Chapter 28: Skin Disorders

Question 0

What is the difference between a 1st, 2nd, 3rd degree burn?

Answer 0

1st: includes only the epidermis, skin is red and painful, like a superficial sunburn without blisters, dry, healing in 3-5 days
2nd: entire epidermis and upper layers of dermis, skin is pink/red and painful, appear wet. heal in 10-21 days
3rd: all layers destroyed, extend into subcutaneous tissues, can appear black or white and will be dry, leathery in texture, will no blanch when pressure is applied, no pain by now

Question 1

What is the epidermis composed of? What about the dermis?

Answer 1

epidermis: outermost layer - stratified squamous epithelium with proliferating basal and differentiated suprabasal keratinocytes
dermis: composed of two layers - an outer layer of stratified squamous keratinized epithelium and an inner layer of dense irregular connective tissue

Question 2

Give an example of a pustule

Answer 2

pustule: like a vesticle or bulla but contains pus.

aka acne

Question 3

Give an example of a vesicle

Answer 3

vesicle: fluid-filled elevation less than 1 cm, just below the epidermis

aka smallpox or chickenpox

Question 4

Give an example of a papule

Answer 4

papule: solid elevation less than 1 cm in diameter

aka wart

Question 5

Give an example of a wheal

Answer 5

wheal: papule or plaque caused by serum collection into the dermis or allergic reactions

aka urticaria (hives)

Question 6

What is a callus? What about a corn?

Answer 6

callus: circumscribed thickening and hypertrophy of the horny layer of the skin. may be ovular, elongated, brownish, and/or slightly elevated. may not be painful
corn: hyperkeratoses caused by abnormal skin pressure and friction. may be hard (tops of hammertoes. appears hard and dry with a callus that is sharply demarcated) or soft (pain laterally on the fifth toe. circular piece of thickened, white, macerated skin on the lateral side of the first toe at the base of the proximal head of the phalanges).

Question 7

What is hyperkeratosis?

Answer 7

def: excessive growth of the horny tissue layer. caused by excessive rubbing. often found in soles of feet and palms of hands

Question 8

Should a file/stone be used in a treatment of a callus?

Answer 8

NO - their use results in frictional forces that stimulate the skin to produce additional calluses

Question 9

What is a proper way to treat a closed blister? Partially open? Mostly open?

Answer 9

closed: leave blister for the first 24 hours, clean it throughly, with sterile scalpel, cut a small incision, disperse the fluid by applying pressure with a pad, clean the area again with an antiseptic, place a doughnut pad around the dressed blister, monitor it daily, replace if dressing becomes wet.
partially open (less than one-half of diameter): keep it clean, apply hydrogen peroxide and antibiotic ointment, lay the skin back then apply sterile dressing and doughnut pad, monitor daily
completely: torn 1/2 inch or more, completely remove it. clean and dress it. apply second skin.

Question 10

What is the proper way to cut a toenail? A fingernail?

Answer 10

toe: trimmed weekly, cut straight across, avoid rounding
finger: same, nail should be left sufficiently log so that it is clear of the underlying skin.

Question 11

How do you manage an ingrown toenail?

Answer 11

soak the inflamed to in warm water and betadine for 20 minutes, pry nail out from skin and use sterile equipment. insert a piece of cotton to keep the nail out of the skin - do this daily until corner has grown past the irritated tissue OR apply anesthetic and slip the nail-splitting scissor under the ingrown nail. then cut away and remove the wedge-shaped nail.

Question 12

What are the 5 different types of open wounds?

Answer 12

abrasions: occur when the skin is scraped against a rough surface
punctures: direct penetration of tissues
lacerations: when sharp or pointed object tears the tissues - jagged edge cavity
incisions: similar to lacerations but the cut is smooth
avulsions: when the skin is torn from the body - major bleeding

Question 13

What are common signs of wound infection?

Answer 13

red, swollen, hot, tender tissue. swollen and painful lymph glands near the area of infection. mild fever and headache

Question 14

What is staphylococcus? Streptococcus?

Answer 14

both are bacterial infections

staph: genus of gram-positive bacteria normally present on the skin and in the upper respiratory tract and prevalent in localized infections. common cause of skin infection. MRSA is a type (menicillin-resistant)
strep: genus of gram-positive bacteria found in the throat, respiratory tract, and intestinal tract. associated with scarlet fever and common cause of skin infection

Question 15

What is an abscess?

Answer 15

a

Question 16

What is a carbuncle? Where do you commonly see them? How do you care for them?

Answer 16

def: are similar to furnucles (boils) as they are infections of the hair follicle due to pustule formation. carbuncles are larger and deeper and usually have several openings in the skin though. they may produce fever and elevation of WCC. starts as a painful node covered by tight, reddish skin than later becomes thin.

it occurs commonly in the back of the neck - may result in internal infections

management includes surgical drainage combined with antibiotics and a warm compress

Question 17

What is another name for a boil?

