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Examination of skin
- 1. Examination of Skin Presentedby: Dr Ekta CBPACS,N.Delhi
- 2. Surface area of1.5-2mm in adults Layers- mainly two-1.Epidermis 2.Dermis Skin
- 3. • Most superficiallayer of skin • Composed of stratified squamous epithelium • Thickest on palms and soles • No nerve ending or blood vessels Epidermis
- 4. • Tough andelastic • Formed from connective tissue and collagen fibers • Main cells-Macrophage - Mast cells - Fibroblast Structures- Blood vessels -Lymph vessels -Sabaceous glands Dermis
- 6. • How longhas the lesion been present ? • Has its distribution changes over time? • Has it been associated with sun exposure / exposure to heat/cold? Dermatological history
- 7. • Is theirany associated Pruritis? • Is the lesion painful? • Does patient have any constitutional symptoms? • Does patient having any past h/o skin disease or allergy ?
- 8. • Does patienthaving any past h/o systemic disease e.g DM ? • Does patient having any h/o exposure to chemicals ? • Does patient have family h/o melanoma ? • What medications patient is taking ?
- 9. • Lesions mustbe described according to their color , shape, and using dermatological terms • Distribution and pattern must be described • Lesion must be palpated for consistency ,tenderness ,temperature ,depth etc. Points to be assesed -
- 10. Macule Flat lesion upto 1 cm in diameter of skin color change Circular , oval, or irregular Well demarcated E.g- flat nevus Dermatological terms
- 11. Patch • Flat lesion1 cm or greater in diameter • E.g.- vitiligo
- 12. Papule • Elevated superficialsolid lesion up to 1 cm diameter • Round or flat topped • Irregularly distributed • Sharply defined (superficial ) or indistinct border (deep) • E.g- acne
- 13. Plaque • Flat elevatedsuperficial lesion 1cm or more • Often formed by coalescence of papules • May be centrally depressed • Usually well defined • E.g psoriasis
- 14. Nodule • Superficial solid“marble like” lesion greater than 1 cm diameter • Larger , often deeper and firmer than papule • Hard or soft • E.g. -acne or keloid
- 15. Wheal (“hives”) • Irregularand oedematous like elevations • Round ,or irregular • Discrete or may be coalesce • E.g. Urticaria
- 16. Vesicle • Well definedsuperficial elevation containing serous fluid up to 1cm • Discrete irregularly scattered grouped or linear • E.g. varicella
- 17. Bulla • Superficial elevationcontaining serous fluid more than 1 cm • Differ from vesicles only in size • E.g contact dermatitis
- 18. Pustules • Small superficialelevation containing turbid purulent fluid (usually necrotic inflammatory cells ) • Vary in size and shape • Exudates may be white-yellow ,greenish- yellow • E.g. Pustular acne , Pustular psoriasis
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