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Is it focal or diffuse? Focal rashes suggest the dermatophytoses, scabies, actinic dermatitis, herpes zoster, warts, contact dermatitis, erythema nodosum, actinic dermatosis, dyshidrosis, skin tumors, nummular eczema, stasis ... DIAGNOSTIC WORKUP
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...
Is the rash macular or papular? A macular or papular rash would suggest scarlet fever, measles, erythema multiforme, exfoliative dermatitis, pityriasis rosea, eczema, contact dermatitis, secondary syphilis, drug eruption, and actinic dermatoses.
... DIAGNOSTIC WORKUP
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... Itching at the anus is almost always due to anal or rectal conditions, the most likely of which is hemorrhoids. If there is frequent passage of bright red blood in the stool along with a painful bowel movement, one should look for an anal fissure. If there is a chronic discharge, one... DIAGNOSTIC WORKUP
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Is the pruritus associated with a generalized rash? Almost every generalized rash may be associated with pruritus, but the most common ones are urticaria, dermatitis herpetiformis, eczema, scabies, and pemphigus.
Is ... DIAGNOSTIC WORKUP
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...
Is there a vaginal discharge? The presence of a vaginal discharge should suggest candidiasis, trichomoniasis vaginitis, and bacterial vaginitis.
Is there a rash? The presence of a rash would suggest eczema, herpes simplex, ... DIAGNOSTIC WORKUP
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... 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
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...
Pruritus, or itching, is the most common dermatologic complaint. When pruritus occurs without cutaneous findings, a thorough history, physical exam, and laboratory tests must be obtained to rule out a systemic disease as a cause of pruritus. The prevalence of... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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...
Pruritus, or itching, is the most common dermatologic complaint. When pruritus occurs with cutaneous findings, the clinician must carefully analyze the dermatologic findings to identify the underlying cause. Severe pruritus may lead to lifestyle... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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...
The etiologies of rash with fever are vast, but a systematic approach will help the clinician quickly narrow the differential. Patients who appear “toxic” with fever and prostration must be rapidly and thoroughly evaluated to rule out life-threatening... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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...
Scalp dermatitis or infection is easy to diagnose, but it can be challenging to treat. Topical therapy or topical plus systemic therapy for prolonged periods are often necessary to successfully control these disorders. Seborrheic dermatitis is a... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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...
Hand and foot rashes do not all look alike: Look for the subtle clues discussed below and obtain a detailed exposure and health history to narrow the differential. Be sure to evaluate the full extent of the skin rash before finalizing your differential diagnosis.... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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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
... 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... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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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... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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...
Papulosquamous is a term used for skin lesions that are papular and present in the superficial skin layer (the squamous layer). Papulosquamous rashes are defined as exanthems that have palpable epidermal changes with scale. The diagnoses within the papulosquamous... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Vesicular and bullous rashes must be approached systematically so that serious causes are not missed. Initially, a determination as to whether the lesions are focal or diffuse is made, followed by a history of the lesions, a review of systems, and a focused physical... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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...
Pruritus is the desire to scratch that is induced by unpleasant cutaneous sensations caused by histamines and other endogenous substances. Atopic dermatitis is one of the most common childhood skin diseases; emergencies include severe angioedema... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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...
Annular rashes (from Latin “annulus” = ring; syn. circinate) are ring-shaped lesions, although their morphology can vary and may also present as irregular, oval, semiannular, target-like, polycyclic, serpiginous, or reticular lesions.
Differential Diagnosis
... Workup and Diagnosis ... Treatment
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...
Hand and foot rashes are generally nonspecific, but their presence or absence might help in establishing the diagnosis in a wide variety of conditions. The palms and soles are covered with squamous epiderma that is thicker than in other parts of the body (1.5 mm) and... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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...
The term morbilliform means “measles-like.” Approximately 80% of all cutaneous drug reactions are morbilliform in nature, and many nonspecific viruses cause a morbilliform rash. True measles is rare in the developed nations because the measles vaccine is very... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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A vesicle is <5 mm and a bulla is >5 mm in diameter (epidermal is flaccid; sub-epidermal is tense), a pustule is a pus-filled vesicle or bulla. The most common causes are benign lesions of the newborn (e.g., miliaria, erythema toxicum), infections, and>... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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... The differential diagnosis of pruritus is best developed by anatomy. Local conditions such as bites and parasitic infestations (e.g., scabies, hookworms, and schistosomiasis) usually reveal an obvious lesion. Generalized skin conditions such as dermatitis herpetiformis, atopic
... READ EXCERPTS »
... The best way to recall the causes of a general rash while still examining the patient is to think of the mnemonic DERMATITIS. 4 (See figures on pages 447, 448, 449, and 450.)
