... Thickening of the skin is most commonly seen in myxedema and scleroderma. The association of Raynaud's phenomena will help distinguish scleroderma. Thickening of the skin of the lower legs may also be seen in lymphedema, carcinoid syndrome, and vascular insufficiency.... DIAGNOSTIC WORKUP
... READ EXCERPTS »
...
Xerosis, or dry skin, is extraordinarily common. Simple measures, such as daily emollient use, can make a big difference in patients’ lives. More than 99% of cases are benign.
Differential Diagnosis
... Workup and Diagnosis ... Treatment
... READ EXCERPTS »
...
Skin lesions in the genital area are common, and the etiology can range from simple irritation to sexually transmitted diseases to malignancy. The appearance of the lesion, the presence of pain and/or itching, and a description of how the lesion has changed... Differential Diagnosis ... Workup and Diagnosis ... Treatment
... READ EXCERPTS »
...
Distinguishing between hypopigmentation and depigmentation is crucial to narrowing the differential diagnosis. Hypopigmentation is a decrease in the level of pigmentation of the skin, whereas depigmentation is a total loss of skin pigment. Both can be either localized or generalized, which... Differential Diagnosis ... Workup and Diagnosis ... Treatment
... READ EXCERPTS »
... Conditions of the skin, subcutaneous tissue, vascular wall, and blood may all be associated with bleeding under the skin or purpura, thus both anatomy and physiology must be used to develop this differential ( Table 12 ). The
... READ EXCERPTS »
... Masses of the skin may be better termed nodules if they are larger than 0.5 cm and are not just neoplastic in origin. The term VINDICATE serves as a useful mnemonic to recall the important skin masses. When the physician is considering the cause of a mass in any part of
... READ EXCERPTS »
... To recall the causes of a diffuse pigmentation of the skin, one might simply visualize various organs of the body where a cause may originate. The adrenal gland brings to mind Addison disease, the liver suggests hemochromatosis, the thyroid
... READ EXCERPTS »
... The differential diagnosis of skin ulcers may be approached with anatomy as the basic science, particularly if the ulcer is on one of the legs. Beginning with the skin itself and applying the mnemonic MINT, one can recall the following:
M—Malformations
... READ EXCERPTS »
... The differential diagnosis of a weeping skin lesion is covered in the section on rash (see page 446), but certain conditions should be mentioned here. In all nonbloody discharges, infection (usually bacterial) is the most prominent etiology;
... READ EXCERPTS »
... Skin turgor — the skin’s elasticity — is determined by observing the time required for the skin to return to its normal position after being stretched or pinched. With decreased turgor, pinched skin “holds” for up to 30 seconds, and then slowly... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
... READ EXCERPTS »
... Clammy skin — moist, cool, and usually pale — is a sympathetic response to stress, which triggers release of the hormones epinephrine and norepinephrine. These hormones cause cutaneous vasoconstriction and secretion of cold sweat from eccrine glands,... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
... READ EXCERPTS »
... Mottled skin is patchy discoloration indicating primary or secondary changes of the deep, middle, or superficial dermal blood vessels. It can result from a hematologic, immune, or connective tissue disorder; chronic occlusive arterial disease;... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
... READ EXCERPTS »
... Scaly skin results when cells of the uppermost skin layer (stratum corneum) desiccate and shed, causing excessive accumulation of loosely adherent flakes of normal or abnormal keratin. Normally, skin cell loss is imperceptible; the appearance of scale indicates increased... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
... READ EXCERPTS »
... Inflammation of the skin, dermatitis occurs in several forms: atopic (discussed here), seborrheic, nummular, contact, chronic, localized neurodermatitis, exfoliative, and stasis. (See Types of dermatitis, pages 1258 to 1261.) Atopic dermatitis (atopic or... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
... READ EXCERPTS »
... Atopic dermatitis is a chronic skin disorder that’s characterized by superficial skin inflammation and intense itching. Although this disorder may appear at any age, it typically begins during infancy or early childhood. It may then subside spontaneously, followed... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
... READ EXCERPTS »
... Staphylococcal scalded skin syndrome (SSSS), also known as Ritter’s disease or Ritter-Lyell syndrome, is marked by epidermal erythema, peeling, and necrosis that give the skin a scalded appearance. This severe skin disorder follows... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
... READ EXCERPTS »
... Skin is man’s front-line protective barrier between internal structures and the external environment. It’s tough, resilient, and virtually impermeable to aqueous solutions, bacteria, or toxic compounds. It also performs many vital functions. Skin protects against trauma,... Nails, glands, and hair ... Vascular influence ... Assessing skin disorders ... Diagnostic aids ... Special considerations ... Pictures
... READ EXCERPTS »
... Skin turgor—the skin’s elasticity—is determined by observing the time required for the skin to return to its normal position after being stretched or pinched. With decreased turgor, pinched skin “holds” for up to 30... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... The result of excessive circulating melanin, a bronze skin tone tends to appear at pressure points—such as the knuckles, elbows, toes, and knees—and in creases on the palms and soles. Eventually, this hyperpigmentation may extend to the buccal mucosa and gums before covering... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
... READ EXCERPTS »
... Clammy skin—moist, cool, and usually pale—is a sympathetic response to stress, which triggers release of the hormones epinephrine and norepinephrine. These hormones cause cutaneous vasoconstriction and secretion of cold sweat from eccrine glands,... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
... READ EXCERPTS »
