Skin, Hair, and Nails - Palmer, Palmer：皮肤，头发和指甲-帕尔默，帕默.pptVIP

Skin, Hair, and Nails Adapted from Mosby’s Guide to Physical Examination, 6th Ed. Ch. 8 Newborn Vernix caseosa Mixture of sebum and cornified epidermis covers the infant’s body at birth Whitish, moist, cheeselike substance Protective Newborn Transient puffiness of the hands, feet, eyelids, legs, pubis or sacrum occurs in some newborns Not a concern if it disappears within 2-3 days Newborn Lanugo Fine, silky hair covering the newborn particularly shoulders and back Shed within 10-14 days Newborn Some newborns are bald while others are born with an inordinate amount of head hair… Shed within 2-3 months and replaced by more permanent hair (new texture and color) Newborn Dark-skinned newborns do not always manifest the intensity of melanosis that will be readily evident in 2-3 months Exceptions: nail beds and skin of the scrotum Newborn Skin may look very red the first few days of life Skin color is partly determined by subcutaneous fat (the less fat, the redder and more transparent the skin) Newborn Subcutaneous fat Poorly developed in newborns Predisposed to hypothermia *Newborns lose heat 4x faster than an adult Expected Color Changes - Newborn Acrocyanosis Cyanosis of hands feet Cutis marmorata Transient mottling when infant is exposed to decreased temperature CLINICAL NOTE An underlying cardiac defect should be suspected if acrocyanosis is: persistent more intense in the feet than hands Expected Color Changes - Newborn Harlequin color change Clearly outlined color changes as infant lies on side Lower half of body becomes pink and upper half is pale Expected Color Changes - Newborn Mongolian spots Irregular areas of deep blue pigmentation Usually in sacral and gluteal regions *Seen predominantly in African, Native American, Asian or Latin descent Expected Color Changes - Newborn Telangiectatic nevi (“stork bites”) Flat, deep pink, localized areas usually seen in ba