Integumentary System

Abnormalities of the Nail Bed

Type	Characteristics	Assess for
Edema	Fluid accumulation	Trauma, murmur, third heart sound
Diaphoresis	Sweating	Pain, fever, anxiety, insulin reaction
Bromhidrosis	Foul perspiration	Infection, poor hygiene
Hirsutism	Hair growth	Adrenal function
Petechiae	Red or purple spots	Hepatic function, drug reactions
Alopecia	Hair loss	Hypopituitarism, medications, fever, starvation

Type	Characteristics
Albinism	Decreased pigmentation
Vitiligo	White patches on exposed areas
Mongolian spots	Black and blue spots on back and buttocks
Jaundice	Yellow pigmentation of skin or sclera
Ecchymosis	Black and blue marks; assess for trauma, bleeding time, or hepatic function
Cyanosis	Bluish color of lips, earlobes, or nails; assess lung and heart status

Type	Definition	Example
Macule	Flat, nonpalpable	Freckle, measles
Papule	Palpable, less than 1 cm diameter	Wart, psoriasis
Vesicle	Palpable, less than 1 cm, with fluid	Blister, chickenpox
Nodule	Hard, less than 1 cm, into dermis	Dermofibroma
Plaque	Palpable or not, greater than 1 cm	Psoriasis, candidiasis
Bulla	Vesicle, greater than 1 cm	Poison oak, impetigo
Tumor	Nodule, greater than 1 cm	Lipoma, fibroma
Pustule	Pus-filled vesicle	Acne
Wheal	Irregular, flat-topped	—
Cyst	Fluid-filled, large	—