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Describe the epidermis
Outler layer of skin made of dead squamous cells and melanocytes which gives us pigmentation.
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Describe the dermis
Provides support for the epidermis and gives it flexibility and strength.
Made of fat and collagen fibers
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Eccrine sweat glands
- Provides heat regulation, found on the :
- forehad
- palms and soles of feet
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Apocrine Sweat Glands
Causes body odor and found in the axillary and genital areas
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Macule
flat spot less than 1 cm that changes color(freckle or mole)
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Patch
Larger than 1 cm flat, changes color (Cafe au Lait)
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Papule
warts, elevated mole....less than 1 cm
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Plaque
larger than 1 cm, superficial and elevated, plateau like
psoriasis
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Nodule
Lipoma or fatty tumor
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Cyst
Large nodule filled with liquid or semi solid material
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Wheal
Hive, insect bite, TB skin test
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Abrasion
oozing, scraping surface, loss of superficial structure of skin
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Ulceration
Loss of deeper layers...scooped out
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Petechiae
small, flat, round purplish, red spot.
Interadermal or submucosal hemorrhage
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Ecchymosis
Discoloration, reddish purple, escape of blood in to tissues
Black and Blue marks
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When assessing dark skin remember:
- Take a picture, it shows variations better.
- Color change is less obvious
- Palpate for warm, smooth or hard spots
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Erythema
dark skin turning purple/gray with inflammation
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How do I tell if a black person has jaundice?
Check their palate...cuz sclera always looks yellowish.
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What does skin of a dark person look like if they are in trouble perfusion wise?
- white, grey.
- Lips, mucous membrane, conjunctiva and nail beds ashen grey or yellow brown.
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How to you confirm shock with a black person?
Vital signs and O2 saturation
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Whats a discrete, individual or separate lesion?
Insect bite
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What's it called when a lesion merges or they run together?
Measles, chicken pox, roseola
Confluent
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Whats it called when lesions are arranged in a circular pattern?
Ring Worm
Annular
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Whats it called when you have lesions scattered all over the body?
Measles
Generalized
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What's it called when you have acluster of lesions in one spot?
Herpes Simplex
Grouped
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Whats it called when lesions form a line?
Poison Ivy and Oak
Linear
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Whats it called when lesions are arranged in concentric circles?
Hives
Polycyclic
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Whats it called when there's a linear arrangement along a nerve root?
Herpes Zoster, Shingles, Chicken Pox
Zosteriform
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Signs of Squamous Cell Carcinoma
- Red
- Scaly
- slightly elevated
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Dangers of Squamous Cell Carcinoma
Can change to malignancy if get it on ear, nose, lips
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Signs of Basal Cell Carcinoma
- Red
- scaly
- plaque like macule on the trunk
- RARELY METASTASIZES
LEAST LIKELY TO SPREAD!! MOst COMMON SKIN CANCER
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Both Basal Cell and Squamous Cell carcinoma effect:
Surface Epithelium
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Malignant Melanoma is
abnormal growth of melanocytes
Rapidly metastasizes
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Where do you find melanoma?
Comes from a mole on the head, trunk or legs
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What puts a person at greatest risk for melanoma?
- Ultraviolet Radiation
- blistering sunburns at a young age (3 or more)
- working outdoors
- sunlamps and tanning beds
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SCC and BCC comes from?
they are both CARCINOMAS that are found on surface epithelium in areas covering organs
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Malignant Melanoma comes from?
CANCER in melanocytes of the skin
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Malignant Melanoma is most common in....
light skinned people with blue green eyes, freckles and those that sunburn easily
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ABCD warning signs of Malignant Melanoma
- A=asymmetry (irregular surface or larger on one side than the other
- B= Border Irregularity
- C=Color changes (many colors in 1 mole)
- D=Diameter Large (or sudden growth in size)
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Dysplastic Nevi
unusual mole that is larger than 5 mm that is likely to progress to malignant melanoma
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What does age have to do with skin cancer?
Skin cant repair its DNA any more
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How do you prevent skin cancer?
- Inspect all moles....especially for Pigmented Nevi
- Avoid unnecessary sun exposure
- Use broadspectrum sun protection of SPF 15 or higher
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Treatment of skin cancer:
- Wide excision to fascia and lymph node eval.
- Skin graft
- Chemo
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How do you treat skin after intervention of skin cancer?
- Change, clean and redress wound
- Watch for bleeding and infection
- Emollient cream to decrease drying
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