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BOC > Chapter 28 - Skin Disorders > Flashcards

Chapter 28 - Skin Disorders Flashcards

1
Q

Epidermis

A

acts as a barrier against invading microorganisms, foreign particles from dirt and debris, chemicals, & UV rays

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2
Q

migration of keratinocytes

A

stratum corneum - stratum granulosum - stratum spinosum - stratum basale

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3
Q

melanocytes

A

synthesize and transfer to keratinocytes the pigment melanin, which blocks solar radiation

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4
Q

langerhans cells

A

aid immune system by collecting & presenting to lymphocytes foreign substances

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5
Q

Dermis

A

composed of connective tissue, provides mechanical support to epidermis and contains blood vessels,nerves, sweat glands, hair follicles, and sebaceous glands

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6
Q

Adnexal structures

A

hair, sebaceous glands, eccrine glands

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7
Q

sebaceous glands secrete

A

sebum

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8
Q

sweat glands

A

cools the surface of the body and internal organs (eccrine glands and apocrine glands)

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9
Q

nails

A

the nail matrix (white semilunar structure) synthesizes the keratinaceous nail plate

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10
Q

cafe au lait spots

A

areas of increased melanin; appear pale brown

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11
Q

pale/red skin

A

may be hereditary

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12
Q

cellulitis

A

infectious inflammation of deep skin structures

erythema and increased warmth

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13
Q

primary lesions

A

macules, papules, nodules, tumors, cysts, wheals, vesicles, bull, pustules

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14
Q

secondary lesions

A

excoriations (result from primary lesions that have been manipulated)

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15
Q

hyperkeratosis

A

epidermal skin layer increases in thickness where constant pressure/friction is applied externally

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16
Q

hyperkeratosis etiology

A

skin is less pliable and mechanical stress on hyperkeratotic skin can result in tears or cracks in the epidermis that are painful and could result in infection

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17
Q

hyperkeratosis prevention

A

properly fitted shoes and cushioning

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18
Q

hyperkeratosis s/sx

A

callus may be ovular, elongated, brownish, and or slightly elevated

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19
Q

hyperkeratosis management

A

exposure to rubbing/shearing forces should be minimized; use moisturizers, possibly carefully shave down calluses

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20
Q

blisters

A

shearing forces produce a raised area that contains a collection of fluid below/within epidermis

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21
Q

blisters etiology

A

sports associated with horizontal shearing

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22
Q

blisters prevention

A

talcum powder/petroleum jelly, socks/well fitted shoes, second skin or mole skin

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23
Q

blisters s/sx

A

sharp, burning sensation where “hot spot” is formed; may contain clear liquid or blood (blood blisters result when deeper skin is disrupted)

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24
Q

blisters management

A

leave blister intact for first 24 hours, then disperse fluid (do not cut off skin), clean and place a doughnut pad around dressed blister

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25
Q

soft corns and hard corns

A

types of hyperkeatosis

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26
Q

hard corns etiology

A

most serious - caused by pressure of shoes, hammertoes are usually associated with hard corns that form on top of deformed toes

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27
Q

soft corns etiology

A

result of the combo of wearing narrow shoes and excessive foot perspiration - usually b/w 4 and 5 toes

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28
Q

corns prevention

A

wear properly fitted shoes

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29
Q

soft corn s/sx

A

appears a circular piece of thickened, white, macerated skin

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30
Q

hard corn s/sx

A

on top of hammer toes, bony prominence is pushed against top of shoe

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31
Q

macerated

A

softened by wetting

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32
Q

corn management

A

properly fitted shoes and socks, small feet pad, keep toes separated

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33
Q

hyperhidrosis

A

excessive perspiration

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34
Q

hyperhidrosis etiology

A

emotional excitement often worsens sweating; palms sweat is syrup like; increases possibility of skin irritation and makes adherence of bandages difficult; calluses and blisters more likely to occur

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35
Q

hyperhidrosis management

A

using an astringent (alcohol) or an absorbent powder; aluminum chloride

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36
Q

chafing etiology

A

occurs in athletes who obese or have large limbs,

fiction/maceration (softening) of the skin in a climate of heat and moisture

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37
Q

chafing prevention

A

keep skin dry, clean, and friction free; groin - wear loose, soft cotton underwear

