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Pathophysiology II class notes > Ch. 46 Disorders of Skin Integrity and Function > Flashcards

Ch. 46 Disorders of Skin Integrity and Function Flashcards

1
Q

What is tinea corpus?

A

Ringworm

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2
Q

Who is most prone to tinea corpus (ringworm)?

A

Children.

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3
Q

How is tinea corpus (ringworm) transmitted?

A

Transmission from kittens, puppies, and other children.

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4
Q

What is the appearance of tinea corpus? (ringworm)

A 
Circular/oval lesions on trunk,
 back, buttocks
Red papule with sharp border
Central clearing
Pruritus, mild burning, erythema
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5
Q

What is tinea capitis?

A

Fungal infection on the head. Usually on scalp and shaft of hair.

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6
Q

What is the appearance of primary tinea capitis lesions?

A

Primary lesions are gray, round, hairless patches.

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7
Q

What is the appearance of the inflammatory type of tinea capitis?

A

Delayed hypersensitivity
Pustular, scaly, round
Can evolve to bacterial infection

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8
Q

What is tinea pedis?

A

Athlete’s foot. It occurs between the toes, soles/sides of feet.

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9
Q

What are the risk factors for tinea pedis?

A 
Men
Barefoot in public swimming pools, saunas, etc
Sharing area/clothes with
 someone with infection
Recurrance with 
exercise/sweating
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10
Q

What is the appearance of tinea pedis (Athlete’s foot)?

A

Mild to inflamed lesion
Possible exudate
Painful pruritis
Foul odor

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11
Q

What is candidiasis?

A 
Yeast-like fungus: Candida albicans
Normally in GI tract, mouth, vagina
Thrives in warm, moist areas of skin
Oral infection can be
d/t long-term antibiotic use 
initial sign of human immunodeficiency virus (HIV)
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12
Q

What is the appearance of candidiasis?

A

Red rash with well defined border
Pruritus, burining
Can form pustules, infection

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13
Q

What is impetego?

A

Common in infant and young children

Usually d/t staphylococci or steptocci

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14
Q

What is the appearance of impetego?

A

Small vesicles on face (usually)
Ruptures honey-colored serous that hardens and crusts
Pruritus
Multiplies with scratching

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15
Q

What is cellulitis?

A

Deeper infection of dermis and subcutaneous tissue

Normal skin flora or exogenous bacteria

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16
Q

How is cellulitis transmitted?

A

Transmission via previous skin opening/injury
Handling fish
Swimming
Animal bites

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17
Q

What are the manifestations of cellulitis?

A

Red, edematous, shiny
Possible fever, pain
Can result in septicemia
if not treated properly

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18
Q

What is necrotizing fasciitis?

A

Rare bacterial infection.
Usually streptococcal but can be others.
Involves deep skin and facial plane of subcutaneous tissues.

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19
Q

What are the risks for necrotizing fasciitis?

A

Immunocompromised
Cancer
Diabetes
Recent major infection

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20
Q

What are the manifestations of necrotizing fasciitis?

A

Red, swollen, painful area that expands quickly
Signs/symptoms of inflammation/infection
Progressive to sepsis

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21
Q

What is the treatment for necrotising fasciitis?

A

Needs to be immediate
Antibiotics - high doses
Surgical debridement

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22
Q

What are verrucae?

A

Warts.
Benign human papilloma virus lesion
There are multiple kinds/shapes/sizes

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23
Q

How are verrucae (Warts) transmitted?

A

Direct contact via break in skin
Sexual contact for genital warts
Non-genital warts are common

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24
Q

What is the appearance of verrucae (warts)?

