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 lesions
Black base
Sharp edges
Surrounding 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
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