HA - Skin, hair, nails

• Pale


  • Anemia due to decreased hemoglobin, hematocrit and RBC (skin of patient will appear pale or normal color of patient is white: more on Caucasian patients – they look pale)
  • Anemia due to decreased amount of melanin (the patient will also look pale because of the white skin)
  • To know if patient is anemic: Check the conjunctiva of the patient
• Jaundiced


  • Yellowing of the skin tones
  • Sclera, oral mucosa, tongue, skin, and soles of the patient
  • Patient with liver diseases – impairment of the flow of the bile (reabsorbed by the patient's circulation and skin that will give the yellowish color of the skin, sclera, oral mucosa, tongue, and soles of patient)
• Cyanotic or Cyanosis


  • White skinned: Blue-tinged in color (perioral, nail bed and conjunctiva)
  • Dark-skinned: Blue and dull
  • Causes: bluish discoloration of skin
  • Due to cyanotic heart disease (mixture of oxygenated and deoxygenated circulating in the patient's body)
  • Manifestation due to respiratory diseases
• Acanthosis Nigricans


  • Velvety and darkening in skin folds and creases especially neck, groin, axilla
  • Obese, diabetic w/ insulin resistance
  • In chubby patients (normal)
  • Obese patients – need to check BP to know if diabetic
• Freckles


  Flat macules of pigment that appear following sun exposure (white-skinned people)
• Vitiligo


  • Depigmentation of skin due to destruction of melanocytes
  • Autoimmune disease wherein the patient's system attacking the melanocytes (whitening of skin)
• Striae


  • Stretchmarks
  • Found in the lower abdomen of pregnant women
  • Thigh, buttocks and axilla of obese patients
• Linea Nigra


  • Pregnancy line
  • Dark line that develops across the belly; during pregnancy
  • Prior to pregnancy; unnoticeable because of its light color
• Butterfly Rash


  • Also called "Malar rash"
  • Characterized by an erythematous flat or raised rash across the bridge of the nose and cheeks
  • It is frequently seen in patients with systemic lupus erythematosus
• Mongolian Spot


  • Frequently seen pigmented lesions in newborn
  • Present at birth or developed within the first few weeks of life (common in Asians and Native Americans
  • Flat, blue-gray in color or green-blue
  • Size varies (very large)
  • Common sites: sacral, gluteal, and shoulders
• Cutaneous Tag


  • Skin tags or small growth of tissues on skin surface
  • Benign and painless
  • Found anywhere in the body (usually located neck, armpit, trunk, face, and body folds)
  • Common in obese and diabetic patients
• Cutaneous Horn


  • Hard-conical projection from the skin, made of compact keratin
  • Resemble from an animal horn
  • Arise from benign, pre-cancerous or cancerous skin lesions
• Cherry Angiomas


  • Bright-red or purple spot on the skin made up of blood vessels
  • Torso, or can develop in any part of the body
• Sebborheic Keratosis


  • Brown, black, light-tan in color
  • Lesions look like waxy, scaly, razed and flaky
  • Harmless and non-contagious
• Scar


  • Red-purple in color: no-scar, healing
  • White: older scar
  • Keloid or Hypertrophic scar: thick raised scar – result of overgrowth tissue
• Mole


  • Also called "Nevus"
  • Flat or raised
  • Tan or brown
  • Less than 6mm in diameter
  • Can develop anywhere in the body
• Basal Cell Carcinoma


  • Basal cells are affected – beginning of cancer
  • Begins in the basal cell in the skin that produces new skin cells
  • Basal cells are fast replicating cells
• Squamous Cell Carcinoma


  Cancer that start at the topmost layer of the epidermis
• Melanoma


  • Most serious type of skin cancer
  • Developed in the cells that produce melanin (melanocytes: give color of the skin or pigment cells)
  • ABCDE assessment for melanoma: Asymmetry, Border, Color, Diameter, Elevation
• • Basal cell cancer – basal cells (fast dividing cells)
  • Squamous cell cancer – epidermis
  • Melanoma – pigment producing cells or melanocytes
• Macule


  Flat lesion less than 10mm
• Patch


  Flat lesion greater than 10mm
• Papule


  Raised lesion less than 10mm
• Plaque


  Raised lesion greater than 10mm
• Vesicle


  Elevated circumscribed superficial fluid-filled blister less than 10mm in diameter
• Bullae


  Large raised circumscribed blister fluid-filled greater than 10mm
• squamous cell carcinoma

  
• Melanoma (skin cancer)

  
• basal cell carcinoma

  
• pale (skin variation)

  
• jaundiced (skin variation)

  
• cyanotic/cyanosis (skin variation)

  
• acanthosis nigricans (skin variation)

  
• freckeles (skin variation)

  
• vitiligo (skin variation)

  
• striae (skin variation)

  
• linea nigra (skin variation)

  
• butterlfy rash (skin variation)

  
• mongolian spot (skin variation)

  
• cutaneous tag (skin variation)