Skin

1
Skin

• Object is for you to learn and identify skin
  lesions

2
Describe his skin
3
Normal skin

• Color Brown
• Normal hair
• No lesions
• Should feel for texture, turgor, moisture and
  warmth

4
Describe the lesion
5
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

6
Describe skin over legs
7
Chronic ITP

• Hyperpigmentation

8
Describe the lesion
9
Campbelld morgan spots

• Cherry angiomas are
• Bright red
• Small (usually 1-4 mm)
• Papules
• Commonly seen on the trunk of adults.
• Medically insignificant

10
Describe the skin
11
Hodgkins disease

• Dry
• Scaly

12
What do you see
13
Senile purpura

• Red
• Patch
• Does not blanch on pressure
• Thin skin

14
Describe the lesions
15
Steroid induced purpura

• Red
• Patch
• Does not blanch on pressure

16
Describe the lesions
17
Schonlein-Henoch purpura

• Ankle locaton
• Multiple
• Red
• Not blanching on pressure
• Less than 5 mm
• Vasculitis

18
What type of skin lesions do you see?
19
Henoch Schonlein purpura

• Multiple
• Red
• Not blanching on pressure
• Less than 5 mm
• Vasculitis

20
Describe the lesion
21
Echymosis

• Red
• Large patch
• Irregular edge
• Changing colors
• Coagulation defect

22
Describe the skin lesions
23
Vasculitis

• Multiple
• Red
• Not blanching on pressure
• Less than 5 mm
• Coalesing
• Vasculitis drug induced

24
Describe each lesion
25
Leukemia cutis

• Ulcerating lesions
• Black base
• Sharp edges
• Surrounding echymoses
• Blister
• 1 cm
• Fluid filled

26
Patient with HIV. Describe the legs
27
Kaposi Sarcoma

• Nonblanching red macule
• Surrounding ecchymoses and acquire more of a
  violet hue
• The lesions may become nodular

28
Describe the lesions
29
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 gt 6 millimeters

30
Describe the lesions
31
Sarcoidosis

• Patch
• O.5-1 cm in size
• Different color than skin
• Slightly elevated
• Maculo-papular lesions

32
Descrbe the skin lesions
33
Sarcoidosis

• Multiple
• Less than 1 cm
• Raised spot
• Dome shaped
• Papular lesions

34
What do you see?
35
Sickle cell anemia

• Over ankle
• Patch
• larger than 1 cm
• Thin skin
• Loss of substance of skin
• Old scar

36
Interpret his Nails
37
Normal

• Transluscent
• Shiny
• Appears firm

38
Describe the nails
39
Doxorubicin

• Transeverse band
• White in color

40
Describe the Nails
41
Iron deficiency anemia

• Spooning
• concave
• Koilonychia

42
Describe the scar
43
Ehlers danlos syndrome

• Patch
• larger than 1 cm
• Thin skin
• Loss of substance of skin
• Old widened scar

44
Describe the skin
45
Gardner Diamond syndrome

• Multiple
• Leniar wide
• Thin skin
• Striae

46
Describe the lesion
47
Suqmous cell carcinoma

• Ulcer
• Ear lobe
• Crusted lesion
• Sharp margin
• Indurated

48
What is the lesion behind Ear?
49
Keloid (after piercing)

• Very firm
• Rubbery lesions
• Reddish or darkly colored
• Occur after trauma sometimes very minor trauma
• May itch.

50
Describe the skin
51
Eczema dyshydrotic
52
Chest wall. Warm. Diagnosis?
53
Empyema

• Posterior chest wall
• Red patch
• Raised area
• Warm
• Tender

54
Describe his scar in chest
55
Empyema

• Posterior chest wall
• Wide scar
• Loss of rib
• Previous open drainage

56
Describe her face
57
Sezary syndrome

• Red face
• Erythroderma

58
Diagnosis
59
Erythroderma

• Differential diagnosis includes psoriasis,
• eczema, drug reaction, pityriasis rubra pilaris
  (PRP), seborrheic dermatitis, lymphoma, mycosis
  fungoides, and other dermatoses.

60
Painful lesions. Diagnosis?
61
Erythema nodosum

• Well-localized, multiple tender, red, deep
  nodules, 1 to 5 cm in size
• bilaterally over the pre-tibial areas

62
Painful. Diagnosis?
63
Herpes Zoster

• Rash
• Along a dermatome
• Blisters not seen
• Crosses mid-line

64
Describe the lesion
65
Strawberry hemangioma

• Red
• Patch
• 5 cms
• Elevated
• Blanch with pressure
• Capillary angiomas composed of small, superficial
  vessels

66
Diagnosis?
67
Plantar Warts

• Sole of foot
• Multiple
• Raised
• Rough
• Varying size
• Verrucous
• Skin-colored papules
• .

68
Describe the skin lesions
69
Psoriasis

• Larger than 1 cm
• Elevated patches
• Plaques
• Silvery scale

70
Describe the lesion
71
Superficial Epidermal cyst

• 5 cm
• Fluid filled
• Fluctuant
• Orifice or "pore" near the center

72
What do you see?
73
Stasis ulcer

• Location in leg
• Denuded skin
• Hyper-pigmentation
• Firm skin