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Skin
Object is for you to learn and identify skin lesions
Describe his skin
Normal skin
Color: Brown
Normal hair
No lesions
Should feel for texture, turgor, moisture and warmth
Describe the lesion
Normal Mole
• Tan to brown • 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’d morgan spots
Cherry angiomas are• Bright red • 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• Patch• Does not blanch on
pressure• Thin skin
Describe the lesions
Steroid induced purpura
• Red• Patch• Does not blanch on
pressure
Describe the lesions
Schonlein-Henoch purpura
• Ankle locaton• 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• Coalesing
Vasculitis drug induced
Describe each lesion
Leukemia cutis
• Ulcerating lesionsBlack base
Sharp edgesSurrounding echymoses
• Blister
1 cm
Fluid filled
Patient with HIV. Describe the legs
Kaposi Sarcoma
• Nonblanching red macule
• Surrounding ecchymoses and acquire more of a violet hue
• The 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
• Patch• O.5-1 cm in size• Different color than
skin• Slightly elevated
Maculo-papular lesions
Descrbe 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 his Nails
Normal
Transluscent
Shiny
Appears firm
Describe the nails
Doxorubicin
• Transeverse band• White in color
Describe the Nails
Iron deficiency anemia
• Spooning • concave
Koilonychia
Describe the scar
Ehler’s danlos syndrome
• Patch• 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
Suqmous cell carcinoma
• Ulcer• Ear lobe• Crusted lesion • Sharp margin• Indurated
What is the lesion behind Ear?
Keloid (after piercing)
• Very firm • Rubbery lesions • Reddish or darkly
colored • Occur after trauma
sometimes very minor trauma
• May itch.
Describe the skin
Eczema dyshydrotic
Chest wall. Warm. Diagnosis?
Empyema
• Posterior chest wall• Red patch• Raised area• Warm• Tender
Describe his scar in chest
Empyema
• Posterior chest wall• Wide scar• Loss of rib
Previous open drainage
Describe her 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 pre-tibial areas
Painful. Diagnosis?
Herpes Zoster
• Rash• Along a dermatome• Blisters not seen• Crosses mid-line
Describe the lesion
Strawberry hemangioma
• Red• Patch• 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