Common Skin Disorders Flashcards by McKenna Hunter

What is dermatitis? What causes it? (3)

dermatitis aka eczema
- caused by:

1) contact/allergic (poison ivy, adhesive tape)
2) actinic: photosensitivity, reaction to sunlight, UV
3) atopic: etiology unknown, associated with hereditary or psychological disorders

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Your patient has a history of eczema and asks you what else they can do for their flare up. How should you respond?

Have you talked with your doctor about this? On any meds? (could be taking corticosteroids or immunosuppressants or antihistamines)

Daily care = hydration/lubrication of skin

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How does one get a bacterial skin infection?

bacteria entering a portal in the skin (like an abrasion or puncture wound)

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What is impetigo? Is it contagious?

superficial skin infection caused by staph or strep
- associated with inflammation, small pus-filled vessicles, and itching

YES CONTAGIOUS

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Your patient presents with a closely defined area of redness, which is hot to the touch. What is the indication that you believe it’s NOT cellulitis?

cellulitis is red/hot/edematous, but it’s NOT well defined

- usually poorly defined and widespread

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What does management of cellulitis include?

ANTIBIOTICS (since it’s a bacterial infection)
elevation
cool/wet dressings

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What populations are at increased risk for cellulitis?

elderly, individuals with diabetes, wounds, malnutrition, or on steroid therapy are at increased risk

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What is an abcess?

cavity containing pus and surrounded by inflammed tissue

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What’s the difference between herpes 1 and herpes 2?

1 = cold sores, on face or mouth
2 = genital, spread by sexual contact, can be fatal to newborns

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A patient comes into your clinic with back pain, presenting with a diagnosis of shingles. What modality is contraindicated in this case?

heat and ultrasound is contraindicated as they’ll increase symptoms

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Where do patients with shingles have pain?

along a peripheral or cranial dermatome, progressing to papules along that distribution

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What other symptoms may accompany shingles?

GI issues
eye pain/vision issues (with CN involvement)
fever
chills
malaise

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What precautions should be taken when working with a person with a fungal infection?

standard precautions (wash hands/glove)

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What is tinea corporis?

ringworm

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What is tinea pedis?

athletes foot (typically found between the toes)
- needs to be treated cause can progress to cellulitis or bacterial infection if untreated

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Psoriasis can also be associated with what kind of pain?

joint pain

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What can be a precipitating factor for psoriasis exacerbation?

trauma
pregnancy
infection
cold weather
smoking
anxiety/stress

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Can PT be used to treat psoriasis?

modalities can be used: UV light, combination UV light with oral photosensitizing drugs

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What is Lupus?

chronic, progressive autoimmune inflammatory disorder of connective tissues
- can be discoid (skin only) or systemic

With systemtic lupus, what are all the systems that are affected?

skin
joints
kidneys
heart
nervous system
mucous membranes

You have a patient with chronic systemic lupus. What issues should you be looking out for?

any indication of kidney/heart/nervous issues
side effects of corticosteroids: edema, weight gain, acne, HTN, bruising, osteoporosis, myopathy, tendon rupture, diabetes

So what are the side effects of corticosteroids again?

myopathy, tendon rupture, weight gain, acne, HTN, osteoporosis

What autoimmune disease presents with butterfly rash?

lupus

- butterfly rash is on the face

What auntoimmune disease is commonly accompanied by Raynaud’s phenomenon?

scleroderma

- lupus can have it occur too, but more common in scleroderma

What does scleroderma present like?

taut, firm skin that's edematous and firmly bound to subcutaneous tissues - late visceral and pulmonary hypertension involvement

What are PT's main goals for a patient with scleroderma?

slow development of contracture and deformity

A patient arrives at your clinic with scleroderma. What precautions should you take?

take vitals and stress they do this often at home since acute HTN can occur sensitive to pressure, so watch for that with manual

What internal organs are commonly involved with diffuse systemic scleroderma?

heart, kidney, lungs | - almost same as lupus, which is kidney/heart/nervous

What is polymyositis?

CT disease characterized by edema, inflammation, and degeneration of muscles - primarily proximal muscles: shoulder/pelvic girdle, neck

What causes polymyositis?

unknown; autoimmune reaction affecting muscle tissue with degeneration/regeneration, atrophy, and inflammatory infiltrates

T/F: polymyositis has a rapid onset.

true, severe onset that may require ventilatory assistance

You have a patient come into your clinic with polymyositis. What precautions should you take as far as exercise?

additional muscle fiber damage occurs with too much exercise | - but they do need exercise d/t pressure ulcers and contractures from prolonged bed rest

What are the goals of PT management of polymyositis?

fatigue management/energy conservation exercise at low levels without overload positioning to prevent contractures/ulcers

What might a patient first experience with polymyositis?

difficulty lifting head from pillow, muscle ache/sensitivity, fatigue, malaise, weight loss, fever

What type of benign tumor can lead to squamous cell carcinoma?

actinic keratosis | - flat, round, or irregular lesion covered by dry scale on sun-exposed skin

What is a benign tumor that you commonly see on the trunk of older individuals, that often is untreated unless causing irritation?

seborrheic keratosis

What would indicate that a common mole may be changing into melanoma?

new swelling, redness, scaling, oozing, bleeding

When examining a mole for melanoma, what clinical rule helps you identify what to look for?

ABCDE - asymmetry: uneven edges, lopsided - border: irregular with poorly defined edges - color: variations in color - diameter: >6mm - evolving (or elevation)

What are the different types of autoimmune skin disorders? (4)

1) psoriasis 2) lupus 3) scleroderma 4) polymyositis

What are the 4 different malignant skin tumors?

1) basal cell carcinoma 2) squamous cell carcinoma 3) malignant melanoma 4) karposi's sarcoma

What's the difference between basal cell and squamous cell carcinoma?

Basal = raised area with red area of eczema, indented center or thickened area of skin; rarely metastasizes Squamous = poorly defined margins, red flat area, grows quickly, common on sun-exposed areas; much higher risk to metastasize

What can cause lingual or mucosal squamous cell carcinoma?

alcohol and tobacco use

What are risk factors for melanoma?

family history, intense year-round sun exposure, fair skin/freckles, changing moles esp. if over 50yo

What is karposi's sarcoma?

lesions of endothelial cell origin d/t human herpes virus 8

What causes basal cell carcinoma?

sun exposure

How can you limit a contusion's effects?

``` aka bruise (skin not broken) - immediately apply heat ```