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PHYSICAL DIAGNOSIS OF THE SKIN PowerPoint Presentation

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Description : PHYSICAL DIAGNOSIS OF SKIN LECTURED IN MY UNIVERSITY

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Published on : Mar 19, 2021 | Views : 1507 | Downloads : 7

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PHYSICAL DIAGNOSIS OF THE SKIN
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SKIN Heaviest organ (16% Body weight) Homeostasis Provides boundary Modulates Body Temperature Synthesize Vitamin D
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SKIN Layers (epidermis, dermis, subcutaneous) Appendages ( Hair, nails, sebaceous glands, sweat glands)
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COMMON OR CONCERNING SYMPTOMS Hair loss Rash Moles
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TECHNIQUES FOR EXAMINATION General survey Proper Draping Natural light vs. artificial light
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COLOR OF NORMAL SKIN Melanin Carotene Oxyhemoglobin Deoxyhemoglobin
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COLOR OF THE SKIN Generalized erythema Ashy black color Hypopigmented/white
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SKIN color Pallor- anemia, fainting or arterial occlusion Central cyanosis- advanced lung disease (COPD, pulmonary edema), congenital heart disease, hemoglobinopathies Peripheral cyanosis- heart failure Jaundice- liver disease, excessive hemolysis of RBC Carotenemia
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Moisture Dryness- hypothyroidism Oiliness- acne
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Temperature Generalized warmth- fever, hyperhyrodism Coolness- hypothyroid Local warmth- inflammation or cellulitis
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Texture Roughness- hypothyroidism velvety texture- hyperthyroidism
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Mobility and Turgor Decreased mobility- edema, scleroderma Decreased turgor- dehydration
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Lesions Anatomic location or distribution (acne- face, chest, upper back; Psoriasis- extensors; Candida- intertriginous) Types- macule, papule etc Color Patterns and shapes
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HAIR Vellus hair Terminal hair
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HAIR Anagen Catagen Telogen
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Hair Alopecia- diffuse, patchy or total Sparse hair- hypothyroidism Fine, silky hair- hyperthyroidism
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NAILS Nail plate Nail bed Lunula Proximal nail fold Cuticle Lateral nail fold
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GLANDS Sebaceous Sweat (eccrine, apocrine)
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SKIN CARCINOMAS Basal cell carcinoma Squamous cell carcinoma Melanoma
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RISK FACTORS FOR MELANOMA > 50 Common moles 1 -4 atypical or unusual moles, dysplastic Red or light hair Actinic lentgenes / freckles Heavy sun exposure Light eye or skin color (burns easily) Family history < 3 mm (good prognosis)
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ABCDE OF MELANOMA A – asymmetry B – irregular borders C – variation or change in color D – diameter > 6 mm E – elevation or enlargement
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Total Body Skin Examination- the most commonly recommended screening measure
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The average patient has 15-30 moles or nevi Junctional nevi- typically brown macules Intradermal nevi- typically colored papules Compound nevi- brown macules
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DERMOSCOPY Useful office procedure to determine whether a lesion is benign or malignant
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RECORD YOUR FINDINGS
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GENERALIZED ITCHING Dry skin Aging Pregnancy Uremia Jaundice Lymphomas Leukemia Drug reaction Lice
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CUTANEOUS FINDINGS IN SYSTEMIC DISEASE Nodules – metastatic carcinoma Vascular lesions Petechiae, ecchymoles – malignancies Purpura – acute leukemia Splinter hemorrhages – SLE, leukemia Flushing – carcinoid syndrome Pruritus – lymphoma or polycythemia vera – liver disease, renal failure, iron deficiency, thyroid or parathyroid disease
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Eczema Nipple eczema – Paget’s disease T – cell lymphoma Vesicles and Bullae Dermatitis herpetiformis Herpes zoster HIV Erythroderma – malignancy (lymphoma) Erythema and edema Dermatomyositis Myelogenous leukemia Erythematous nodules Hodgkin’s disease Metastatic carcinoma Tuberculosis
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sarcoidosis Ulcerative colitis Hyperkeratosis Hodgkin’s disease Lymphocytic leukemia Hyperpigmentation Pituiatary tumors Addison’s disease Acanthosis nigricans
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Alopecia Mycoses fungoides Syphilis Thyroid disease Iron deficiency Hirsutism and Hypertrichosis Adrenal or ovarian carcinomas
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Urticaria Hodgkin’s disease Multiple myeloma Sulfur yellow Plaques on Shins Necrobiosis lipoidica
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DISEASES Papule- Molluscum, Insect bites Plaque- Atopic dermatitis, Erysipelas Macule- Tinea versicolor, Freckles/Lentigenes Patch- Pityriasis alba, Tinea cruris Nodule- Prurigo nodularis, Furuncle Wheals- Urticaria Pustule- Acne grade II
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DISEASES Vesicle- Dyshidrotic eczema, Herpes Bullae- Bullous impetigo Tumor- Squamous cell ca, Basal cell ca
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DISEASES Scales- seborrheic dermatitis, xerosis Crusts- Impetiginized diseases Excoriation- Atopic dermatitis, Scabies Fissure- Tinea pedis Scar- Keloid
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