Answer 17

furuncles

Question 18

What is impetigo? Where does it commonly occur? How do you care for it?

Answer 18

aka impetigo contagiosa

an extremely common skin disease in children in late summer and early fall. spreads rapidly in close proximity. first characterized by mild itching and soreness which is followed by the eruption of small vesicles that rupture to form honey-colored crusts.

commonly occurs in body folds that are subject to friction

management include thorough cleansing followed by a topical antibacterial agent.

Question 19

What is folliculitis? Where does it commonly occur?

Answer 19

def: inflammatory condition of the hair follicle.

common in the beard, scalp, groin, and butt.

moist heat pack and antibiotic medication is used

Question 20

What is paronychia? Onychia? How should you care for it?

Answer 20

paronychia: a purulent infection of the proximal and/or lateral nail folds
onychia: infection of the nail bed itself

management includes soaking nail in epson salts or boric acid at least three times a day. topical antibiotics are good too

Question 21

What is tinea cruris? Tinea pedis? Tinea capitis? Tinea Corporis? Tinea unguium/onychomycosis?

Answer 21

cruris: aka jock itch
pedis: aka athlete’s foot
capitis: aka ringworm (scalp)
corporis: body
un/ony: toenails and fingernails.

Question 22

What is the difference between type 1 and type 1 herpes simplex virus?

Answer 22

both are associated with skin and mucous membrane infection. both cause cutaneous lesions and are indistinguishable from one another

type 1: found extragenitally
type 2: found genitally.

Question 23

What is herpes zoster?

Answer 23

def: aka shingles - appears in a specific pattern on the body in an area that is innervated by a specific nerve root.

Question 24

What is verruca vulgaris and verruca plantaris?

Answer 24

vulgaris: general warts?
plantaris: plantar wart - found on the sole of the foot, seen as areas with excessive epidermal thickening and cornification. general discomfort and point tenderness. feels as if they have step on broken glass, looks like a cluster of small black seed. management can be frozen of paring away accumulation of tissue

Question 25

What is molluscum contagiosum? How is it cared for?

Answer 25

poxvirus infection, more contagious than warts. appear as small, red or flesh-colored, smooth-domed papules with a central umbilication. must be referred immediately. treatment with cleansing, surgery, or powerful counterirritant

Question 26

What is dermatitis? What causes it?

Answer 26

aka contact dermatitis aka skin reaction

there’s often reddening, elevated patches and eczema. from plants that include poison ivy, oak, sumac, ragweed, and primrose. topical ointment, chemical, detergents, soaps, deodorant.

managed by determining the allergy and not using it anymore

Question 27

What is psoriasis? Where does it occur?

Answer 27

def: chronic disease of the skin that causes itching. exact cause is unknown. can be caused by infection, smoking, drugs, climate, hormonal factors and genetics

begins as reddish papules that collectively form plaques with distinctive borders. will then become yellow-white and scaly. appears most on the elbow, knees, scalp, genitalia, trunk, and mostly around the belly button

treatment includes topical glucocorticoids.

Question 28

What is scabies? Where does it occur?

Answer 28

def: aka mites - skin disease caused by the mite sarcoptes scabiei which produces extreme nocturnal itching.

burrows appear as dark lines between the fingers, toes, body flexures, nipples, and genitalia. body will develop a hypersensitivity.

treatment is the use of permethrin 5% cream

Question 29

What is pediculosis? How do you care for it?

Answer 29

aka LICE

def: an infestation by the louse, of which three types are parasitic to humans (head, crab, body)

its bite causes itching dermatitis which causes a lot of scratching.

treatment with NIX shampoo, cream, and cleaning everything

Question 30

What is macerated skin?

Answer 30

skin softened by exposure to wetting - often associated with soft corn

Question 31

What is Hyperhidrosis? Xerotic?

Answer 31

hyper: excessive perspiration
xerotic: dry skin

Question 32

What is tetanus?

Answer 32

aka lockjaw

an acute, sometimes fatal condition characterized by tonic muscular spasm, hyperreflexia, and lockjaw

immunization should be okay.

Question 33

What is miliaria?

Answer 33

aka prickly heat - common and occurs most often during the hot season to those who perspire profusely and wear heavy clothing

Question 34

What is the difference between fleas and ticks?

Answer 34

fleas: small wingless insects that suck blood. bite pattern of three
ticks: parasitic insects that have an affinity for the blood of many animals, can cause Rocky Mountain spotted fever or Lyme disease. purpura (small, dark spots that retain their color when pressure is applied)