... Mottled skin is patchy discoloration indicating primary or secondary changes of the deep, middle, or superficial dermal blood vessels. It can result from a hematologic, immune, or connective tissue disorder; chronic occlusive arterial disease; dysproteinemia; immobility;... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Scaly skin results when cells of the uppermost skin layer (stratum corneum) desiccate and shed, causing excessive accumulation of loosely adherent flakes of normal or abnormal keratin. Normally, skin cell loss is imperceptible; the appearance of scale indicates increased... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling
... READ EXCERPTS »
... Differential Overview
❑Lyme disease
❑Erythema nodosum
❑Rheumatoid arthritis
❑Systemic lupus erythematosus
❑Psoriatic... Clinical Findings
... READ EXCERPTS »
... An inflammation of the skin, dermatitis occurs in several forms: atopic (discussed here), seborrheic, nummular, contact, chronic, localized neurodermatitis (lichen simplex chronicus), exfoliative, and stasis. (See Types of dermatitis, pages 260 to 263.) ... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
... READ EXCERPTS »
... A severe skin disorder, staphylococcal scalded skin syndrome (SSSS) is marked by epidermal erythema, peeling, and superficial necrosis that give the skin a scalded appearance. SSSS is most prevalent in infants ages 1 to 3 months but may develop in... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
... READ EXCERPTS »
... Clammy skin — moist, cool, and commonly pale — is a sympathetic response to stress, which triggers release of the hormones epinephrine and norepinephrine. These hormones cause cutaneous vasoconstriction and secretion of cold sweat from eccrine glands,... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... Mottled skin is patchy discoloration indicating primary or secondary changes of the deep, middle, or superficial dermal blood vessels. It can result from a hematologic, immune, or connective tissue disorder. Other causes include chronic occlusive... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... The result of excessive circulating melanin, a bronze skin tone tends to appear at pressure points — such as the knuckles, elbows, toes, and knees — and in creases on the palms and soles. Eventually, this hyperpigmentation may extend to the buccal mucosa and gums... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Clammy skin — moist, cool, and usually pale — is a sympathetic response to stress, which triggers release of the hormones epinephrine and norepinephrine. These hormones cause cutaneous vasoconstriction and secretion of cold sweat from eccrine glands,... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Mottled skin is patchy discoloration indicating primary or secondary changes of the deep, middle, or superficial dermal blood vessels. It can result from a hematologic, immune, or connective tissue disorder; chronic occlusive arterial disease;... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Scaly skin results when cells of the uppermost skin layer (stratum corneum) desiccate and shed, causing excessive accumulation of loosely adherent flakes of normal or abnormal keratin. Normally, skin cell loss is imperceptible; the appearance of scale indicates... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
...This chapter focuses on many skin lesionsand rashes seen in pediatric practice. Note that some lesions andrashes fall into more than 1 category in the classification. Principal Causes of Skin Lesions and Rashes Blistering(vesiculobullous) lesions Miliaria ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
... READ EXCERPTS »
... Skin turgor—the skin's elasticity—is determined by observing the time required for the skin to return to its normal position after being stretched or pinched. With decreased turgor, pinched skin “holds” for up to 30 seconds, and then slowly returns to... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... Clammy skin—moist, cool, and usually pale—is a sympathetic response to stress, which triggers release of the hormones epinephrine and norepinephrine. These hormones cause cutaneous vasoconstriction and secretion of cold sweat from eccrine glands, particularly on the... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... Mottled skin is patchy discoloration indicating primary or secondary changes of the deep, middle, or superficial dermal blood vessels. It can result from a hematologic, immune, or connective tissue disorder; chronic occlusive arterial disease; dysproteinemia; immobility; exposure to... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... Scaly skin results when cells of the uppermost skin layer (stratum corneum) desiccate and shed, causing excessive accumulation of loosely adherent flakes of normal or abnormal keratin. Normally, skin cell loss is imperceptible; the appearance of scale indicates increased cell proliferation... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
...
Conditions of the skin, subcutaneous tissue, vascular wall, and blood
may all be associated with bleeding under the skin or purpura, thus both
anatomy and physiology must be used to develop this differential
(Table 12). The skin may hemorrhage... Pictures
... READ EXCERPTS »
...
Masses of the skin may be better termed nodules if they are larger than
0.5 cm and are not just neoplastic in origin. The term VINDICATE
serves as a useful mnemonic to recall the important skin masses. When the
physician... Pictures
... READ EXCERPTS »
...
To recall the causes of a diffuse pigmentation of the skin, one might
simply visualize various organs of the body where a cause may originate. The
adrenal gland brings to mind Addison disease, the liver
suggests... Pictures
... READ EXCERPTS »
...
The differential diagnosis of skin ulcers may be approached with
anatomy as the basic science, particularly if the ulcer is on one
of the legs. Beginning with the skin itself and applying the mnemonic
MINT, one can recall the... Pictures
... READ EXCERPTS »
...
The differential diagnosis of a weeping skin lesion is covered in the
section on rash , but
certain conditions should be mentioned here. In all nonbloody discharges,
infection (usually bacterial) is the most prominent etiology;
... READ EXCERPTS »
Every parent knows at least one thing about keeping children clean: it's not easy. But cleanliness is about more getting rid of smudges and...
Eczema may not be a life-threatening condition, but it is life altering. Learn how people can manage eczema by avoiding triggers and treating...
Alleviating the symptoms of eczema is important for people who suffer with this skin condition. Steroid therapies have been a great help, but their...
There are a variety of different treatments that can help control eczema. The therapies can come as creams, ointments or even as pills. However, not...
