Assessmnet Of The Skin

SKIN ASSESSMENT Anatomy and Physiology of Skin Skin: heaviest single and the largest organ, 16% of body weight, 1.2-2.3 meters squared

STRUCTURE 

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Epidermis is composed of several thin layers: o stratum basale o stratum spinosum o stratum granulosum o stratum lucidum o stratum corneum The several thin layers of the epidermis contain the following: o melanocytes - produces melanin 1. pigment that gives skin its color 2. protects the skin from the damaging effects of ultraviolet radiation o keratinocytes - produce keratin 1. water-repellent protein 2. gives the epidermis its tough, protective quality Dermis is composed of a thick layer of skin that contains: collagen and elastic fibers, nerve fibers, blood vessels, sweat and subcutaneous glands and hair follicles Subcutaneous tissue composed of a fatty layer of skin that contains: blood vessels nerves lymph loose connective tissue filled with fat cells

TECNIQUES OF EXAMINATION

normal findings

deviations from normal

findings:

1. Inspection a. general pigmentation of the skin

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uniform pigmentation areas of lighter pigmentation on the palms, nail beds, lips, and soles of the feet (in dark-skinned patients)

A. benign pigmented lesions 1. ephelides (freckles) pigmentation change evidenced by small, flat macules of brown melanin pigment occurring on sunexposed skin 2. nevus (mole) pigmentation change evidenced by a flat or raised even proliferation of melanocytes, tan to brown in color

3. birthmark pigmentation change evidenced by a patchy, flat proliferation of melanocytes, tan to brown in color 4. vitiligo pigmentation change evidenced by a patchy, complete absence of melanin pigment on the face, neck, hands, feet, body folds, and around body orifices 5. albinism pigmentation change evidenced by a generalized, complete loss of melanin pigment 6. cholasma pigmentation change evidenced by a patchy, flat proliferation of melanocytes on the forehead adjacent to the hairline, malular prominence, upper lip, and chin also known as the "mask of pregnancy" anger signs in pigmented lesions A = asymmetry not regularly round or oval

B = border irregularity notching, scalloping, poorly defined margins C = color areas of brown, tan, black, blue, red, white, or combinations thereof D = diameter greater than 6 milliliters