Assessing the skin

Mr. Jhessie L. Abella, RN, RM, MAN

Assessing the SKIN

PRIMARY SKIN LESIONPrimary lesions are those objective lesions with which coetaneous or skin diseases begin. This type of skin lesion may continue as such or may undergo modification, passing into the secondary or consecutive skin lesions.

MACULEThe lesion appears circular

small and flat spot that is less than

in (1mm to 1 cm) in diameter

and withthe color not the same as that

of nearby skin. It has in different

shapes usually red, brown, and white.

Flat moles, measles, petechiae and

freckles are the examples of macule.

Macule that is more than in (1 cm) in diameter is called a patch; it

has an irregular in shape.

VESICLEA raised lesion that is less

than in (0.5 cm) across. Lesions are

round or oval in shape with thin mass

filled with serous blood or clear

fluid. Herpes simplex, burn blister

and early chicken pox are

examples of vesicle. Bullae are another

example of vesicle that is more than in

(5 mm) across. Lesions are

cause by chemical burn, exposure to

sunlight, insect bites or viral infection.

PUSTULEA raised vesicle or bulla

lesion filled with pus. Infection is the

primary cause. Acne vulgaris,

impetigo and boils are examples.

PAPULE A solid elevated skin lesion

less than in (1 cm) across. Lesions are

rough in texture and usually color

pink, red and brown. This lesion is

associated with psoriasis, skin cancer,

actinic keratosis, and syphilis. Warts,

acne, pimples and elevated moles

are examples.

NODULEA solid elevated lesion that

has edges and area 0.5 to 2 cm.

Physician describes this as "palpable,"

where hard mass is felt from the

tissue surrounding it. The size of the nodule is more than 2 cm in diameter. The other term is

tumor which is associated with

lipomas, and keratinous. malignant melanoma and hemangioma

are examples.

WHEAL

A red swelling skin itchy lesion and

localized edema. Lesion is usually

cause by an allergic reaction, insect

bites or reaction from drugs. Hives,

urticaria and mosquito bites are

examples.

TELANGLECTASIA

A dilated small blood vessels in the

surface of the skin. It is often manifestation of certain

diseases such scleroderma or rosacea.

PLAQUE

A patch of closely grouped papules more than in (1 cm) across. Lesions are rough in texture and color brown, red, or pink. The

size is larger than 1 cm. Rubeola and psoriasis are

examples.

CYSTElevated skin lesion and encapsulated filled with fluid.

The size is 1 cm or larger.

Epidermoid and sebaceous cyst and

chalazion of the eyelid or meibomian

gland lipogranuloma are examples.

SECONDARY SKIN LESION

Skin lesion is an alteration in the integumentary system or skin. There are in two forms, the primary skin lesion and secondary skin lesion. Secondary skin lesions are not initially appears; usually result from a trauma or chronic infection.

SCALEThickened epidermal cell

that flake off

CRUSTDried serum or pus on the

skin surface.

FISSURE

Click icon to add picture

A Linear crack.

EROSION


Loss of all or part of the epidermis

EXCORIATION


Linear or hollowed out crusted area exposing dermis

ATROPHY


A decreased in the volume of the epidermis

SCAR


A formation of connective tissue

ULCER


An excavation extending into the dermis or below

KELOID


LICHENIFICATION


A distinctive thickening of skin that is characterized by accenuated skin-

fold markings.

THE NAILS

A Paronychia is an infection around the nail. Many organisms can cause a paronychia. This particular case is caused by the yeast-like organism Candida. Note the inflammation (red, swollen area) at the base of the nail and the changes that are apparent in the nail itself.

Nails may exhibit many different abnormalities. In the

condition known as Koilonychia, the nails are flattened and have concavities. This condition may be

associated with iron deficiency.

In Onycholysis the nails become loose. They may even detach from the nail bed. When not held firmly in place, the nails are rapidly damaged and debris collects

beneath them.

White nail syndrome may also be called

leukonychia. Leukonychia can occur with arsenic poisoning, heart disease, renal failure, pneumonia, or

hypoalbuminemia.

Yellow nail syndrome is characterized by yellow nails that lack a cuticle, grow slowly, and are loose or detached (onycholysis). Yellow nail syndrome is most commonly associated with lung disorders, and with

lymphedema.

Half and Half Nails

Yellow nail syndrome is characterized by yellow nails that lack a cuticle, grow slowly, and are loose or detached (onycholysis). Yellow nail syndrome is most commonly associated with lung disorders, and with

lymphedema.

CLUBBING is a condition in which the angle between the nails and the nail bed is 180 degree or greater.

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Assessing the skin