Dermatological Pathologies Flashcards
3 layers of the skin
- epidermis (superficial)
- dermis (middle)
- endodermis (deep)
Function of the skin
interface between the body and external environment
- protection
- environmental sesnation
- thermoregulation
- proprioception and kinesthetic
- synthesis of vitamin D
- human communication
Lesion
abnormal tissue
Pruritic
itchy
erythema
redness
dysplastic nevi
atypical moles
exudate
seeping fluid
Primary skin lesions
caused by condition or disease
- maculae
- wheal
- tumor
- plaque
- papule
- vesicle
- bulla
- pustule
Macule
(Primary lesion)
- flat, discolored area
- non-palpable
(i.e. freckles)
Wheal
(Primary lesion)
- temporary inflamed solid bump
(i.e. mosquito bite)
Tumor
(Primary lesion)
- mass lesion (malignant of benign)
(i.e. inflammatory reaction)
lesionPlaque
(Primary lesion)
- flat, raised patch
(i.e. dental plaque)
Papule
(Primary lesion)
- small, solid bump (under 5 cm)
(i.e. mole or warts)
Vesicle
(Primary lesion)
- small, fluid-filled blister (under 5 cm)
(i.e. herpes simplex)
Bulla
(Primary lesion)
- Fluid-filled blister (above 5 cm)
(i.e. blister)
Pustule
(Primary lesion)
- elevated lesion (filled with WBC or bacteria)
(i.e. acne)
Secondary Skin Lesions
Caused by external forces
- excoriation
- fissure
- erosion
- ulcer
- crust
- scale
- scar
- keloid
Excoriation
(secondary lesion)
- abrasion
- (i.e. scratch)
Fissure
(secondary lesion)
- split through all layers of dermis
(i.e. athletes foot)
Erosion
(secondary lesion)
- Loss of epidermis
(i.e. ruptured chickenpox vesicle)
Ulcer
(secondary lesion)
- loss of skin through dermis
(i.e. stasis ulcer)
Crust
(secondary lesion)
- Dried exudate on skin
(i.e. impetigo)
Scale
(secondary lesion)
- plates or plates on skin
(i.e. psoriasis scale)
Scar
(secondary lesion)
- Fibrotic change in tissue
(i.e. acne scar)
Keloid
(secondary lesion)
- Obvious & prominent raised scar tissue
(i.e. post acne scar)
Dermatitis
An inflammatory of skin
- Contact: caused by direct contact with an allergen
- Actinic: caused by exposure to sunline or another irritating light source
Dermatitis S&S
- Redness
- inflammation
- itching
- lesion of rash
Dermatitis Treatment
- Cleanse area
- avoid triggers
- ice
- corticosteroid creams
- oral corticosteroids
- antihistamines
Eczema
Most common inflammatory disease
- chronic dermatitis that consists of erythema, scales, and vesicles
Eczema S&S
- red, swollen, itchy skin
- tiny red vesicles
- thickened, cracked, crusty, or scaly skin
Eczema Treatment
Hormone Care:
- ice, corticosteroid cream, light therapy
Meds:
- oral corticosteroids, antihistamines, immunimodoulators
Psoriasis
- A genetic, chronic, and recurring disorder that begins in childhood
- scaling, papular infection
- can lead to psoriatic arthritis that affects the interphalangeal joints of the fingers and toes
Psoriasis S&S
Salivary white plague surrounded by erythema (extensor surfaces, scalp, fingers, gluteal folds)
Psoriasis Treatment
- moisturizes, corticosteroid cream, retinol cream, salicylic acid cream, light therapy
- Meds: anthralin (normalizes DNA activity) & Retinoids (reduces skin cell production)
Rosacea
A chronic skin disorder which affects the central facial area (most often affects fair-skinned people who blush easily)
Triggers:
- sun, stress, hot weather, wind, alcohol, heavy exercise
Rosacea S&S
Early stages:
- redness of nose, cheeks, chin, or forehead
Later stages:
- visible blood vessels, swelling, or skin eruptions similar to acne
Advanced:
- nose may become enlarged and bulbous (rhinophyma)
Rosacea Treatment
- Prescription gels or creams (ClinaMax)
- antibiotics to treat swelling/redness (erythromycin)
- laser treatment of visible blood vessels
Methicillin-Resistant Staphylococcus Aureus (MRSA)
Methicillin-Resistant Staphylococcus Aureus (MRSA) S&S
- begins as small, pimple-like lesion or abrasion then becomes inflamed and painful
- red and sometimes purple
- may contain pus
- surrounding skin is warm to touch
- fever
Methicillin-Resistant Staphylococcus Aureus (MRSA) Treatment
easily treatable in early stages but can lead to death if left untreated
- Aspiration
- tetracycline meds
- hospitalization
Methicillin-Resistant Staphylococcus Aureus (MRSA) Prevention
avoid touching infected skin or contaminated objects & proper hygiene
Cellulitis & Eryspipelas
Acute bacterial infections (typically at site of previous wound
Cellulitis & Eryspipelas S&S
- redness, swelling, and warmth at site of infection
- systemic (fever & malaise)
- looks like the skin of an orange
- Cellulitis (raised red plaque takes days to develop)
- Erysipelas: superficial, raised, red plaque
Cellulitis & Eryspipelas Treatment
