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Sports Medicine > Chapter 12 - Dermatology > Flashcards

Chapter 12 - Dermatology Flashcards

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1
Q

Integumentary System:

Skin

A

largest organ of the body

  • protect the body against germs
  • helps in the regulation of body temperature
  • assists with the elimination of wastes through sweat
  • epidermis = composed of keratinized, stratified, squamous epithelial tissue with 4 layers: stratum corneum, stratum granulosum, stratum spinosum, and stratum basale
  • dermis = composed of strong, flexible connective tissue
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2
Q

Integumentary System:

Sweat glands

A

located throughout the skin

  • help to regulate body temperature and excrete wastes
  • each coiled, tubular gland has a secretory portion that lies within the dermis and a duct that travels to the surface of the skin where it forms a funnel shaped pore
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3
Q

Integumentary System:

Sebaceous (oil) glands

A

located in all areas of the skin except over the palms of hands and feet

  • sebum = an oily substance secreted
  • blockage of a gland duct leads to an accumulation of sebum, which causes a “whitehead” to form
  • acne is caused by inflammation of the sebaceous glands and appears as pustules (pimples) and cysts on the skin
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4
Q

Integumentary System:

Hair and Nails

A
  • hair follicles extend from the dermis up to the epidermal surface
  • folliculitis = infection of the hair follicle
  • nails provide a protective covering for the dorsal aspect of the fingers and toes
  • each nail consists of a free edge, body, and root
  • the skin surrounding the nail forms the eponychium (cuticle) and proximal and lateral nail folds
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5
Q

Repetitive Trauma:

Blisters

A

occur most frequently on soles of feet and palms of the hands

  • appear as tender vesicles filled with either clear or serous fluid
  • caused by combination of moisture and repetitive friction
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6
Q

Repetitive Trauma:

Calluses

A

occur most often on the plantar surface of the foot or hand

- thickened areas of skin occur in response to repetitive friction

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7
Q

Repetitive Trauma:

Acne Mechanica

A

typically presents as either papules or pustules in mild to moderate cases and may transition to cysts or nodules in more severe cases

  • caused by combination of pressure, friction, heat, and occlusion
  • occurs most often on forehead, chin, shoulders, and upper back
  • treated with topical or systemic antibiotics like topical retinoids or benzoyl peroxide
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8
Q 
Repetitive Trauma:
Talon Noir (black heel)
A

associated with sports involving sudden stops and starts, like basketball and tennis

  • lateral shearing forces cause intra-epidermal bleeding that presents as horizontally arranged rows of small dots along the posterior or post lateral heel
  • also be seen on palms of hands from racket sports or weight-lifting
  • paring down the superficial skin layers using a scalpel will remove the pigmented black heel
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9
Q

Primary and Secondary Skin Infections

A

primary = involve an infectious agent entering and affecting normal skin

secondary = results from an infectious agent entering an existing break in the skin (cuts, laceration, other wounds)

risk factors = (1) warm, moist environment produced by perspiration and increased body temperature, (2) occlusive clothing and equipment, (3) close skin-to-skin contact, (4) acute and chronic trauma to skin

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10
Q

Skin Infections:

Bacterial

A

classified into 1 of 3 categories:

  1. contagious (impetigo)
  2. continued competition can cause further tissue damage (cellulitis, furuncles, and carbuncles)
  3. neither contagious or pose further risk to the patient (folliculitis)
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11
Q

Bacterial Infections:

Staphylococcus aureus

A

present with small pimple-like lesions, pustules, or boils

  • can attack existing cuts and abrasions
  • easily spread to entire sports teams
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12
Q

Bacterial Infections:

Impetigo

A

most commonly caused by the S aureus bacteria, some cases may involve the Group A Streptococcus (GAS) bacteria

  • presents with honey-colored, crusted, well-defined, erythematous vesicles
  • occurs most frequently on the face and other exposed areas
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13
Q

Bacterial Infections:

Cellulitis and Erysipelas

A

acute bacterial infections involving the skin and subcutaneous tissues
- occur at the site of a previous wound (cut, laceration, bug bite)
- caused by either S.aureus or GAS
- present with redness, swelling, and warmth at the site of infection, and may include systemic symptoms like fever and malaise
- may look like the skin of an orange
- treated with antibiotics, and may in some cases require an incision to drain the abscess for full resolution
erysipelas = more superficial infection involving epidermis and upper portion of dermis with a raised, well-defined, expanding, red plaque
cellulitis = presents with a raised rede plaque, however will take several days to fully develop