D—
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... The differential diagnosis of a local rash is best approached with the mnemonic VINDICATE.
V—Vascular suggests livedo reticularis, acrocyanosis, gangrene of Raynaud syndrome, necrotic areas of periarteritis nodosa, and petechiae from emboli. Varicose and
... 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
... 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 suggests hyperthyroidism,
... 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
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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;
... 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 the body, he or
... READ EXCERPTS »
... Bleeding from the Ear
This is not usually a serious condition. Anatomy is again applied to formulate a diagnosis. The blood may be from the external or middle ear and usually is caused by diseases of the skin or drum. Trauma is the
... READ EXCERPTS »
... A papular rash consists of small, raised, circumscribed — and perhaps discolored (red to purple) — lesions known as papules. It may erupt anywhere on the body in various configurations and may be acute or chronic. Papular rashes characterize many cutaneous disorders; they... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
... READ EXCERPTS »
... 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... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
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... Commonly provoking scratching to gain relief, this unpleasant itching sensation affects the skin, certain mucous membranes, and the eyes. Most severe at night, pruritus may be exacerbated by increased skin temperature, poor skin turgor, local... 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 ... Pictures
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... The presence of a butterfly rash is typically a sign of systemic lupus erythematosus (SLE), but it can also signal dermatologic disorders. Typically, butterfly rash appears in a malar distribution across the nose and cheeks. (See Recognizing butterfly rash,... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pictures
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... A vesicular rash is a scattered or linear distribution of blisterlike lesions — sharply circumscribed and filled with clear, cloudy, or bloody fluid. The lesions, which are usually less than 0.5 cm in diameter, may occur singly or may occur in... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... 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 ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
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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... History and physical examination ... Medical 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 cell... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
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... Pruritus with Diagnostic Skin Lesions
Infestation (especially scabies, lice, fleas)
Xerosis (dry skin; for example, secondary to low humidity or excessive bathing)
Infection, especially bacterial, fungal,
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... Rocky Mountain spotted fever (RMSF) is a febrile, rash-producing illness caused by Rickettsia rickettsii. The disease is transmitted to humans by a tick bite.
RMSF is fatal in about 5% of patients. Mortality rises when... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Pruritus ani is perianal itching, irritation, or superficial burning. This disorder is more common in males than in females and occurs in adults and children.
Causes
Factors that contribute to pruritus ani include... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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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 pattern of... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... 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 protects against trauma,... Nails, glands, and hair ... Vascular influence ... Assessing skin disorders ... Diagnostic aids ... Special considerations ... Pictures
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... A papular rash consists of small, raised, circumscribed—and perhaps discolored (red to purple)—lesions known as papules. It may erupt anywhere on the body in various configurations and may be acute or chronic. Papular rashes characterize many... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... 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. ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
... READ EXCERPTS »
... Commonly provoking scratching to gain relief, this unpleasant itching sensation affects the skin, certain mucous membranes, and the eyes. Most severe at night, pruritus may be exacerbated by increased skin temperature, poor skin turgor, local vasodilation, dermatoses,... History and physical examination ... 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;... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... A butterfly rash is typically a sign of systemic lupus erythematosus (SLE), but it can also signal dermatologic disorders. Typically, this rash appears in a malar distribution across the nose and cheeks. (See Recognizing butterfly rash.) Similar rashes may appear... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
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... An important indicator of neurofibromatosis and other congenital melanotic disorders, café-au-lait spots appear as flat, light brown, uniformly hyperpigmented macules or patches on the skin surface. They usually appear during the first 3 years of... History and physical examination ... Medical causes ... Special considerations
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... A vesicular rash is a scattered or linear distribution of blisterlike lesions that are sharply circumscribed and filled with clear, cloudy, or bloody fluid. The lesions, which are usually less than 0.5 cm in diameter, may occur singly or in groups. (See ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... 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, then slowly returns to its normal... 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... 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... History and physical examination ... Medical 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 ... Patient counseling
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... Beverly A. VonderPool
Approach Pruritus, a sense of the need to scratch, is an unpleasant cutaneous sensation that has numerous causes. A practical approach is to look for causes with the highest probability first; generally, pruritus is caused... History ... Physical examination ... Diagnostic tests ... Diagnostic assessment
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... Michael L. O’Dell
Fever with an accompanying rash represents a diagnostic challenge for even the most experienced of clinicians, as this combination of signs can represent trivial or life-threatening illnesses.
