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Mechanical barrier between the body and outside world Protects the body from infection & injury and from UV rays Body temperature regulation Sensory organ providing sensation for |
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EPIDERMIS DERMIS SUBCUTANEOUS LAYER |
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Stratum Corneum Stratum Granulosum Stratum Spinosum |
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keratin layer Non-living, horny layer Stratified layers of Keratincytes Not found in mucous membranes The Major Barrier |
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Contains keratin-forming cells Melanocytes Langerhans’ cells – found throughout epidermis Merkel’s cells |
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Blood vessels Sebaceous glands Sweat glands Hair follicles |
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Reticulin fibers Elastin fibers |
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Amorphous matrix of proteins |
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Large blood vessels Nerves Lymphatics |
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Insulation for retaining heat Shock absorber |
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Vellus hair
Terminal hair |
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Thin Inconspicuous relatively unpigmented |
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Scalp, brow, extremities, pubic, axillae coarser thicker more conspicuous typically pigmented |
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Growing phase x 2-5 yrs 85-90% of scalp hair ↓ with age/male pattern baldness |
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site where so many physical signs of generalized disease can be found |
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the cuticle = fold of skin at the proximal end of the nail |
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the fold of skin on the sides of the nail |
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hard & translucent portion, composed of keratin |
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Formed by proximal nail matrix |
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Formed by distal nail matrix (lunula) |
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the adherent connective tissue that underlies the nail |
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the crescent shaped whitish area of the nail bed (when visible) Distal nail matrix |
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fold of hard skin overlapping the base/sides |
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related to anxiety levels |
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Skin Medications and allergies |
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Skin care routines. types of cosmetics, soaps, oils, and deodorant products used. Home remedies Hair and nail care products and routines – new containers opened, new brands Detergents or changes in them |
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2 classifications of skin lesions |
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initial lesion, beginning of most skin diseases |
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subsequent lesions that develop during the evolutionary process of skin disease or are created by scratching or infection Maybe the only type of lesion present |
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types of primary skin lesions |
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Non-palpable
palpable
fluid filled
vascular (within and outside)
special |
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non palpable primary lesion |
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Papule Plaque Wheal Nodule Tumor |
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fluid filled primary lesion |
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Vesicle Bulla Pustule Cyst |
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Telangiectasia Spider angioma Venous star Capillary hemangioma Cherry angioma |
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Vascular (outside of vessel) |
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Petechia Purpura Ecchymosis |
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Comedo Burrow Abscess Furuncle Carbuncle |
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Loss of Skin Surface Material on skin surface |
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different color from surrounding tissue May have non-palpable, fine scale |
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papule nodule tumor plaque wheal |
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discrete, solid, elevated, firm circumscribed Wart or elevated moles |
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Circumscribed, elevated, solid Dermal or subdermal |
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Elevated, firm, rough lesions with flat top surface **Surface area > height Psoriasis, Seborrheic/actinic keratoses |
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Elevated, irregular-shaped area of cutaneous edema Solid, transient, variable diameter Hives or whelts Insect bites PPD |
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Shape Size Color Surface change |
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Wheals are elevated, blanched lesions which result from increased tissue fluid dispersed in the dermis. |
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raised palpable, fluid fille |
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Elevated, circumscribed Superficial, not into dermis Filled with serous fluid Varicella Herpes Zoster |
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Elevated, superficial Vesicle filled with purulent material (pus) Acne Impetigo |
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Elevated, circumscribed, encapsulated lesion Filled with liquid (purulent) or semisolid substance that is surrounded by a membranous sac |
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lesion filled with fluid and leukocytes (pus) |
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Deeper collections of pus (subdermal) |
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Visible, persistent, dilation of small superficial cutaneous blood vessels |
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Bright red Blanch with pressure to central area faintly pulsatile consists of a central arteriole with slender projections resembling spider legs |
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reddish purple discoloration |
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will turn white with pressure to central area |
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WITHIN the vessels--spider angioma |
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indication of possible liver problems |
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Most commonly found on the Face Scalp Back chest Usually gone by age ten |
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A dilated veins that form a spider like pattern Larger and darker than spider angiomas (less red and more violaceous and blue) |
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Sometimes surrounded by a pale halo Usually found on trunk |
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Caused by leakage of red blood cells out of vessels (extravasation) into skin or mucous membranes |
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vascular primary lesions outside the vessel |
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will not "blanch" with pressure |
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primary lesions outside of the vessel |
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Due to vascular inflammation in skin & extravasation of red blood cells |
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Plugged opening of sebaceouc gland with a collection of keratin & sebum |
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linear tunnel in epidermis |
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circumscribed collection of pus Infection |
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acute, very deep, hot, tender abscess/nodule Inflamed hair follicle |
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deeper interconnecting infections, coalesced, multiple furuncles that communicate |
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Thin linear papule or plaque |
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More extensive infection of hair follicle |
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Extensive infection of several adjoining hair follicles that drains with multiple openings onto the skin surface |
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loss of superficial epidermis Depressed, moist, glistening Follows rupture of vesicle or bulla Heals without scarring |
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deeper loss of both epidermis and even into dermis Concave Varies in size |
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Linear or vertical crack/split in the epidermis to the dermis Moist or dry |
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Localized loss of the epidermal |
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Depth border/shape Edge Tissue at its base |
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localized loss of epidermis and at least dermis |
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Material on skin surface: |
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Dried serum (yellow/brown), blood (black/red), purulent (yellow, yellow-green) exudates Various sizes Brown, red, black, tan, straw-colored |
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Heaped-up keratinized cells Flacky skin Irregular Thick or thin Varies in size |
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Linear erosion (hollowing out) of epidermis Crusted |
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Abrasion or scratch Scabies |
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Thin to thick fibrous tissue that replaces normal skin following injury or laceration to the dermis Collection of new fibrous connective tissue |
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Irregular-shaped, elevated, progressively enlarging scar Grows beyond boundaries of the wound Caused by extensive collagen formation during healing |
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Rough, thickened epidermis 2° persistent rubbing, itching, skin irritation Often involves flexor surfaces of extremities |
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Abnormal skin thickening of the superficial layer of the epidermis |
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Thinning of the skin surface and loss of skin margins Skin becomes translucent and paper-like |
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are superficial, often linear ulceration caused by scratching |
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englarged scar, grows beyond the boundary of the initial wound |
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Increased amount of stratum corneum |
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Never put high concentration corisone on |
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decreased redness due to lack of oxyhemoglobin |
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best seen where the horny layer of the epidermis is the thinnest |
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associated with Anemia arterial insufficiciency\ h/o fainting |
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consistent with decreased oxygenation of blood |
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