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38
Q

chafing s/sx

A

oozing wounds that develop into crusting and cracking lesions

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39
Q

chafing management

A

chafed area should be cleaned daily with soap and water, a medicated solution, and applying hydrocortisone cream

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40
Q

xerotic (dry) skin etiology

A

athletes exposed to the weather and who bathe often; decrease in humidity along with cold winds causes the skin to lose water

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41
Q

xerotic skin s/sx

A

skin appears dry with variable redness and scaling may be itching or cracking of skin

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42
Q

xerotic skin management

A

prevent water loss and replace lost water (shower once per day, use moisturizing soaps, use lotions)

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43
Q

Ingrown Toenails

A

nail grows into the lateral nail fold and enters the skin

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44
Q

ingrown toenails etiology

A

results from lateral pressure of poorly fitting shoes, improper trimming, or trauma

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45
Q

ingrown toenails prevention

A

properly fitted shoes and sock, cutting toenails straight across

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46
Q

ingrown toenails s/sx

A

skin swells and is painful, may grow purulent

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47
Q

ingrown toenail management

A

soak in hot water, lift nail from soft tissue and insert a piece of cotton

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48
Q

abrasion

A

top layer of skin is worn away, exposing capillaries;

would is easily infected is not cleaned

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49
Q

punctures

A

may introduce tetanus bacillus into bloodstream

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50
Q

lacerations

A

sharp/pointed objects tears the tissues - susceptible to severe infection

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51
Q

skin incision

A

cut is smooth

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52
Q

skin avulsions

A

skin is torn from the body; keep avulsed tissue for possible reattachment

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53
Q

skin bruises

A

ecchymosis results from disruption of superficial blood vessels (RICE)

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54
Q

wound management

A

clean all wounds with soap and water, dress it with antiseptic

most lacerations/puncture wounds should be treated by a physician

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55
Q

who decides if sutures are required

A

a physician

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56
Q

staphylococcus

A

genus of gram-positive bacteria that commonly appear in clumps on the skin and in the upper respiratory tract. common cause of skin infection

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57
Q

streptococcus

A

also a genus of gram-positive bacteria, appears in long chains. some species are among the most dangerous bacteria that affect humans (scarlet fever), often cause skin infections

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58
Q

impetigo contagiosa

A

primarily in children in late summer and early fall (bacterial)

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59
Q

impetigo contagiosa etiology

A

caused by streptococci or S. aureus - spread rapidly by close contact (wrestling)

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60
Q

impetigo contagiosa s/sx

A

mild itching and soreness, followed by eruption of small vesicles and/or pustules that rupture to form honey-colored crusts - often develops in body folds subject to friction

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61
Q

impetigo contagiosa management

A

thoroughly clean crusted area and apply topical antibacterial agent

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62
Q

furunculosis: medical term for _______

A

boils

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63
Q

furunculosis etiology

A

infections of the hair follicle that usually result in pustule formation (staphylococci)

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64
Q

furunculosis s/sx

A

back of neck, face, buttocks most affected

pustules may be enlarged, reddened and hard from internal pressure

most will mature and rupture spontaneously, emitting pus - DO NOT SQUEEZE

pustules on the face can be dangerous, especially if they drain into veins that lead to brain

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65
Q

furunculosis management

A

protect furuncle from further irritation, administer antibiotics, keep athlete from contact with team while boil is draining

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66
Q

carbuncles

A

develop from staphylococci. similar to furuncles

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67
Q

carbuncles s/sx

A

carbuncles are larger and deeper and usually have several openings in the skin

could cause a systemic infection

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68
Q

carbuncles generally seen around

A

back of neck

first a dark red, hard area and in a few days emerges
into a lesion that discharges yellowish-red pus

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69
Q

carbuncles management

A

surgical drainage combined with antibiotics administration

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70
Q

folliculitis

A

inflammatory condition of the hair follicle (beard, scalp, groin, buttocks)

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71
Q

folliculitis etiology (occlusive, PFB, infectious)

