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.