A

Small, gray-white to tan flat papules with rough surface

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25
What is herpes simplex (cold sore) associated with?
Associated with oropharynx infections (Type 1)
26
What are the triggers of herpes simplex outbreaks?
Stress, menses, infection, UV burns
27
How is herpes simplex transmitted?
It is transmitted while active. Direct contact with infected saliva Skin contact via athletics/dentistry/healthcare Sexual contact (usually results in Type 2)
28
What is the appearance of herpex simplex type 1 (cold sores)?
Burning, tingling pustules that crust and heal Common on face, mouth, nasal septum More often and severe if immunocompromised
29
What is herpes zoster?
Shingles. Result of reactivation of latent varicella-zoster virus infection dormant in dorsal root ganglia since primary childhood infection. It travels up the dermatome. It is only transmitted when active.
30
What are the risk factors for shingles?
``` History of chicken pox varicella-zoster infection Age HIV, immunosuppression Malignancies Corticosteroid/chemo/radiation therapy ```
31
What are the manifestations of herpes zoster?
``` Burning pain, pruritis Sensitive skin Vesicles form, erupt, Crust, fall off 2-6 weeks ```
32
What are the complications of herpes zoster?
Neuralgia 1-3 months after skin clears (common) | Blindness if contact with eyes (permanent, rare)
33
What is acne vulgaris?
Lesions of face, neck, back (usually) d/t increased testosterone during puberty 85% of teens Self-esteem issues Familial connection
34
What is non-inflammatory acne vulgaris?
Sebaceous glands plug up Blackheads: melanin moves into gland Whitehead: pale, fatty acid irritation
35
What is inflammatory acne vulgaris?
Pustules, nodules, cysts
36
What is rosacea?
Chronic inflammatory skin disorder of UKE | Usually affects middle-aged adults, women
37
What are the manifestations of rosacea?
Repeated “blushing” episodes, eventually remains Usually nose, cheeks Inflammatory facial pustules, nodules, edema Dry, itchy, burning eyes Telangiectasia Skin thickens and is sensitive to heat
38
What is psoriasis?
Chronic skin inflammation | 3rd decade onset
39
What are the risk factors for psoriasis?
Heredity, age
40
What are the manifestations of psoriasis?
Elbows, knees, scalp, lumbosacral, intragluteal cleft Well-defined red plaques with silver scales Hyperkeratosis: epidermal thickening over time. Permanent damage to capillaries leads to bleeding points under scales.
41
What is UVA (and what does it do)?
Ultraviolet radiation not absorbed by ozone. Deep penetration and immediate effect (tan).
42
What is UVB?
Ultraviolet mostly absorbed by ozone. Delayed response, more genotoxic (burn) d/t free radical formation damage to cellular proteins and DNA
43
What is a first degree thermal burn?
``` Outer epidermis Pink/red/dry/painful Usually without blister (like a sunburn) Skin can still “function” Heals in 3-10 days ``` More serious with infants/elderly
44
What is a second degree burn?
Epidermis and dermis is involved.
45
What is a partial-thickness second degree burn?
Red, painful, moist, blister that weep Sensitive to touch/heat/air Intact blisters help maintain body fluids Heals in 1-2 weeks
46
What is a full-thickness second degree burn?
Hair follicles and sweat glands remain intact Mottled pink/red or waxy with flat, dry blisters, edema Loss of sensation possible Scarring 1 month to heal
47
What is a third degree burn?
Involves subcutaneous tissue, possible muscle & bone. Waxy white/yellow/or tan/brown/black Extensive edema Can be no pain but seldom exists without 1st and 2nd degree burn pain
48
In burns, what is the "rule of nines"?
``` Head & neck 9% Each arm 9% (x2) Each leg 18% (x2) Anterior trunk 18% Posterior trunk 18% Perineum 1% ```
49
What are the hemodynamic complications of burns?
Injury to capillaries & surrounding tissues | Fluid loss = hypovolemic shock
50
What are the respiratory complications of burns?
Smoke inhalation CO, toxins, ammonia, chlorine, sulfur dioxide Damage to mucosa = bronchospasm, edema Thermal injury Resulting pneumonia, pulmonary embolism, pneumothorax, etc
51
What are the hypermetabolic response complications of burns?
Catecholamine and cortisol released in response to stress Muscle/fat wasting, glucose stores depleted Heat production is increased due to heat losses from burned area
52
Why is sepsis a serious complication of burns?
Burn site is ideal for microorganism growth.
53
What are circumferential burns?
Encircle body or body part. Healing to "eschar" constricts (leathery) and must be removed/lysed. (Escharotomy/fasciotomy)
54
What are the treatments of burns?
``` Active cooling Fluids Hemodynamic balance Nutrition Analgesia Wound care ```
55
What are ways to protect burn wounds?
``` Antimicrobial Skin grafts Autograft (from own body) Homograft (from another person, alive or not) Heterograft (from another species) Synthetic ```
56
What are decubitus ulcers? (What causes them)
``` "bedsores" Pressure Shearing forces Friction Moisture ```
57
What are nevi?
Moles. Congenital or acquired benign skin tumors.
58
What is the appearance of nevi?
Pigment or not Flat or elevated Hairy or non-hairy
59
What are melanocytic/junctional/compound nevi?
Dysplastic nevi Rough/pebbly surface, irregular shape Capacity to transform into malignant melanoma, usually related to increased size
60
What is malignant melanoma?
Melanocytic tumor typically sun-exposed areas | Rapid progression
61
What are the risks for malignant melanoma?
Increased UV light exposure; h/o blistering sunburns Family history of MM; h/o dysplastic nevus syndrome Fair hair & skin, freckles Immunosuppression
62
What are the manifestations of malignant melanoma?
Slightly raised, irregular border and surface Independent or from previous nevi May have erythema, tenderness, ulceration, bleeding Often mottled (red/white/blue)
63
What two directions can malignant melanoma grow?
Radial (horizontal) Vertical (down in to deeper dermis) There is an increased risk of metastasis in vertical growth.
64
How is malignant melanoma diagnosed? (ABCDE)
``` Diagnosis A = asymmetry B = border irregularity C = color variegation D = diameter >6mm E = evolution ```
65
What is basal cell carcinoma?
Neoplasm of basal layer of epidermis Most common neoplasm, rarely metastasizes Slow-growing
66
What are the risk factors for basal cell carcinoma?
Fair skin, history of sun exposure
67
What are the manifestations of basal cell carcinoma?
Nodular: small flesh-colored/pink smooth translucent nodule enlarging over time Superficial: scaly erythematous patch/plaque
68
What is squamous cell carcinoma?
Malignant tumor on sun-exposed area Confined to epidermis for long periods, then converts to “invasive” stage Usually older population
69
What are the risk factors for squamous cell carcinoma?
UV exposure Arsenic, industrial tar, coal, paraffin Men; rare if of African descent
70
What are the manifestations of squamous cell carcinoma?
Red-scaling, slightly elevated, irregular border Shallow chronic ulcer, crusts Can metastasize if not excised early

Pathophysiology II class notes (15 decks)

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