- antibiotics
- incision & drain
Folliculitis
Bacterial infection of hair on the face, chest, axilla, buttocks, groin, and legs
- most caused by shaving with a razor, friction from sports equipment, excessive perspiration, and hot tubs
Folliculitis S&S
cluster of small/tender/red papules or bumps in the hair follicles with a hair shaft within the papule
Folliculitis Treatment
topical or oral antibiotics, warm saline compress and aspiration, wash area multiple times a day with antibacterial soap, change razors after each use
Abscess
A collection of pus that can arise anywhere on the body
Abscess S&S
- painful swollen bump
- redness
- skin warmth
Abscess Treatment
- incision and drainage
- antibiotics
Furuncle
a furuncle, or boil, is a walled-off abscess containing pus that usually develops in a pre-existing site of folliculitis
- usually occur at sites of trauma or friction
Furuncle S&S
- painful pea-sized red bump
- increases in size over a few days
- may develop a white tip of pus
Furuncle Treatment
- warm compress followed by incision and drainage
- antibiotics
Carbuncle
collection of several coalescing furuncles, such as MRSA
Acne Vulgaris
- commonly occurs where sebaceous and sweat glands are located
- equally common in both males and females during the adolescent years (caused by overproduction of oil and the buildup of bacteria)
Acne Vulgaris S&S
- small raised bumps
- whiteheads or blackheads
- skin tenderness
- papules/pustules/deep cysts
Acne Vulgaris Treatment
- benzoyl peroxide
- salicylic acid
- topical prescriptions
- light/laser therapy
- microdermabrasion
- antibiotics
- oral contraceptives
Necrotizing Fasciitis
- rare, but serious bacteria that causes tissue death
- aka “flesh-eating bacteria”
- caused by streptococcus bacteria that grows and released toxins that directly kill cells, occludes blood flow to tissues, and spreads quickly
Necrotizing Fasciitis S&S
- starts as small, red, painful bump
- becomes quick growing painful bronze or purple patch
- center of tissue may turn black
- may have fluid discharge
- flu-like symptoms
- shock
Necrotizing Fasciitis Treatment
(fatal if not treated)
- IV antibiotics
- skin grafts
- limb amputation
- hyperbaric oxygen therapy
Herpes Simplex
Extremely contagious with more than 80 types
- HSV-1: herpes labialis, herpes gladiatorum
- HSV-2: sexually transmitted genital herpes
Commonly affects the mouth, lips, fingers, and genitals
- Transmission: infected saliva and direct skin-to-skin contact
Herpes Simplex S&S
- blisters or ulcers with redness
- enlarged lymph nodes
Herpes Simplex Treatment
- shower with antibacterial soap
- wash towels and uniforms daily
- antiviral medications with increased fluid intake
Herpes Labialis
- cold sore
- fever blister
- triggered by exposure to sun, emotional stress
- reporting tingling or burning prior to apperance
Herpes Gladiatorum
- commonly affects wrestlers
- open wounds necessary to occur
- presents with clustered vesicular lesions on erythematous base
- systemic symptoms: fever, chills, sore throat, headache, malaise, myalgia, regional lymphadenopathy
Herpes Simplex RTP
Athletes cannot participate in contract sports until:
- they are asymptomatic
- no new lesions are found for 3 days
- they take antiviral meds for 5 days
- there is a firm, adhered crust on each lesion
Molluscum Contagiosum
Spread through direct skin contact
Molluscum Contagiosum S&S
- white, pinkish, skin-colored dome-shaped papule
- center dimple
- individual or group lesions
Molluscum Contagiosum Treatment
- destruction of papules
- topical agents
- NCAA requires papules to be curetted or removed and covered with gas permeable dressing
Warts
Caused by viral infection, specifically by one of the many types of HPV
- majority are harmless
- they spread through skin-to-skin contact and occur at sites of abrasive trauma
Warts S&S
- small, painless growth
- can become rough, flat, callused lesions
- sone have small black dots in the middle from coagulated blood
Warts Treatment
- OTC creams
- liquid nitrogen
- salicylic acid
- HPV Gardasil vaccine
Ringworm
- Transmitted through direct skin-to-skin contact
- fungus develops in dark, humid, damp conditions
Tinea Corporis
RW of the body
Tinea Capitis
RW of the scalp
Tinea Unguium
RW of the nails
Ringworm S&S
- circular rash that is red and inflamed around the edges
- itchy
- slightly raised/scaly skin
Ringworm Treatment
- OTC antifungal creams
- shower daily
- clean towels/clothes
- oral antifungals
Ringworm RTP
athletes may return to contact activities after 3 days of treatment, but the rash must be completely covered by adhesive dressing
Jock Itch