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14
Q

Bacterial Infections:

Folliculitis

A

gram-negative infection (S aureus) of the hair follicle most often caused by friction from clothing or equipment

  • involve the superficial portion of the hair follicle, resolve on their own, and usually do not require treatment
  • more extensive cases involve the deeper portion of the hair follicle and are associated with redness and tenderness
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15
Q

Viral Infections

A
  • spreading requires direct skin contact with infected lesions or their secretions
  • prevention by covering all abrasions and other open wounds
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16
Q

Viral Infections:

Herpes Simplex Virus

A

2 types:

  • type 1 (HSV-1) = associated with herpes labialis and herpes gladiatorum
  • type 2 (HSV-2) = associated with sexually transmitted genital herpes
  • both can produce primary and secondary infections with primary more severe and produce systemic symptoms
  • become dormant in neural ganglia, leading to periodic recurrences (shorter duration and less severe symptoms)
17
Q 
Viral Infections:
Herpes Labialis (cold sore or fever blisters)
A

caused by HSV-1 and can present as a single vehicle or cluster of vesicles on the lips

  • exposure to the sun and physical or emotional stress triggers for the development
  • usually report prodomal symptoms of tingling or burning prior to appearance of lesions
18
Q

Viral Infections:

Herpes Gladiatorum

A

commonly affects wrestlers

  • presents with clustered vesicular lesions on an erythematous base
  • itching or burning in the area of the lesions prior to the actual appearance of the vesicles
  • head, face, and extremities are most common sites affected as well as trunk and eyes
19
Q

Viral Infections:

Molluscum Contagiosum

A

spread through direct skin contact or sexual contact (STD)

  • presents with a rash that includes white, pinkish, or skin-colored, dome-shaped papules with a center dimple
  • definitive diagnosis made through histology or through a Molluscum preparation
20
Q

Viral Infections:

Warts

A

caused by HPV

  • contagious and are spread by either skin-to-skin contact or contact with a contaminated surface
  • treatment focuses on destroying the lesions by freezing, burning, electrocautery, or applying topical acids
21
Q

Viral Infections:

Plantar Warts

A

found on the soles of the feet

  • commonly occur within calluses, where they hide the usual swirls or “fingerprints” of the callus
  • grow into the foot rather than growing above the skin surface
22
Q

Fungal Infections

A

most common type of dermatological infections in athletes

  • caused by dermatophytes and named for the sites they attack: tinea capitis (scalp), tinea barbae (beard area), tinea pedis (feet), tinea manum (hands), tinea cruris (groin area), tinea unguium (fingernails and toenails, tinea corporis. (all other skin areas)
  • warm, moist environment serves as the primary predisposing factor
23
Q 
Fungal Infections:
Tinea Pedis (feet)
A
  • interdigital tinea pedis = first and most common form, occurs in web spaces of the toes and presents with a scaly, peeling area that may also be erythematous, with mace ration and fissuring
  • second form = presents with vesicles or bullae on the mid foot
  • third form = involves hyperkeratonic scale on the plantar surface of the foot
24
Q 
Fungal Infections:
Tinea Cruris (jock itch)
A

caused by T rubrum or T mentagroohytes

  • involves the proximal medial thighs, inguinal folds of the groin, and buttocks
  • present with large, round, scaly plaques that have pustules and papules at the edges
  • tight clothing, obesity, and chronic corticosteroid use are associated risk factors
25
Q

Fungal Infections:

Tinea Unguium

A

caused by T rubrum

  • affects the fingernails and toenails
  • distal subungual onychomycosis is most common form of nail fungus and appears white, hyperkeratotic patch under the nail
  • nail will become thickened and discolored and will eventually separate from the nail bed
  • does not respond well with topical anti fungal
26
Q 
Fungal Infections:
Tinea Corporis (all other skin areas)
A

caused by T rubrum dermatophyte and often referred as tinea gladiatorum
- presents with a circular, erythematous, pruritic (itchy) plaque, with a raised edge, scaling, and central clearing

27
Q

Fungal Infections:

Tinea Versicolor

A

superficial fungal infection caused by Malassezia furfur organism

  • presents with macules or patches that have either a hypopigmented or hyper-pigmented appearance and may also include a dust-like scale
  • produces variations in skin color from white to red to brown
  • not contagious
28
Q

