Chapter 10: Skin, Hair, & Nails

Skin, Hair, & Nails starts with the fundamental anatomy of the epidermis, dermis, and subcutaneous layers, highlighting the skin's vital roles in protection, temperature regulation, and vitamin D production. The curriculum transitions into the health history, where practitioners learn to investigate common concerns like pruritus, rashes, and changing lesions while considering personal and family risk factors for malignancy. A significant focus is placed on the standardized language of dermatology, teaching students to meticulously document findings based on size, color, shape, and configuration. The text introduces the critical ABCDE-EFG framework for melanoma detection, emphasizing that a diameter (greater than) 6 mm or rapid evolution are key warning signs. Learners are guided through the identification of various primary lesions, from flat macules and patches to raised papules, plaques, and fluid-filled vesicles or bullae. The physical examination section outlines best practices for lighting and the use of tools such as the dermoscope to enhance diagnostic accuracy. Additionally, the chapter addresses specialized assessment techniques for hair loss patterns and nail pathologies, alongside the updated staging criteria for evaluating pressure injuries in vulnerable, immobilized patients. Finally, it reinforces the principles of health promotion, focusing on skin cancer epidemiology and prevention strategies, including the avoidance of ultraviolet radiation and the necessity of regular clinical screenings for early detection of basal cell and squamous cell carcinomas.