(4) Family history: skin diseases; allergies; diabetes; hypertension;
bleeding disorders; anemia; and nervous, muscular, intellectual, or emotional
disturbances.
2-3.
ELEMENTS TO CONSIDER WHILE DOING AN INSPECTION
a. General. Consider the skin as a separate organ system; that is, a group of
tissues that perform several specific functions. The skin is an organ of relatively unique
size. One of its unique features is the large surface area. The size of an adult male
skin is roughly equal to a 6 by 3 foot sheet. Skin has many functions. It serves as a
sensory organ, as an organ of metabolism having synthesizing, excretory, and
absorptive functions; as a protective barrier against the external environment; and as an
important factor in temperature regulation. A clinical examination of the skin is an
assessment of all these special functions. Additionally, the skin works with internal
organs and often reflects diseases in internal body organs. Therefore, the skin is not
only an organ with its own special patterns, but it is also a mirror reflecting the condition
of the interior of the body.
b. The Examination. The examination should be conducted in a well-lighted
room. If possible, use natural daylight or a daylight type of artificial light. Begin by a low
power scan of the patient's skin as a whole--skin surface, nails, and mucous
membranes. Assess color, the degree of moisture, the turgor (normal tension in a cell),
and the texture of the skin. Remember that inspection of skin involves looking for
changes on the skin surface and changes immediately beneath the surface.
c. Ultraviolet Light Inspection. Sometimes skin conditions are best seen
under ultraviolet light.
(1) Wood's lamp (black light). This light, developed by R. W. Wood, a
United States (US) physicist, is used to diagnose fungal infections. The light filter,
made of glass containing nickel oxide, transmits only ultraviolet rays. When placed
under this lamp, the fungal lesions on skin with the disease tinea capitis, for example,
fluoresce. This ultraviolet light, a black light, allows the doctor to see the skin lesions
clearly.
(2) Tinea versicolor. This superficial fungal infection is characterized by
scaling, annular red, white, or brown patches. When these patches are viewed under
the Wood's lamp, the skin lesions are a gold color. These eruptions are not dangerous
but are not pleasant to look at. A physician can diagnose this disease by looking at the
lesions, putting potassium hydroxide on the lesions, and examining the lesions under a
Wood's light.
MD0575
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