Tenia Cruris affects the skin of the inner thighs, buttocks, and genitals
- most common in men
- caused by friction from sweating of clothing and is spread through direct contact or sharing infected towels of clothes
Jock Itch S&S
- itching and redness in groin area
- burning sensation
- scaly rash
Jock Itch Treatment
- OTC antifungal cream/powder/spray
- wear loos fitting clothes
- dry off completely after showering
- oral antifungals
Athletes Foot
Tinea Pedis develops in moist areas around toes
Athletes Foot S&S
dry, scaly, itchy, red lesions between and around toes
Athletes Foot Treatment
- OTC creams and powders
- oral antifungal meds
Yeast Infection
- Tenia Versicolor is not contagious and found mostly on the trunk, groin, arms, neck, and mouth in high humidity climate
- yeast is naturally occurring in the skin but can cause infection in warm.moist places
Yeast Infection S&S
- multiple small, round, scaly patches
- white, brown, or pink
- may or may not itch
Yeast Infection Treatment
- OTC antifungal shampoo, lotion, cream with selenium sulfide for 7 days
- oral antifungals
Head Lice
- pediculosis (capitis)
- tiny insects that live on the scalp and feed on human blood
- multiply quickly by laying eggs at the base of the hair shafts
- spread by: close contact with infected person & sharing combs, towels, hats, and clothes
Head Lice S&S
- intense itching
- small red bumps on scalp
- tiny white specks at base of hair follicle
Head Lice Treatment
- OTC 1% permethrin shampoos and lotions
- remove eggs with metal fine-toothed comb
- wash all clothes and bed linens
- vacuum floor and furniture
- recheck for live every 2-3 days for 2 weeks after treatment
Scabies
- infestation of small mites that burrow into the skin and deposit eggs (eggs mature in 21 days)
- spread by skin-to-skin contact and sharing infested clothes/bed linens
- commonly seen on the hands, wrists, fingers, genitals, and abdomen
Scabies S&S
-small red bumps
- itching
- thin/pencil-mark lines
Scabies Treatment
- 5% permethrin cream
- wash clothes, towels, and linens
- vacuum floor and furniture
Bed Bugs
- small, oval, brownish insects that love on the blood of animals or humans
- they are active mainly at night and feed by piercing the skin and withdrawing blood through an elongated beak
Bed Bugs S&S
initially painless red sports on any area of the body, become itchy welts over time
Bed Bugs Treatment
- treat symptoms
- remove/clean all linens
- clean mattress/pillow/carpet
- exterminator
Insect stings/bites S&S
- often result in pain, redness, and swelling, blistering
Spider bites:
- brown recluse: blistering, abdominal pain, nausea, vomiting, chest pain
- black widow: more systemic; abdominal pain, nausea, vomiting, chest pain
Insect stings/bites Treatment
depends on bug species
Cholinergic Urticaria
occurs during or shortly after exposure to heat or overheating
Cholinergic Urticaria S&S
- itching/burning/tingling/warmth/irritation of the skin
- wheezing
- high core temp
Cholinergic Urticaria Treatment
- limit strenuous exercise/stressful environments
- antihistamines
Cold/Solar Urticaria
Cold - exposure to cold
Solar - exposure to UV light
Cold/Solar Urticaria S&S
hives lasting for 1-3 hrs after removal of stimulus
Cold/Solar Urticaria Treatment
- antihistamines
- avoid triggers
- proper clothing
Poison ivy/oak/sumac
allergic reaction to an oily resin that is on the leaves, stems, or roots of poison ivy, oak, or sumac
Poison ivy/oak/sumac S&S
- redness
- itching
- blisters
- swelling
Poison ivy/oak/sumac Treatment
- natural resolution in 2-3 weeks
- oral corticosteroids
- calamine lotion
- cool-water bath or shower
Non-melanoma Skin cancer
Basal cell carcinoma:
- look like open sores, red patches, pink growths, shiny bumps, or scars
Squamous cell carcinoma:
- scaly red patches, open sores, elevated growths with central depression, or wards
- may crust or bleed
Non-melanoma Skin cancer Treatment
- surgical removal
- electrodesiccation
- cryotherapy
- topical chemotherapy
- Mohs micrographic surgery: traditional cancer treatment if metastasized
Melanoma Skin Cancer
- melanoma arises from melanocytes
- found in stratum basal, eye, inner ear, meninges, heart, and bone
Melanoma Skin Cancer Types
Superficial Spreading:
- 70% of melanomas, asymptomatic brown or black macule with irregular borders, does not have tobe sun-damage and my grow from an existing mole
Nodular:
- most common melanoma in fair-skinned individuals, bluish-black/reddish-pink nodule on sun-exposed skin, grows deeper into skin
Melanoma Skin Cancer Treatment
- excision
- lymph node treatment
- chemotherapy
- chemo/radiation/immunotherapy/biochemotherapy/molecular target therapy
