... 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... DIAGNOSTIC WORKUP
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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
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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 over time can help... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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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... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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... 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;
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... 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
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... 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 from
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... 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 suggests hyperthyroidism,
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... 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
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... A pustular rash is made up of crops of pustules — a visible collection of pus within or beneath the epidermis, commonly in a hair follicle or sweat pore. These lesions vary greatly in size and shape and can be generalized or localized to the hair follicles or sweat glands. (See ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
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... 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
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... 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... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
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... 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... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
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... 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
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... 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... Nails, glands, and hair ... Vascular influence ... Assessing skin disorders ... Diagnostic aids ... Special considerations ... Pictures
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... 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 a consistent... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... A pustular rash is made up of crops of pustules—a visible collection of pus within or beneath the epidermis, commonly in a hair follicle or sweat pore. These lesions vary greatly in size and shape and can be generalized or localized to the hair follicles or sweat glands. (See ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
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... 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 palms,... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
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... 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... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling
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... 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, then slowly returns to its... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... 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
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... 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 ... Patient counseling ... Pictures
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... 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 children; it’s rare... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... 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 arterial disease, dysproteinemia,... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... A pustular rash is made up of crops of pustules — visible collections of pus within or beneath the epidermis, commonly in a hair follicle or sweat pore. These lesions vary greatly in size and shape and can be generalized or localized to the hair follicles or sweat glands. (See ... 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... History ... Physical assessment ... Medical 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... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric 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... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric 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; dysproteinemia; immobility;... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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...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 ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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... A pustular rash is made up of crops of pustules—a visible collection of pus within or beneath the epidermis, commonly in a hair follicle or sweat pore. These lesions vary greatly in size and shape and can be generalized or localized to the hair follicles or sweat glands. (See ... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... 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 ... 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... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... 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 seconds, and then slowly... 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;... 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... 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 hemochromatosis, the thyroid... 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,... 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;
Staphylococcus
... 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... Pictures
... READ EXCERPTS »
There are many situations in which you need sunscreen - and many types of sunscreen to choose from. How do you know you're picking the right...
Millions of people suffer from the skin condition eczema marked by red, itchy patches that sometime become infected. Listen to experts talk about the...
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Psoriasis is a chronic disease characterized by flaking, redness and inflammation of the skin. Though it affects over 7 million people in the U.S....