Integument

The appearance of the skin and mucous membranes may identify anaemia, jaundice, cyanosis, or carbon monoxide poisoning. Bruising over the scalp or mastoids, or the presence of blood in the external auditory meatus or nostrils, raises the possibility of basal skull fracture, and bruising elsewhere in the body raises the question of trauma. An exanthem may indicate the presence of a viral infection causing meningoencephalitis or of meningococcal septicaemia, or raise the question of haemorrhagic disease. Hyperpigmentation raises the possibility of Addison's disease. Bullous skin lesions are frequently seen in barbiturate intoxication. Kaposi's sarcoma, anogenital herpetic lesions, or oral candidiasis would raise the question of the acquired immune deficiency syndrome (AIDS) with a consequent plethora of possible central nervous system disease.

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