Skin

Object is for you to learn and identify skin lesions

Describe his skin

Normal skin

Color: Brown Normal hair No lesionsShould 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 colorsCoagulation defect

Describe the skin lesions

Vasculitis

• Multiple• Red• Not blanching on

pressure• Less than 5 mm• CoalesingVasculitis drug induced

Describe each lesion

Leukemia cutis

• Ulcerating lesionsBlack base

Sharp edgesSurrounding echymoses

• Blister1 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 irregularityC: 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

skinOld scar

Interpret his Nails

Normal

TransluscentShinyAppears firm

Describe the nails

Doxorubicin

• Transeverse band• White in color

Describe the Nails

Iron deficiency anemia

• Spooning • concaveKoilonychia

Describe the scar

Ehler’s danlos syndrome

• Patch• larger than 1 cm• Thin skin• Loss of substance of

skinOld widened scar

Describe the skin

Gardner Diamond syndrome

• Multiple• Leniar wide• Thin skinStriae

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 ribPrevious open drainage

Describe her face

Sezary syndrome

• Red faceErythroderma

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 pressureCapillary 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 cmElevated patchesPlaquesSilvery 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