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43 Brown-brown pigmentation of the skin, combined with puffiness of the eyes (a symptom of glasses), is characteristic of patients with dermatomyositis. An earthy gray tint is observed in malignant tumors, but it can also be with severe exhaustion that is not associated with the tumor. Color «coffee with milk » – for septic endocarditis. Skin derivatives-nails, hair. Hair. The severity of the hair, color, integrity, Shine. Changes in the hair cover have a known diagnostic value. Early baldness, premature graying may indicate» wear and tear « of the body, early old age. The absence of facial hair in men aged 18–20 years or the development of facial hair in women indicates an endocrine disorder. In men, the hair may be on the chest and back, the same hairiness in women indicates endocrine diseases. Along with this, with myxedema, scleroderma, alimentary dystrophy, hair loss on the head, from the eyebrows, and their fragility is observed. Nails. Normally, the nail bed is pale pink, the nail plate is transparent, whole, and shiny. Symptom of «watch glasses» – nails with this symptom acquire a significant bulge, as in watch glasses, in most cases combined with thickening of the end pha- langes of the fingers and toes in the form of» drumsticks», which occurs due to the proliferation of soft tissues of the nail phalanges of the fingers. The main causes are long-term suppurative processes in the lungs (abscess, gangrene, bronchiectasis), subacute infectious endocarditis, some congenital heart and main vascular defects accompanied by severe tissue hypoxia, biliary cirrhosis of the liver. Koilonhii are spoon – shaped depressions of the nails, combined with their striation, more often appear in patients with chronic iron deficiency anemia. Thimble symptom-pinpoint depressions on the surface of the nail plate that occur in patients with psoriasis. Nails become cloudy, acquire transverse and (or) longitudinal striation, thin and atrophy. Brittleness and delamination of nails appears when vitamin metabolism is disturbed. Nail changes occur with fungal lesions, nails become dull, thickened, crumble. Palpation of the skin . Elasticity (turgor). Reduced skin elasticity is observed in elderly and senile patients, with dehydration, with cachexia; increased skin turgor and increased skin tension often indicates fluid retention in the body (hidden edema). Moisture of the skin. It can be affected by a number of physiological condi- tions: overheating of the body, increased muscle work, stress. In pathological cas- es, the increase in humidity is due to a reflex increase in sweating with severe pain, suffocation, in stage III fever (with a decrease in temperature), with thyrotoxicosis. Pulmonary tuberculosis is characterized by debilitating night sweats, and sweat- ing may not be accompanied by a drop in body temperature. A decrease in skin moisture is observed with significant dehydration of the body, with diabetes mel-