An acquired condition is vitiligo complete absence of

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Understanding Health Insurance: A Guide to Billing and Reimbursement
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An acquired condition is vitiligo— complete absence of melanin pigment in patchy areas of white or light skin on the face, neck, hands, feet, and body folds, and around orifices.
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Chapter 9 / Exercise 6
Understanding Health Insurance: A Guide to Billing and Reimbursement
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- Can occur in all people, although dark-skinned people more severely affected Psychological effects may be more severe General Pigmentation Normal Range of FindingsFreckles: small, flat macules of brown melanin pigment that occur on sun-exposed skinMole: a proliferation of melanocytes, tan to brown colour, flat or raised-Characterized by symmetry, small size, smooth borders, and single uniform pigmentation -Junctional nevusis macular only and occurs in children and adolescents-Young adults it progresses to compound nevithat are macular and papular -Intradermal nevus (in older age) has nevus cells only in dermis Birthmarks: may be tan to brown Abnormal FindingsDanger signs: abnormal characteristics of pigmented lesions are summarized in the mnemonic ABCDE:-Asymmetry-Border irregularity-Colour variation-Diameter greater than 6 mm-Elevation and enlargement LesionsNormal Findings - If any lesions present, note these characteristics:1.Colour2.Elevation: flat, raised, or pedunculated3.Pattern or shape: grouping or distinctness of each lesion i.e. annular, grouped, confluent, or linear4.Size, in centimetres 5.Location and distribution6.Any exudate: colour and any odourAbnormal FindingsWhen a lesion develops on previously unaltered skin, it is primary. When a lesion changes over time or changes because of a factor such as scratching or infection, it is secondary. Common Shapes and Configurations of Lesions (Abnormal)Primary skin lesions-Macule— solely a colour change; flat and circumscribed, <1 cm diameter Examples: freckles, flat envi, hypopigmentation, petechiae, measles, scarlet fever-Papule— palpable: solid, elevated, circumscribed, <1 cm diameter; caused by superficial thickening in the epidermis
Examples: elevated nevus (mole) lichen planus, molluscum, wart (verruca) -Wheal— superficial, raised, transient, and erythematous; slightly irregular shape because of edema Examples: mosquito bite, allergic reaction, dermographism-Vesicle— also called blister; elevated cavity containing free fluid, up to 1 cm; clear serum flows if wall is rupturedExamples: herpes simplex, early varicella, herpes zoster (shingles) contact dermatitis -Pustule— cavity filled with turbid fluid (pus); circumscribed and elevatedExamples: impetigo, acne Secondary skin lesions-Fissure— linear crack with abrupt edges, extending into dermis, dry or moistExamples: cheilosis (at corners of mouth as a result of excess moisture); athlete’s foot-Ulcer— deeper depression extending into dermis, irregular shape; may bleed; leaves scar when healsExamples: stasis ulcer, pressure sore, chancre-Keloid— hypertrophic scar; elevation of the resulting skin level by excess scar tissue, which is invasive beyond the site of original injury; may increase long after healing occurs; looks smooth, rubbery, and “claw-like”; has a higher incidence among individualsof African descent

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