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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
Q

What is herpes simplex (cold sore) associated with?

A

Associated with oropharynx infections (Type 1)

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26
Q

What are the triggers of herpes simplex outbreaks?

A

Stress, menses, infection, UV burns

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27
Q

How is herpes simplex transmitted?

A

It is transmitted while active.
Direct contact with infected saliva
Skin contact via athletics/dentistry/healthcare
Sexual contact (usually results in Type 2)

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28
Q

What is the appearance of herpex simplex type 1 (cold sores)?

A

Burning, tingling pustules that crust and heal
Common on face, mouth, nasal septum
More often and severe if immunocompromised

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29
Q

What is herpes zoster?

A

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
Q

What are the risk factors for shingles?

A 
History of chicken pox varicella-zoster infection
Age
HIV, immunosuppression
Malignancies
Corticosteroid/chemo/radiation therapy
31
Q

What are the manifestations of herpes zoster?

A 
Burning pain, pruritis
Sensitive skin
Vesicles form, erupt, 
Crust, fall off
2-6 weeks
32
Q

What are the complications of herpes zoster?

A

Neuralgia 1-3 months after skin clears (common)

Blindness if contact with eyes (permanent, rare)

33
Q

What is acne vulgaris?

A

Lesions of face, neck, back (usually) d/t increased testosterone during puberty
85% of teens
Self-esteem issues
Familial connection

34
Q

What is non-inflammatory acne vulgaris?

A

Sebaceous glands plug up
Blackheads: melanin moves into gland
Whitehead: pale, fatty acid irritation

35
Q

What is inflammatory acne vulgaris?

A

Pustules, nodules, cysts

36
Q

What is rosacea?

A

Chronic inflammatory skin disorder of UKE

Usually affects middle-aged adults, women

37
Q

What are the manifestations of rosacea?

A

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
Q

What is psoriasis?

A

Chronic skin inflammation

3rd decade onset

39
Q

What are the risk factors for psoriasis?

A

Heredity, age

40
Q

What are the manifestations of psoriasis?

A

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
Q

What is UVA (and what does it do)?

A

Ultraviolet radiation not absorbed by ozone. Deep penetration and immediate effect (tan).

42
Q

What is UVB?

A

Ultraviolet mostly absorbed by ozone.
Delayed response, more genotoxic (burn)
d/t free radical formation
damage to cellular proteins and DNA

43
Q

What is a first degree thermal burn?

A 
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
Q

What is a second degree burn?

A

Epidermis and dermis is involved.

45
Q

What is a partial-thickness second degree burn?

A

Red, painful, moist, blister that weep
Sensitive to touch/heat/air
Intact blisters help maintain body fluids
Heals in 1-2 weeks

46
Q

What is a full-thickness second degree burn?

A

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
Q

What is a third degree burn?

A

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
Q

In burns, what is the “rule of nines”?

A 
Head & neck 9%
Each arm 9% (x2)
Each leg 18% (x2)
Anterior trunk 18%
Posterior trunk 18%
Perineum 1%
49
Q

What are the hemodynamic complications of burns?

A

Injury to capillaries & surrounding tissues

Fluid loss = hypovolemic shock

50
Q

What are the respiratory complications of burns?

A

Smoke inhalation
CO, toxins, ammonia, chlorine, sulfur dioxide
Damage to mucosa = bronchospasm, edema
Thermal injury
Resulting pneumonia, pulmonary embolism, pneumothorax, etc

51
Q

What are the hypermetabolic response complications of burns?

A

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
Q

Why is sepsis a serious complication of burns?

A

Burn site is ideal for microorganism growth.

53
Q

What are circumferential burns?

A

Encircle body or body part. Healing to “eschar” constricts (leathery) and must be removed/lysed. (Escharotomy/fasciotomy)

54
Q

What are the treatments of burns?

A 
Active cooling
Fluids
Hemodynamic balance
Nutrition
Analgesia
Wound care
55
Q

What are ways to protect burn wounds?

A 
Antimicrobial
Skin grafts
Autograft (from own body)
Homograft (from another person, alive or not)
Heterograft (from another species)
Synthetic
56
Q

What are decubitus ulcers? (What causes them)

A 
"bedsores"
Pressure
Shearing forces
Friction
Moisture
57
Q

What are nevi?

A

Moles. Congenital or acquired benign skin tumors.

58
Q

What is the appearance of nevi?

A

Pigment or not
Flat or elevated
Hairy or non-hairy

59
Q

What are melanocytic/junctional/compound nevi?

A

Dysplastic nevi
Rough/pebbly surface, irregular shape
Capacity to transform into malignant melanoma, usually related to increased size

60
Q

What is malignant melanoma?

A

Melanocytic tumor typically sun-exposed areas

Rapid progression

61
Q

What are the risks for malignant melanoma?

A

Increased UV light exposure; h/o blistering sunburns
Family history of MM; h/o dysplastic nevus syndrome
Fair hair & skin, freckles
Immunosuppression

62
Q

What are the manifestations of malignant melanoma?

A

Slightly raised, irregular border and surface
Independent or from previous nevi
May have erythema, tenderness, ulceration, bleeding
Often mottled (red/white/blue)

63
Q

What two directions can malignant melanoma grow?

A

Radial (horizontal)
Vertical (down in to deeper dermis)
There is an increased risk of metastasis in vertical growth.

64
Q

How is malignant melanoma diagnosed? (ABCDE)

A 
Diagnosis
A = asymmetry
B = border irregularity
C = color variegation
D = diameter >6mm
E = evolution
65
Q

What is basal cell carcinoma?

A

Neoplasm of basal layer of epidermis
Most common neoplasm, rarely metastasizes
Slow-growing

66
Q

What are the risk factors for basal cell carcinoma?

A

Fair skin, history of sun exposure

67
Q

What are the manifestations of basal cell carcinoma?

A

Nodular: small flesh-colored/pink smooth translucent nodule enlarging over time

Superficial: scaly erythematous patch/plaque

68
Q

What is squamous cell carcinoma?

A

Malignant tumor on sun-exposed area
Confined to epidermis for long periods, then converts to “invasive” stage
Usually older population

69
Q

What are the risk factors for squamous cell carcinoma?

A

UV exposure
Arsenic, industrial tar, coal, paraffin
Men; rare if of African descent

70
Q

What are the manifestations of squamous cell carcinoma?

A

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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