The document discusses different types of primary and secondary skin lesions. It describes macules, vesicles, pustules, papules, nodules, wheals, telangiectasias, plaques, and cysts as examples of primary skin lesions. Secondary skin lesions result from trauma or infection and include scales, crusts, fissures, erosions, excoriations, atrophy, and scars. The document also discusses abnormalities of the nails including paronychia, koilonychia, onycholysis, white nail syndrome, yellow nail syndrome, and clubbing.

1. Assessing
the SKIN
Mr. Jhessie L. Abella, RN, RM, MAN

2. PRIMARY SKIN LESION
Pr i ma r y l e s i o n s a r e
t h o s e o b j e c t i v e l e s i o n s
wi t h wh i c h c o e t a n e o u s
o r s k i n d i s e a s e s b e g i n .
Th i s t y p e o f s k i n l e s i o n
ma y c o n t i n u e a s s u c h o r
ma y u n d e r g o
mo d i f i c a t i o n , p a s s i n g
i n t o t h e s e c o n d a r y o r
c o n s e c u t i v e s k i n
l e s i o n s .

3. MACULE
The lesion appears circular small
and flat spot that is less than in
(1mm to 1 cm) in diameter and with
the color not the same as that of
nearby skin. It has in different shapes
usually red, brown, and white. Flat
moles, measles, petechiae and freckles
are the examples of macule. Macule
that is more than in (1 cm) in
diameter is called a patch; it has an
irregular in shape.

4. VESICLE
A raised lesion that is less than in
(0.5 cm) across. Lesions are round or
oval in shape with thin mass filled
with serous blood or clear fluid.
Herpes simplex, burn blister and
early chicken pox are examples of
vesicle. Bullae are another example
of vesicle that is more than in (5
mm) across. Lesions are cause by
chemical burn, exposure to sunlight,
insect bites or viral infection.

5. PUSTULE
A raised vesicle or bulla lesion filled
with pus. Infection is the primary
cause. Acne vulgaris, impetigo and
boils are examples.

6. PAPULE
A solid elevated skin lesion less than
in (1 cm) across. Lesions are rough
in texture and usually color pink, red
and brown. This lesion is associated
with psoriasis, skin cancer, actinic
keratosis, and syphilis. Warts, acne,
pimples and elevated moles are
examples.

7. NODULE
A solid elevated lesion that has edges
and area 0.5 to 2 cm. Physician
describes this as "palpable," where
hard mass is felt from the tissue
surrounding it. The size of the
nodule is more than 2 cm in
diameter. The other term is tumor
which is associated with lipomas,
and keratinous. malignant
melanoma and hemangioma are
examples.

8. WHEAL
A red swelling skin itchy lesion and
localized edema. Lesion is usually
cause by an allergic reaction, insect
bites or reaction from drugs. Hives,
urticaria and mosquito bites are
examples.

9. TELANGLECTASIA
A dilated small blood vessels in the
surface of the skin. It is often
manifestation of certain diseases
such scleroderma or rosacea.

10. PLAQUE
A patch of closely grouped papules
more than in (1 cm) across.
Lesions are rough in texture and
color brown, red, or pink. The
size is larger than 1 cm. Rubeola and
psoriasis are examples.

11. CYST
Elevated skin lesion and
encapsulated filled with fluid. The
size is 1 cm or larger. Epidermoid
and sebaceous cyst and chalazion of
the eyelid or meibomian gland
lipogranuloma are examples.

12. SECONDARY SKIN LESION
Skin lesion is an alteration in the integumentary system
or skin. There are in two forms, the primary skin lesion
and secondary skin lesion. Secondary skin lesions are
not initially appears; usually result from a trauma or
chronic infection.

13. SCALE
Thickened epidermal cell that
flake off

14. CRUST
Dried serum or pus on the skin
surface.

15. FISSURE
A Linear crack.

16. EROSION
Loss of all or part of the epidermis

17. EXCORIATION
Linear or hollowed out crusted area exposing
dermis

18. ATROPHY
A decreased in the volume of the epidermis

19. SCAR
A formation of connective tissue

20. ULCER
An excavation extending into the
dermis or below

21. KELOID

22. LICHENIFICATION
A distinctive thickening of skin that
is characterized by accenuated skin-
fold markings.

24. THE NAILS

25. A Paronychia is an infection around the nail.
Many organisms can cause a paronychia. This particular
case is caused by the yeast-like organism Candida. Note
the inflammation (red, swollen area) at the base of the
nail and the changes that are apparent in the nail itself.

26. Nails may exhibit many different abnormalities. In the
condition known as Koilonychia, the nails are
flattened and have concavities. This condition may be
associated with iron deficiency.

27. In Onycholysis the nails become loose. They may
even detach from the nail bed. When not held firmly in
place, the nails are rapidly damaged and debris collects
beneath them.

28. White nail syndrome may also be called
leukonychia. Leukonychia can occur with arsenic
poisoning, heart disease, renal failure, pneumonia, or
hypoalbuminemia.

29. Yellow nail syndrome is characterized by yellow
nails that lack a cuticle, grow slowly, and are loose or
detached (onycholysis). Yellow nail syndrome is most
commonly associated with lung disorders, and with
lymphedema.

30. Half and Half Nails

31. Yellow nail syndrome is characterized by yellow
nails that lack a cuticle, grow slowly, and are loose or
detached (onycholysis). Yellow nail syndrome is most
commonly associated with lung disorders, and with
lymphedema.

32. CLUBBING is a condition in which the angle between the
nails and the nail bed is 180 degree or greater.