This document summarizes notes about a midterm exam on hair, skin, and nails. It covers several topics: conducting a health history by asking open-ended questions; counseling on common skin cancers like basal cell carcinoma, squamous cell carcinoma, and melanoma - the most lethal type; risk factors for melanoma; and classifying primary skin lesions. Key points include that half of melanomas are found by patients themselves and the HARMM model for melanoma risk assessment considers history, age, regular checkups, moles changing, and male gender.

1. 300 Midterm Notes - hair, skin, nails.
I. Health history
A. Open ended questions
1. Notice any change?
2. Anything concerning you?
a) 1/2 melanoma’s found by patient
B. Can wait for physical exam.
II. Health promotion and counseling
A. Skin cancer is the most common cancer in the US.
B. Basal cell carcenoma
1. Lower basal layer of epidermis
2. 80% of skin cancers.
3. sun-exposed areas
a) head
b) neck
4. slow-growing, rarly metastatic
C. Squamous cell
1. upper layer
2. 16%
3. crusty scally red inflammed or ulcers
4. Metastesize
D. Melanoma
1. pigment producing cells
2. 4%
3. MOST LETHAL, most rapidly increasing.
4. Lifetime risk 1 in 49 in men. 80% deaths in skin cancer
E. HARMM melanoma risk model
1. History of melanoma
2. Age >50
3. Regular dermatologist absent
4. Mole changing
5. Male gender

2. F. Other risk factors:
1. > 50 moles
2. 1-4 atypical moles
3. red/fair hair/skin
4. actinic lentigenes or freckles in sun exposed areas.
5. childhood sunburns
6. HIV/chemoreceptors
7. Family history of melanoma
III. Primary skin Lesions
A. non-palpable
1. Macule (hemangioma) <1cm
2. Patch (cafe au Laite) >1
B. Solid Mass
1. Papule <1
2. Plaque >1 (psoriasis)
3. Nodule - marble-like, deeper and firmer than Papule, <0.5
cm,
4. Cyst - nodule filled with material
5. Wheal - irregular transient, superficial area of edema
C. Palpable Elevations with fluid filled Cavities
1. Vesicles, serous filled <1 cm (herpes)
2. Bulla, serous filled >1.0
3. Pustule, pus filled
4.
D.
E.
IV.
V.
VI.
VII.
A. First Point

3. B.
C.
D.
1. Supporting Point
2. Supporting Point
E. Second Point
1. Supporting Point
2. Supporting Point
VIII.Conclusion