Assessment - Secondary Skin Lesions

Crust

thickened, dried out exudate left when vesicles/pustules burst or dry up; color can be red-brown, honey or yellow, depending on fluid's ingredients (blood, serum, pus); ex - impetigo (dry, honey colored), weeping exzematous dermatitis, scab after abrasion

Scale

compact, desiccated flakes of skin, dry or greasy, silvery or white, from sheddingo f dead excess keratin cells; ex - scarlet fever or drug reactions (laminated sheets), psoriasis (silver, mica-like), seborrheic dermatitis (yellow, greasy), eczema, ichthy

Fissure

linear crac with abrupt edges, extends into dermis, dry or moise; ex - cheilosis (at corners ofmouth due to excess moisture), athlete's foot

Erosion

scooped out but shallow depression; superficial; epidermis lost; moist but not bleeding; heals w/o scar because erosions does not extend into dermis

Ulcer

deeper depression extending int dermis, irregular shape; may bleed; leaves scar when heals; ex - stasis ulcer, pressure sore, chancre

Excoriation

self-inflicted abrasion; superficial; sometimes crusted; scrateches from intense itching; ex - insect bites, scabies, dermatitis, varicella

Scar

after skin lesion is reparied, normal tissue is lost and relplaced with connective tissue (collagen); this is permanent fibrotic change; ex - healed area after surgery or injury, acne

Atrophic scar

resulting skin level is depressed with loss of tissue; thinning of epidermis; ex - striae (strech marks)

Lichenification

prolonged, intense scratching eventually thickens the skin and produces tightly packed sets of papules; looks like surface of moss (or lichen)

Keloid

hypertrophic scar; resulting skin level is elevated by excess scar tissue, which is invasive beyond site of orginal injury; may increase long after healing occurs; looks smooth, rubbery and 'clawlike'a nd has a higher incidence in blacks