Black, Asian, American Indian, and Hispanic newborns. careful not to interpret this as child abuse.
Patchy absences of melanin pigment
Asymmetry, Border irregularity, Color variation, Diameter >6cm, Elevation or Enlargement.
Cherry (Senile) angiomas
(1-5mm) smooth, lightly raised, bright red dots.
Brown-black pigmented areas, or linear bands, or streaks along edge of nail. Normal in dark skinned people, abnormal in light skinned people.
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)
Bluish color around lips, fingertips, feet, and toenails. Normal = < few hours. Persistent = cyanotic congenital heart disease.
Transient mottling in trunk and extremities. Persistent/pronounced mottling occurs Down syndrome or prematurity.
Tiny whit papules on neonate face. Sebum occluded follicle openings. Will resolve spontaneously. Advise parents not to squeeze.
Flat, irregular, red/pink patch on neonate face or neck. Fades naturally.
Neonate fine downy hair
Acne, open comedomes, stems from overactive sebaceous glands usually in adolescents.
Acne, closed comedomes. Oily buildup from overactive sebaceous glands.
Hyperpigmentation, "liver spots", small flat brown macules. Aging adults. Excess sun exposure. No treatment req.
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.
"skin tags" polyp like overgrowths of skin. Benign.
Raised, yellow pebbly looking papules. Common in men.
When skin does not readily retract upon turgor test.
Annular lesions grow together
Superficial scooped out shallow depression. Epidermis lost. Most, no bleeding. Heals w/out scarring.
Self/inflicted abrasion. Superficial. Scratches.
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.