Common Skin Disorders Flashcards
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
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
How does one get a bacterial skin infection?
bacteria entering a portal in the skin (like an abrasion or puncture wound)
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
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
What does management of cellulitis include?
ANTIBIOTICS (since it’s a bacterial infection)
elevation
cool/wet dressings
What populations are at increased risk for cellulitis?
elderly, individuals with diabetes, wounds, malnutrition, or on steroid therapy are at increased risk
What is an abcess?
cavity containing pus and surrounded by inflammed tissue
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
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
Where do patients with shingles have pain?
along a peripheral or cranial dermatome, progressing to papules along that distribution
What other symptoms may accompany shingles?
GI issues eye pain/vision issues (with CN involvement) fever chills malaise
What precautions should be taken when working with a person with a fungal infection?
standard precautions (wash hands/glove)
What is tinea corporis?
ringworm
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
Psoriasis can also be associated with what kind of pain?
joint pain
What can be a precipitating factor for psoriasis exacerbation?
trauma pregnancy infection cold weather smoking anxiety/stress
Can PT be used to treat psoriasis?
modalities can be used: UV light, combination UV light with oral photosensitizing drugs
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