A

caused by no infections or infections agents

occlusive: moist/warm environments

psuedofolliculitis barber (PFB) - penetration of skin by curved hair

Infectious: bacteria, yeast, mites

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72
Q

folliculitis s/sx

A

redness around follicle, development of a papule or pustule at the follicle opening,

may cause scarring/permanent baldness in the affected area

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73
Q

folliculitis management

A

apply noise heat intermittently to increase circulation, antibiotics may be applied locally

74
Q

hidradenitis suppurativa

A

chronic inflammatory condition of the apocrine glands or large sweat glands

75
Q

hidradenitis suppurativa etiology

A

often occurs in axilla, scrotum, labia major, and nipples

exact cause is unknown

76
Q

hidradenitis suppurative s/sx

A

begins as small papule

grow to size of small tumor filled purulent material

deep dermal inflammation can occur - causing large abcesses

77
Q

hidradenitis suppurativa management

A

avoid use of antiperspirants/deodorants, shaving creams

use medicated soaps

apply prescribed antibiotic lotion

78
Q

acne vulgaris

A

inflammatory disease involving hair follicles and sebaceous glands

79
Q

acne vulgaris etiology

A

characterized by close comedones (whiteheads), open comedones (blackheads), papule, pustules, and cysts; sex hormones may contribute

80
Q

acne vulgaris s/sx

A

face, neck, back

deep lesions may scar

athlete may have emotional issues

81
Q

acne vulgaris management

A

variety of topical and systemic agents (antibiotics), manipulation of hormone levels, washing with mild soaps, use cosmetics that are non-comedogenic

82
Q

paronychia and onychia

A

purulent infection of the proximal and/or lateral nail folds

83
Q

paronychia and onychia etiology

A

staphylococci, streptococci and fungal organisms that accompany contamination of open wounds/hangnails;

common in football lineman; loss of cuticle is a risk factor

84
Q

paronychia and onychia s/sx

A

painful, bright red swelling of nail fold (acute);

accumulation of purulent material

85
Q

paronychia and onychia management

A

soak affected finger in hot water with epsom salts, topical antibiotics, removal of purulent material may have to be done through a skin incision

86
Q

tetanus infection etiology

A

tetanus (lockjaw) is an acute infection of the CNS by tetanus bacillus

87
Q

tetanus infection s/sx

A

stiffness of the jaw and muscles of the neck, muscles of facial expression become painful, muscles of back and extremities become tetanic, fever elevates, can be fatal

88
Q

tetanus infection management

A

acute infection - treat in an intensive care unit, must get shot,

immunization should start at age 6 and get given every 5-10 years

89
Q

Fungal infections

A

group of organisms that include yeasts and molds

90
Q

ringworm (tinea)

A

superficial fungi infection takes place in superficial keratinized tissue found in hair/nails and the stratum corner of the epidermis

91
Q

Dermatophytes

A

Ringworm Fungi

many different variations

cause of most skin, nail, and hair fungal infections; belong to 3 genera: Microsporum, Trichophyton, Epidermophyton

92
Q

tinea capitis

A

ringworm of the scalp; common in children

93
Q

tinea capitis s/sx

A

small pap

94
Q

tinea capitis management

A

creams typically

95
Q

tinea unguium/ onychomycosis

A

ringworm of the nail; seen in water athletes or chronic athletes foots

96
Q

tinea unguium/ onychomycosis s/sx

A

nail becomes thickened, brittle, and separated from its bed (trauma predisposes)

97
Q

tinea unguium/ onychomycosis management

A

creams typically do not penetrate nail; often systemic antifiungals or surgical removal of nail is required

98
Q

tinea curries/ “Jock Itch”

A

ringworm of the groin

99
Q

tinea curries/ “Jock Itch” etiology

A

bilateral and often symmetric red-brown scaling plaque with a snakelike border

100
Q

tinea curries/ “Jock Itch” s/sx

A

mild to moderate itching, resulting in scratching and the possibility of a secondary bacterial infection

101
Q

tinea curries/ “Jock Itch” management

A

will respond to OTC meds (ointments most commonly used); secondary bacterial infection is common and oral prescription may be necessary

