... 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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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
Dry ... 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... 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 generalized,... 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 examination. For... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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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
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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 of the body, he or
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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
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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
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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; Staphylococcus and
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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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... 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 ... 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... 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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... 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 ... Special considerations ... Pediatric pointers
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... Warts, also known as verrucae, are common, benign, viral infections of the skin and adjacent mucous membranes. The prognosis varies: Some warts disappear readily with treatment; others necessitate more vigorous and prolonged... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... Genital warts (also known as venereal warts or condylomata acuminata) consist of papillomas with fibrous tissue overgrowth from the dermis and thickened epithelial coverings. They’re uncommon before puberty or after menopause. Certain... Causes ... 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... 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... Nails, glands, and hair ... Vascular influence ... Assessing skin disorders ... Diagnostic aids ... 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... 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... 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... 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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... 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
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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... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling
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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... 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... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Nursing considerations ... Patient teaching ... 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. Other causes include chronic occlusive arterial disease,... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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... 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... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric 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 ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... 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 ... 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; dysproteinemia; immobility; exposure... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... 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... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric 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... 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. ... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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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... 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;... 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... 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 »
...
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 ... 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 ... 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 »
... Y. Lily Higgins, MD, MS Warts - BASICS Warts - description Warts (verrucae) are benign epithelial tumors that can occur on any epithelial surface of the body and produce characteristic ... Warts - DIAGNOSIS ... Warts - TREATMENT ... Warts - FOLLOW UP ... Warts - bibliography ... Warts - CODES ... Warts - FAQ
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For many women, the words "pap smear" are synonymous with "embarassment" and "dread". Few would disagree that pap smears are one...
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