Approach A useful way of... History ... Physical examination ... Testing ... Diagnostic assessment
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... Michael L. O’Dell
Approach Rashes are commonly described in a defined set of ways. Macules are skin lesions that are flat and discolored, and up to 1 cm in diameter. Papules are also up to 1 cm, but... History ... Physical examination ... Testing ... Diagnostic assessment ... Pictures
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... Marcia J. Chesebro
Approach The initial approach to the patient with fluid-filled lesions involves assessment of the severity of the illness: Does the patient look sick or toxic or does the patient appear generally well?
... Physical ... Testing ... Diagnostic assessment
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... Differential Overview
❑ Eczema
❑ Atopic dermatitis
❑ Seborrheic dermatitis
❑ Tinea versicolor
❑ ... Clinical Findings
... 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 »
... 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,... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... 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, particularly on the... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... A papular rash consists of small, raised, circumscribed — and perhaps discolored (red to purple) — lesions known as papules. It may erupt anywhere on the body in various configurations and may be acute or chronic. Papular rashes characterize many cutaneous disorders;... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... 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. ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Commonly provoking scratching to gain relief, this unpleasant itching sensation affects the skin, certain mucous membranes, and the eyes. Most severe at night, pruritus may be exacerbated by increased skin temperature, poor skin turgor, local vasodilation, dermatoses, and stress. ... 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;... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... The presence of a butterfly rash is typically a sign of systemic lupus erythematosus (SLE), but it can also signal dermatologic disorders. Generally, butterfly rash appears in a malar distribution across the nose and cheeks. (See Recognizing butterfly rash.... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... A vesicular rash is a scattered or linear distribution of blisterlike lesions — sharply circumscribed and filled with clear, cloudy, or bloody fluid. The lesions, which are usually less than 0.5 cm in diameter, may occur singly or in groups. ... History ... Physical assessment ... Medical 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 extend to the... 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... 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... 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... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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... A papular rash consists of small, raised, circumscribed—and perhaps discolored (red to purple)—lesions known as papules. It may erupt anywhere on the body in various configurations and may be acute or chronic. Papular rashes characterize many cutaneous disorders... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... 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 »
... Commonly provoking scratching to gain relief, this unpleasant itching sensation affects the skin, certain mucous membranes, and the eyes. Most severe at night, pruritus may be exacerbated by increased skin temperature, poor skin turgor, local vasodilation,... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... 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;... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... The presence of a butterfly rash is typically a sign of systemic lupus erythematosus (SLE), but it can also signal a dermatologic disorder. Typically, butterfly rash appears in a malar distribution across the nose and cheeks. (See Recognizing butterfly rash.) ... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... A vesicular rash is a scattered or linear distribution of sharply circumscribed, blister-like lesions, which are filled with clear, cloudy, or bloody fluid. The lesions are usually less than 0.5 cm in diameter and may occur singly or in groups. (See Recognizing common skin lesions,... History and physical examination ... Medical 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 returns to its normal... 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... 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 scale indicates increased cell... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
...
The differential diagnosis of pruritus is best developed by
anatomy. Local conditions such as bites and parasitic infestations
(e.g., scabies, hookworms, and schistosomiasis) usually reveal an obvious
lesion. Generalized skin... 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... 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,... 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 »
...
Bleeding from the ear. This is not usually a serious
condition. Anatomy is again applied to formulate a diagnosis. The
blood may be from the external or middle ear, and usually is caused by
diseases of the skin or drum. Trauma is the most
... 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 »
...
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... Pictures
... READ EXCERPTS »
...
The
best way to recall the causes of a general rash while still
examining the patient is to think of the mnemonic DERMATITIS.
D—Deficiency diseases include pellagra, scurvy, and vitamin A
deficiency.
E—... Pictures
... READ EXCERPTS »
...
The differential diagnosis of a local rash is best approached with the
mnemonic VINDICATE.
V—Vascular lesions suggest livedo
reticularis, acrocyanosis, gangrene of Raynaud syndrome, necrotic areas of
periarteritis nodosa, and... Pictures
... READ EXCERPTS »
... Heather C. Forkey
Approach to the Patient with Rash
I. Definition of the Complaint
Rash, a general term applied to any skin eruption, is the ... Pictures
... READ EXCERPTS »
... I. History of Present Illness
A 7-week-old Caucasian girl had initially presented to a hematologist for
evaluation of bruising. Her mother had noted several small purple bruises on
her right arm and a linear bruise across her left ... Pictures
... READ EXCERPTS »
... Author:
Johann Peterson, MD
What to Do - Gather Appropriate Data
Tinea capitis is a fungal infection of the hair follicles of the scalp and is more
common in prepubertal children than in adolescents or adults. It is typically
caused by fungal species of the... Suggested Readings
... READ EXCERPTS »
Millions of people suffer from the skin condition eczema marked by red, itchy patches that sometime become infected. Listen to experts talk about the...
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...