102
Q

Erythrasma

A

a bacterial infection, may mimic tinea curries but lacks scaling

103
Q

tinea pedis/athletes foot

A

tricophyton species are the most common causes

104
Q

tinea pedis/athletes foot etiology

A

itchy, dry, scaling infection of the sole of the foot; web-space infection between toes often caused by T. mentangrohpytes with the yeast Candida

105
Q

tinea pedis/athletes foot s/sx

A

extreme itching on sole of foot, between and on top of toes, appears as a dry, scaling patch or inflammatory , scaling red papule that may coalesce to form larger plaques; secondary bacterial infection from itching is possible

106
Q

tinea pedis/athletes foot management

A

topical antifungals, *good foot hygiene

107
Q

candidiasis (Moniliasis)

A

yeastlike fungus that can produce skin, mucous membrane, and internal infections

108
Q

candidiasis (Moniliasis) etiology

A

occurs if the environment is right (hot and humid weather, tight nothing, and poor hygiene)

109
Q

candidiasis (Moniliasis) s/sx

A

occurs in body folds (axilla, groin); both candidate and non candidate intertrigo present as beefy red patches but candidate can be distinguished by its satellite pustules.

110
Q

candidiasis (Moniliasis) management

A

maintain a dry area, anti-fungal creams

111
Q

tinea versicolor

A

common fungal infection of young adults

112
Q

tinea versicolor etilogy

A

caused by yeast Malassezia furor (a normal part of the skin’s flora, occurring in areas where sebaceous glands actively secrete body oils

113
Q

tinea versicolor s/sx

A

multiple, small, circular macule that are pink, brown, or white. They commonly occur on the abdomen, neck, and chest. the lesions do not tan when exposed to the sun and are asymptomatic

114
Q

tinea versicolor management

A

selenium sulfide shampoo, or topical econazole nitrate

115
Q

Herpes Simplex Labialis, Gladiatorum, and Herpes Zoster

A

Type 1 is extra genital

type 2 is genital

116
Q

Herpes Simplex Labialis, Gladiatorum, and Herpes Zoster etiology

A

highly contagious and usually transmitted directly through a lesion on the skin or mucous
membrane; after the initial outbreak, it remains dormant and further attacks may be triggered by sunlight,
emotional distress, illness, fatigue, infection.

117
Q

Herpes Simplex Labialis, Gladiatorum, and Herpes Zoster s/sx

A

local swelling followed by appearance of vesicles; vesicles generally rupture in 1-3 days, spilling out serous material that will form a yellowish crust (lesions heal in 10-14 days)

general malaise with sore throat and lymph gland swelling may occur

herpes simplex gladiators

118
Q

herpes simplex gladiatorum

A

lesions on the side of the face neck or shoulders (wrestlers)

119
Q

Herpes Simplex Labialis, Gladiatorum, and Herpes Zoster management

A

therapy usually directed at reducing pain and promoting early healing; antiviral drugs may shorten the course and reduce the recurrence of outbreaks

120
Q

Herpes Simplex Labialis, Gladiatorum, and Herpes Zoster complications

A

can lead to secondary infection (kerato-conjunctivitis=inflammation of cornea and conjunctiva that could lead to loss of vision)

121
Q

Verruca plana

A

flat wat

122
Q

verruca plantaris

A

plantar wart

123
Q

Condyloma acuminatum

A

venereal wart

124
Q

verruca viras and warts

A

The human papillomavirus uses the skinUs epidermal layer for reproduction and growth. The verruca wart enters
the skin through a lesion that has been exposed to contaminated fields, floors, clothing, or other warts

125
Q

common wart

A

verruca vulgaris and plans are prevalent on the hands of children

126
Q

common wart s/sx

A

appears as a small, round, elevated lesion with rough, dry surfaces; may be painful if pressure applied; warts are subject to secondary bacterial infection (esp. warts on hands and feet)

127
Q

common wart managment

A

topical salicylic acid or liquid nitrogen and electrocautery

128
Q

plantar warts

A

found on the sole of the foot; can be spread to hands or other body parts

129
Q

plantar warts s/sx

A

appear as an area with excessive epidermal thickening and cornification; produce general discomfort and point tenderness; major characteristic is hemorrhagic puncta (look like clusters of small black seeds)

