Skin, hair and nails

• Erosion - loss pf superficial epidermis that does not extend to the dermis. It is a depressed moist area.
• Scar (cicatrix) - skin mark after healing of wound or lesion that represents replacement by connective tissue of the injured tissue
• Ulcer - skin loss extending past epidermis, with necrotic tissue loss.
• Fissure- linear crack in the skin that may extend to the dermis and may be painful.
• Vascular skin lessions- are associated with bleeding, aging, circulatory conditions, diabetes, pregnancy, and hepatic disease, among other people.
• Petechia - round red or purple macule that is 1 to 2 mm in size. It is secondary to blood extravasation and associated with bleeding tendencies or emboli to skin
• Ecchymosis- round or irregular macular lession that is larger than petechial lession.
• Hematoma - a localized collection of blood creating an elevated ecchymosis. It is associated with trauma.
• Cherry angioma - papular and round, red or purple lesion found on the trunk or extremities. It mag be blanch with pressure.
• Spider angioma - red arteriole lesion with a central body radiating branches.
• Telangiectasis (venous star) - bluish or red lesion with varying shape found on the legs and anterior chest.
• Basal cell carcinoma, squamous cell carcinoma and melanoma is the most commonly detected skin cancer
• Mnemonic ABCDE to detect skin cancer.

  A - asymmetry

  B- borders

  C- color

  D - diameter

  E- elevated
• Linear configuration - straight line, as in a scratch or streak.
• Annular configuration - circular lesion.
• Clustered configuration - lesions grouped together.
• Discrete configuration- individual and distinct lesions.
• Nummular configuration- coin- shaped lesions.
• Confluent configuration - smaller lesions run together to form larger lesions.
• Common nail disorder:


  Longitudinal ridging

  Half- and- half nails

  Pitting

  Koilonychia

  Yellow nail syndrome

  Paronychia
• Longitudinal ridging - parallel ridges running lengthwise.
• Half and half nails- are white on the upper proximal half and pink on the distal half.
• Pitting - seen with psoriasis
• Koilonychia - spoon- shaped nails may be seen with trauma to cuticles or nail folds or in iron deficiency anemia, or endocrine or cardiac disease
• Yellow nail syndrome - local infection
• Primary skin lesions 


  Macule and patch

  Papule and plaque

  Nodule and tumor

  Vesicles

  bulla

  Wheal

  Pustule

  Cyst
• Generalized - distributed all over the body
• Regionalized - limited to one are of the body
• Localized - sharply limited to a specific area
• Shattered - dispersed either density or widely
• Intertriginous - limited to areas where skin comes in contact with itself.
• Exposed area - limited areas exposed to the air or sun
• Lesion distribution 


  Generalized

  Regionalized

  Localized

  Shattered

  Exposed area

  Intertriginous
• Lesion shapes 


  Poscoid

  Annular

  Target (bull's eye)
• Poscoid - round or oval
• Annular - circular with central cleaning
• Target (bull's eye) - annular with central internal activity