Integumentary Review - NURS 6035
Common Etiologies of Rash - answer Medications
Topical products such as soaps, deodorants, cosmetics, colognes
Family history
Exposure-effects of heat, cold, sunlight
Other factors
- Occupation, food allergies, alcohol
Inquire about what medication specifically for rash - answer Aspirin-containing products
Patients can suddely develop reactions to meds they've been taking for years
Common causes of pruritis - answer Diffuse pruritis
•Biliary cirrhosis, lymphoma, drugs (antibiotics, allopurinol, amiodarone, ACE inhibitors,
estrogen, hydrochlorothiazide, opioids, statins)
•Other causes
•Generalized skin disorder, internal illness, diabetes, dry skin, change in perspiration,
thyroid disease, parasites, inflammatory conditions
•Histamine release
•One of the most important mediators of pruritis
Nail findings - Beau's lines - answer Transverse grooves or depressions
Any severe, systemic illness that disrupts nail growth
Mees bands - answerWhite transverse line or band also parallel to the lunula
Poisoning, acute systemic illness, hodgkin disease, chf
Lindsay nails - answerHalf and half nails
proximal portion of nail bed is whiteish, whereas distal part is red or pink
Chronic renal disease
Azotemia
Terry nails - answerWhite nail be to within 1-2mm of distal border of the nail
Hepatic failure, cirrhosis, hypoalbuminemia, chronic chf, hyperthyroidism
Splinter hemorrhages - answerExtravassation of blood from longitudinal nail bed blood
vessels into adjacent troughs (very common)
Local, light trauma, or systemic disease
Koilonychia - answerSpoon nail
Iron deficiency anemia
, What clarifying questions will you ask a patient who presents with a chief complaint of
changes in nails? - answer1.When did you first notice changes? Any acute illness
recently? Any chronic illness?
2.Been taking any medications? Exposed to chemicals at home or work?
What common conditions are associated with change in nails? - answer1.Medications
and chemicals are notorious for causing nail changes
2.Fungal disease causes thickening of nails
Acute illnesses are associated w/ lines & ridges in nail bed and nail
Primary skin lesions - answer•Rise from normal skin resulting from changes in the
epidermis, dermis, or subcutaneous tissue
•Location on body is important; distribution of eruption is crucial for diagnosis
•Characterize appearance-flat or elevated, solid or fluid-filled
•No "standard" size; dimensions indicated are only approximate
Secondary skin lesions - answer•Result from changes in primary lesion; develop during
the course of the cutaneous disease
•Grouped according to their occurrence below or above the plane of skin
Primary skin lesions - nonpalpable, flat - answerMacule - smaller thatn 1cm, freckles,
moles
Patch- greater than 1cm. Vitiligo, Cafe au lait spots
Primary skin lesions - Palpable, fluid filled - answerVesicle - smaller than 1cm; filled w/
serous liquid. Blister, herpes simplex
Bulla - greater than 1cm; filled w/ serous liquid. Blister, pemphigus vulgaris
Pustule - similar to vesicle; filled w/ pus. Acne, impetigo
Special primary skin lesions - answerComedo - plugged opening of sebaceous gland.
blackhead
Burrow - smaller than 10mm, raised tunnel. Scabies
Cyst - Palpable lesion filled w/ semiliquid material or fluid. Sebaceous cyst
Abscess - localized accumulation of purlent material in the dermis or subcutis
Furruncle - Necrotizing form of inflammation of hair follicle
Carbuncle - a coalescence of severe furuncles
Milia - Tiny, keratin filled cysts representing an accumulation of keratin in the distal
portion of sweat glad
Secondary skin lesions - Erosion - answerLoss of part or all of the epidermis; surgace is
moist.
Rupture of vesicle
Secondary skin lesions - Ulcer - answerLoss of epidermis and dermis; may bleed.
Stasis ulcer, chancre
Common Etiologies of Rash - answer Medications
Topical products such as soaps, deodorants, cosmetics, colognes
Family history
Exposure-effects of heat, cold, sunlight
Other factors
- Occupation, food allergies, alcohol
Inquire about what medication specifically for rash - answer Aspirin-containing products
Patients can suddely develop reactions to meds they've been taking for years
Common causes of pruritis - answer Diffuse pruritis
•Biliary cirrhosis, lymphoma, drugs (antibiotics, allopurinol, amiodarone, ACE inhibitors,
estrogen, hydrochlorothiazide, opioids, statins)
•Other causes
•Generalized skin disorder, internal illness, diabetes, dry skin, change in perspiration,
thyroid disease, parasites, inflammatory conditions
•Histamine release
•One of the most important mediators of pruritis
Nail findings - Beau's lines - answer Transverse grooves or depressions
Any severe, systemic illness that disrupts nail growth
Mees bands - answerWhite transverse line or band also parallel to the lunula
Poisoning, acute systemic illness, hodgkin disease, chf
Lindsay nails - answerHalf and half nails
proximal portion of nail bed is whiteish, whereas distal part is red or pink
Chronic renal disease
Azotemia
Terry nails - answerWhite nail be to within 1-2mm of distal border of the nail
Hepatic failure, cirrhosis, hypoalbuminemia, chronic chf, hyperthyroidism
Splinter hemorrhages - answerExtravassation of blood from longitudinal nail bed blood
vessels into adjacent troughs (very common)
Local, light trauma, or systemic disease
Koilonychia - answerSpoon nail
Iron deficiency anemia
, What clarifying questions will you ask a patient who presents with a chief complaint of
changes in nails? - answer1.When did you first notice changes? Any acute illness
recently? Any chronic illness?
2.Been taking any medications? Exposed to chemicals at home or work?
What common conditions are associated with change in nails? - answer1.Medications
and chemicals are notorious for causing nail changes
2.Fungal disease causes thickening of nails
Acute illnesses are associated w/ lines & ridges in nail bed and nail
Primary skin lesions - answer•Rise from normal skin resulting from changes in the
epidermis, dermis, or subcutaneous tissue
•Location on body is important; distribution of eruption is crucial for diagnosis
•Characterize appearance-flat or elevated, solid or fluid-filled
•No "standard" size; dimensions indicated are only approximate
Secondary skin lesions - answer•Result from changes in primary lesion; develop during
the course of the cutaneous disease
•Grouped according to their occurrence below or above the plane of skin
Primary skin lesions - nonpalpable, flat - answerMacule - smaller thatn 1cm, freckles,
moles
Patch- greater than 1cm. Vitiligo, Cafe au lait spots
Primary skin lesions - Palpable, fluid filled - answerVesicle - smaller than 1cm; filled w/
serous liquid. Blister, herpes simplex
Bulla - greater than 1cm; filled w/ serous liquid. Blister, pemphigus vulgaris
Pustule - similar to vesicle; filled w/ pus. Acne, impetigo
Special primary skin lesions - answerComedo - plugged opening of sebaceous gland.
blackhead
Burrow - smaller than 10mm, raised tunnel. Scabies
Cyst - Palpable lesion filled w/ semiliquid material or fluid. Sebaceous cyst
Abscess - localized accumulation of purlent material in the dermis or subcutis
Furruncle - Necrotizing form of inflammation of hair follicle
Carbuncle - a coalescence of severe furuncles
Milia - Tiny, keratin filled cysts representing an accumulation of keratin in the distal
portion of sweat glad
Secondary skin lesions - Erosion - answerLoss of part or all of the epidermis; surgace is
moist.
Rupture of vesicle
Secondary skin lesions - Ulcer - answerLoss of epidermis and dermis; may bleed.
Stasis ulcer, chancre
