Skin The object of this presentation is to
Skin The object of this presentation is to learn and identify skin lesions.
Describe the patient’s skin.
Normal Skin • Color: brown • Normal hair • No lesions • Feel for texture, turgor, moisture and warmth.
Describe the lesion.
Normal Mole • Tan to brown color • Uniformly pigmented • Small (usually less than 6 mm across) • Solid regions of relatively flat (macules) to elevated skin (papules) • Well-defined, rounded borders
Describe skin over legs.
Chronic ITP Hyperpigmentation
Describe the lesion
Campbell’s Morgan Spots Cherry angiomas are: • Bright red in color • Small (usually 1 -4 mm) • Papules • Commonly seen on the trunk of adults • Medically insignificant
Describe the skin.
Hodgkin’s Disease • Dry • Scaly
What do you see?
Senile Purpura • Red in color • Patchy • Does not blanch on pressure • Thin skin
Describe the lesions.
Steroid Induced Purpura • Red • Patchy • Does not blanch on pressure
Describe the lesions.
Schonlein-Henoch Purpura • Ankle location • Multiple • Red • Not blanching on pressure • Less than 5 mm • Vasculitis
What type of skin lesions do you see?
Henoch-Schonlein Purpura • Multiple • Red • Not blanching on pressure • Less than 5 mm • Vasculitis
Describe the lesion.
Echymosis • Red • Large patch • Irregular edge • Changing colors • Coagulation defect
Describe the skin lesions.
Vasculitis • Multiple • Red • Not blanching on pressure • Less than 5 mm • Coalescing • Drug induced vasculitis
Describe each lesion.
Leukemia Cutis • Ulcerating lesions • Black base • Sharp edges • Surrounding echymoses • Blister • 1 cm • Fluid filled
Describe the legs in this patient with HIV.
Kaposi Sarcoma • Non-blanching red macule • Surrounding ecchymoses and acquire more of a violet hue • Lesions may become nodular
Describe the lesions.
Malignant Melanoma A: Asymmetry- one side or half does not look like the other B: Border irregularity C: Color-black, or much darker than patient's other moles, often with red, white or blue areas. D: Diameter > 6 millimeters
Describe the lesions.
Sarcoidosis • Patchy • O. 5 -1 cm in size • Different color than skin • Slightly elevated Maculo-papular lesions
Describe the skin lesions.
Sarcoidosis • Multiple • Less than 1 cm • Raised spot • Dome shaped Papular lesions
What do you see?
Sickle Cell Anemia • Over ankle • Patch • Larger than 1 cm • Thin skin • Loss of substance of skin Old scar
Interpret male patient’s nails.
Normal Nails • Transluscent • Shiny • Appears firm
Describe patient’s nails.
Doxorubicin • Transverse band • White in color
Describe patient’s nails.
Iron Deficiency Anemia • Spooning • Concave Koilonychia
Describe the scar.
Ehler’s Danlos Syndrome • Patchy • Larger than 1 cm • Thin skin • Loss of substance of skin Old widened scar
Describe the skin.
Gardner Diamond Syndrome • Multiple • Leniar wide • Thin skin Striae
Describe the lesion.
Squamous Cell Carcinoma • Ulcer • Ear lobe • Crusted lesion • Sharp margin • Indurated
What lesion is behind the ear?
Keloid (after piercing) • Very firm • Rubbery lesions • Reddish or darkly colored • Occurs after trauma (sometimes very minor trauma) • May itch
Describe the skin.
Eczema Dyshidrotic
Observe chest wall, warm. Diagnosis?
Empyema • Posterior chest wall • Red patch • Raised area • Warm • Tender
Describe patient’s chest scar.
Empyema • Posterior chest wall • Wide scar • Loss of rib Previous open drainage
Describe patient’s face.
Sezary Syndrome • Red face Erythroderma
Diagnosis?
Erythroderma Differential diagnosis includes: psoriasis, eczema, drug reaction, pityriasis rubra pilaris (PRP), seborrheic dermatitis, lymphoma, mycosis fungoides, and other dermatoses.
Painful lesions. Diagnosis?
Erythema Nodosum • Well-localized, multiple tender, red, deep nodules, 1 to 5 cm in size • Bilaterally over the pretibial areas
Painful lesions. Diagnosis?
Herpes Zoster • Rash • Along a dermatome • Blisters not seen • Crosses mid-line
Describe the lesion.
Strawberry Hemangioma • Red • Patchy • 5 cms • Elevated • Blanch with pressure Capillary angiomas composed of small, superficial vessels
Diagnosis?
Plantar Warts • Sole of foot • Multiple • Raised • Rough • Varying size • Verrucous • Skin-colored papules .
Describe the skin lesions.
Psoriasis • Larger than 1 cm • Elevated patches • Plaques • Silvery scale
Describe the lesion.
Superficial Epidermal Cyst • 5 cm • Fluid filled • Fluctuant • Orifice or "pore" near the center
What do you see?
Stasis Ulcer • Location in leg • Denuded skin • Hyper-pigmentation • Firm skin
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