ASSESSMENT OF SKIN - LEC

• Infants/Young children


  • Skin smoother-lack of exposure to elements
  • Less subcutaneous fat, layer, poorer temperature control
  • Eccrine sweat glands secrete after 1 month
• Acronycyanosis


  • Is a persistent blue or cyanotic discoloration of the extremeties, most commonly occuring in the hands, although it also occurs in the feet and distal parts of face

  
• Transient mottling


  • Is the appearance of uneven spots

  
• Erythema toxicum


  • Characterized by blotchy red spots on the skin with overlying white or yellow papules or pustules
  • It is a common rash in neonates

  
• Harlequin sign


  • Is unilateral flushing and sweating of the face and neck usually after exposure to heat or strenous exertion

  
• Mongolian spots


  • Also known as "Mongolian blue spot", "congenital dermal melanocytosis", and "dermal melanocytosis"
  • Is a benign flat, congenital birthmark with wavy borders and irregular shape

  
• Telangiectatic nevi (stork bite)


  • Appears as a pink or tanned flat, irregularly shaped mark on the knee, back of the neck, and/or the forehead, eyelids, and sometimes, the top lip

  
• Jaundice


  • Yellowish discoloration

  
• Milia


  • Also called a milk spot or oil seed
  • Is a keratin filled cyst that can appear just under the epidermis or on the roof of the mouth
  • Are commonly associated with newborn babies but can appear on all people of all ages

  
• Adolescence

  • Apocrine glands enlarge and become more active
  • Sebaceous glands increase production causing oily skin and predisposition to acne
  • Terminal hair appears in axillae and pubic area for both sexes and on face in males
• Pregnancy


  Increased:

  • Blood flow to skin to balance heat production from increased BMR (Basal metabolic rate)
  • Eccrine sweat gland activity
  • Sebaceous gland activity
  • Fat deposits
  • Pigmentation of face, nipples, areolae, axillary, and vulva
• Older adults

  Decreased:

  • Blood flow to skin
  • Eccrine sweat glan activity
  • Sebaceous gland activity
  • Fat deposits
  • Pigmentation of skin and hair, first in whites, later in blacks and asians
  • Hair production and increase coarseness
• Asians, Latinos, Black

  • Varying Intensity of pigmentation
  • Mucous membranes pink to light brown
  • Sclera white, gray, light brown, often with pigmented spots
  • Mongolian markings common in children
  • Visible difference in pigmentation of ventral and dorsal surfaces of extremities
• Asians, Latinos, Black

  Hair

  • Vellus body hair
  • Scalp hair varies in texture
• Asian, Latinos, Black

  Skin texture

  • Limited apocrine glands (less sweat)
  • Limited sebaceous glands (less body oils)
  • Frequent washing causes increased dryness
• Asian, Latinos, Black

  Skin conditions

  • Fine colored lesions harder to see
  • Pigmentary changes due to lesions may persist for months or years
  • Licenification common with eczema
  • Hypertrophic scars and keloids common
• Whites

  • Less variation in intensity of pigmentation
  • Mucous membranes pink
  • Sclera white
• Whites

  Hair

  • Terminal hair on body common
  • Texture and color vary
• Whites

  Skin texture

  • Increased apocrine sweat glands result in increased body sweat
  • Increased sebaceous glands lubricates skin and scalp
  • Requires frequent washing
• ASSESMENT OF THE SKIN, HAIR, AND NAILS:

  • Inspection
  • Palpation
• ASSESSMENT OF SKIN

  Inspect for:

  • Lesions
  • Skin color
  • Areas of pain or itching
• ASSESSMENT OF SKIN

  Palpate for:

  • Moisture
  • Temperature
  • Texture
  • Turgor
  • Mobility
  • Capability
  • Capillary filling
  • Elevation or depression
• PRIMARY LESIONS:

  • Macule
  • Papule
  • Nodule
  • Vesicle
  • Pustule
  • Wheal
• PRIMARY LESIONS:

  -

  A) macule

  B) papule

  
• PRIMARY LESIONS:

  -

  A) nodule

  B) vesicle

  
• PRIMARY LESIONS:

  -

  A) pustule

  B) wheal

  
• Secondary lesions


  • Change in primary lesion due to external trauma
• SECONDARY LESIONS:

  • Scale
  • Scar
  • Crust or scab
  • Keloid
  • Fissures
  • Lichenification
  • Erosion
  • Atrophy
  • Excoriation
  • Ulcer
• Scale


  • Scaling skin is the loss of the outer layer of the epidermis in large

  
• Scar


  • Are areas of fibrous tissue(fibrosis) that replace normal skin after injury

  
• Crust or scab


  • The dried crusty surface of a healing skin wound or sore

  
• Keloid


  • Is a growth of extra scar tissue where the skin has healed after an injury

  
• Fissures


  • A cutaneous condition in which there is a linear-like cleavage of skin, sometimes defined as extending into dermis

  
• Lichenification


  • Hardening of the skin, usually caused by chronic irritation

  
• Erosion


  • Is a loss of some or all of the epidermis (the outer layer) leaving a denuded surface.

  
• Atrophy


  • Is a condition in which the upper layers of skin gets thin

  
• Excoriation


  • The act of abrading or wearing off the skin

  
• Ulcer


  • Is a sore on the skin or mucous membrane, accompanied by the disintegration of tissue

  
• DESCRIPTION OF LESIONS:

  Shape

  • Linear
  • Round
  • Annular (round with central clearing)
  • Oval
  • Polycyclic (interlocking circles)
  • Morbilliform (confluent, measle-like)
  • Zosteriform (dermatomal)
• DESCRIPTION OF LESION:

  -

  A) Linear Lesion