130
Q

plantar warts management

A

application of a keratolytic, liquid nitrogen or electrodessication, protect with a donut pad

131
Q

molluscum contagiosum

A

poxvirus infection; more contagious than warts (especially during direct body contact activity) - must be immediately referred to a physician

132
Q

molluscum contagiosi s/sx

A

small flesh or red-colored smooth-domed papules with a central umbilication

133
Q

molluschi contagiosum management

A

thorough cleansing and using a destructive procedure (use of a powerful counterirritant, surgical removal of the lesion, or cryosurgery using liquid nitrogen)

134
Q

allergic reactions

A

an allergy is an immunologically mediated reaction to allergen molecules against which the body’s immune system has been previously sensitized

135
Q

Contact dermatitis:

A

allergic contact dermatitis represents an immunologically mediated reaction to a foreign substance, while irritant contact dermatitis represents a non-immunologic reaction to a chemical irritant

136
Q

contact dermatitis etiology

A

most common plant causes include poison ivy, poison oak, sumac, ragweed, and primrose; chemicals; adhesive in athletic tape

137
Q

contact dermatitis s/sx

A

skin reacts with redness, swelling, and the formation of vesicles that ooze fluid and form a crust. A constant itch develops (increased with heat and made worse by rubbing); secondary infection as a result of scratching is common; over time, appearance may change to erythematous, scaling, lichenified papules and plaques

138
Q

contact dermatitis management

A

identify and avoid irritant (may require extensive testing); topical corticosteroids

139
Q

milaria (prickly heat)

A

occurs most often during the hot season in athletes who perspire profusely and who wear heavy clothing

140
Q

milaria (prickly heat) etiology

A

continued exposure to heat and moisture causes retention of perspiration by the sweat glands and subsequent miliaria

141
Q

milaria (prickly heat) s/sx

A

itching and burning vesicles and pustules (arms, trunk, bending areas of the body)

142
Q

milaria (prickly heat) management

A

avoidance of overheating, frequent bathing with a non-irritating soap, wearing loose-fitting clothing, and the use of antipruritic lotions

143
Q

chilblains (pernio) etiology

A

common type of dermatitis caused by excessive exposure to cold

144
Q

chilblains (pernio) s/sx

A

tissue does not freeze but reacts with edema, reddening, possibly blistering, and a sensation of burning and itching after exposure to cold

145
Q

chilblains (pernio) management

A

exercise and a gradual warming of the part; massage and application of heat are contra-indicated

146
Q

Burns

A

may result from excessive exposure to thermal, chemical, electrical, or radiation sources

147
Q

sunburn

A

represents an inflammatory response to UV radiation-induced skin damage

148
Q

sunburn etiology

A

thin, white skin tends to absorb more radiation than more pigmented individuals; medications may also cause an adverse response to sun exposure

149
Q

sunburn s/sx

A

appears 2-8 hours after exposure; prevention by sunscreen is recommended; continued overexposure to sunlight may result in chronic skin thickening, damage, and skin cancer

150
Q

sunburn management

A

mild burns are treated using cool water in a shower or bath; aloe-based compounds are also beneficial; moderate and severe burns can be relieved by a tub bath with cornstarch

151
Q

Psoriasis etiology

A

relatively common chronic disease of the skin that causes itching (exact cause is unknown); certain conditions such as infection, smoking, some drugs, climate and may be hormonal factors may cause an outbreak

152
Q

Psoriasis s/sx

A

lesions begin as reddish papule that collectively form plaques with distinctive borders; lesions may progress to a yellowish-white, scaly appearance; most likely to occur on elbows, knees, scalp, genitalia, and trunk (particularly around umbilicus)

153
Q

Psoriasis management

A

topical glucocorticoids with a kerolytic agent

154
Q

scabies etiology

A

caused by mite Sarcopotes Scabiei which produces extreme nocturnal itching; the mite burrows a tunnel into the skin to deposit its eggs

155
Q

scabies s/sx

A

burrows appear as dark lines between the fingers, toes, body flexures, nipples, and genitalia