Parasitic Infections:

Scabies

A

contagious parasitic infection caused by Sarcoptes scabiei

  • spread through direct skin contact
  • most commonly affected sites are the fingers and toe webs, flexor surfaces of the wrists, elbows, axillae, buttocks, breasts, and male genitalia
  • after transfer from host, a pregnant mite will burrow into the epidermis to lay eggs
  • initially, a vesicles or papule may develop leading the severe itching symptom
29
Q

Parasitic Infections:

Pediculosis

A

parasite infestation with lice

  • most common affected sites are head (pediculus capitis), body (pediculus corporis), and genital area (pediculus pubis)
  • newly hatched lice begin biting and cause small red papules and itching
30
Q

Inflammatory Skin Conditions:

Acne Vulgaris

A

involves the sebaceous glands and hair follicles

- presents as “blackheads” and pimples (pustules) that may progress to erythematous macules, papules, and cysts

31
Q

Inflammatory Skin Conditions:

Contact Dermatitis

A

caused by exposure to or contact with a specific allergen

ex: expose to poison ivy creating a rash
- common symptoms include itching, erythema, wet and weeping skin

32
Q

Inflammatory Skin Conditions:

Chronic Eczema

A

present with slightly different symptoms than acute cases

- associated with dry skin, thickening of the epidermis, and fissure or cracks in the skin

33
Q

Inflammatory Skin Conditions:

Psoriasis (plaque)

A

commonly found on the extensor surfaces of the body (knees, elbows, knuckles)

  • T cell mediated disorder activates cascade of inflammatory processes that lead to rapid growth of epidermal and vascular cells
  • appear as symmetrical, round, erythematous plaques with silver-colored scales
34
Q

Environmental Skin Conditions:

Cold Urticaria

A

caused by exposure to cold

  • commonly associated with application of therapeutic modalities such as ice massage, ice bags, or ice slush baths
  • common symptoms include hives and itching
35
Q

Inflammatory Skin Conditions:

Frostnip

A

superficial skin injury caused by extended exposure to cold temperatures

  • most commonly affects the exposed skin areas like face, nose, chin, and ears
  • produces transient blanching, numbness, throbbing or burning, and a blue-white tint to the affected area
36
Q

Inflammatory Skin Conditions:

Frostbite

A

involves deeper tissues and can lead to damage of the subcutaneous tissue, muscle, and bone, which can also lead to limb loss

  • occurs as ice crystals in extra cellular space
  • skin appears waxy, dry, or cyanotic, and becomes hardened over the joints
  • ice in the tissues draws fluid from the cells, causing permanent damage to epithelial cells no blood vessels
  • once blood supply is disrupted, hypoxia necrosis occurs unless blood can be delivered through adjacent vessels
  • continued exposure progresses to deep frostbite, involving freezing in the deep layers of skin and possibly muscle or underlying tissues
  • during rewarming, intense pain, bright erythema, edema, and eventually blistering occur as blood supply returns
  • area should not be re-thawed if re-freezing is a possibility since it can increase the extent of tissue damage
37
Q

Inflammatory Skin Conditions:

Sunburn

A

extended exposure to UV rays, particularly peak times of 10am to 2pm

  • degree of skin injury can vary based on a variety of factors, like total time of exposure, altitude, and fairness of the skin
  • 1st degree burns = produce erythema
  • 2nd degree burns = erythema and blistering
  • 3rd degree burns = erythema, blistering, and ulcerations
38
Q

Inflammatory Skin Conditions:

Skin Cancer

A

most common form of all cancers

  • nonmelanoma = occur most often, involve the basal and squamous cells of the epidermis
  • basal cell cancers = develop on skin areas that have the greatest sun exposure (head and neck) but does not spread to other parts of the body
  • squamous cell carcinoma = 2nd leading form, occurs most frequently on areas with greatest sun exposure, and grows faster and more likely to spread to other parts of the body
  • melanoma = occurs in the lower epidermis and is formed from melanocytes, can spread to other parts of the body
  • typically brown or black, but also can be pink, red, or white
39
Q

Inflammatory Skin Conditions:
Skin Cancer
Risk Factors

A

2 types of UV rays: UVA and UVB

  • both types can damage DNA of skin cells
  • UV index reported on a scale from 1 to 11+ describes the intensity of UV rays reaching the ground around the time period of noon
  • the higher the UV index, the more damaging the UV rays

Sports Medicine (5 decks)

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