156
Q

scabies management

A

topical application of permethrin (Elimite); all bedding and clothing should be washed with hot water; secondary infection due to itching is common

157
Q

Lice (Pediculosis) etiology

A

head lice (Pedicures humans capitis), pubic lice (Phthirus pubis), or body lice (Pedicures humans corporis - lays eggs in seams of clothing)

158
Q

Lice (Pediculosis) s/sx

A

the louse’s bite causes an itching dermatitis (itching provokes pustules and excoriations)

159
Q

Lice (Pediculosis) management

A

NIX (synthetic pyrethroid permethrin) shampoo/cream; wash all clothes and bedding in hot water

160
Q

Fleas etiology

A

fleas are small, wingless insects that suck blood; individually, bites cause only minor discomfort

161
Q

fleas s/sx

A

a large number of biting fleas will be very uncomfortable; most fleas bite in patterns of three and concentrate their bits on the ankle and lower leg

162
Q

fleas management

A

prevent itching with an antipruritic lotion (calamine or a topical corticosteroid). scratching could result in secondary infection

163
Q

Ticks etiology

A

parasitic insects that are carriers of a variety of micro-organisms that can cause Rocky Mountain spotted fever or Lyme disease (can become easily attached to athletes because they live in grass and bushes)

164
Q

Ticks s/sx

A

RMSF & Lyme disease are characterized by headache, fever, malaise, myalgia, and rash

165
Q

RMSF

A

petechiae and purapura (small dark spots that retain their color when pressure is applied) localized to the distal arms, legs, hands, and feet

166
Q

Lyme disease

A

erythema chronicum migrans (annular red ring) is the typical rash of Lyme disease

167
Q

Ticks management

A

apply mineral oil or fingernail polish to the tick body, at which time it will remove its head (and can thus be removed by grasping or pulling the tick by its head)

168
Q

Mosquitos etiology

A

unless a carrier of a disease, it produces a bite that causes milk discomfort, usually attached to lights, dark clothing, and warm, moist skin

169
Q

mosquitoes s/sx

A

the bite produces a small reddish papule; multiple bites may lead to a great deal of itching

170
Q

mosquitoes mangement

A

topical medication to relieve itching (calamine lotion or topical corticosteroids); repellants

171
Q

stings etiology

A

hypersensitive athletes may respond with an allergic reaction that may be fatal (must be closely monitored in case of anaphylactic reaction); stings to the head, face, and neck are particularly dangerous

172
Q

stings s/sx

A

increased heart rate, fast breathing, chest tightness, dizziness, sweating, and even LOC

173
Q

stings management

A

in uncomplicated situations, the stinger must be removed with tweezers, apply detergent soap

174
Q

spider bite etiology

A

bite marks are usually too small to be seen; spiders don’t bite more than once

175
Q

black widow bite

A

shiny black spider with red to orange colored markings (hour glass shape, on belly)

176
Q

brown recluse bite

A

violin-shaped body with long legs

177
Q

spider bite s/sx

A

pain, small puncture wounds, redness, itching, and swelling that last a few days; the wound will have a center blister surrounded by a red ring and then a white ring. the blister breaks leaving a scab

severe muscle pain and cramps in back, shoulders, and abdomen, weakness, vomiting, fever, or rash

178
Q

spider bite management

A

rash eventually goes away over a 2-10 week period; anti-inflammatory medications may be necessary to stop itching or make the rash go away

179
Q

Pityriasis rosea etiology

A

acute inflammatory skin rash of unknown origin that occurs most often in people ages 10-35. Most common in spring and fall; not a sign of internal disease, nor is it caused by a fungus, bacteria, or allergy;

180
Q

Pityriasis rosea s/sx

A

a single pinkish-red patch called a ‘herald patch’ that appears on the chest or bak and enlarges over several days. within 2-3 weeks, a secondary macular eruption occurs on the trunk over the ribs and on the upper extremity; lesions are red and scaly with a clearing in the center – appear in a symmetrical distribution over the trunk and deformities

181
Q

Pityriasis rosea management

A

rash eventually goes away over a 2-10 week period; anti-inflammatory medications may be necessary to stop itching or make a rash go away

BOC (49 decks)

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