Dermatological Pathologies Flashcards
What is Acne Rosacea and what may trigger it?
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A chronic skin condition of unknown cause.
Seen mostly in fair-skinned people, 30-60 years of age.
It affects the skin of the face, especially the nose and cheeks.
It may be inherited &/or may involve an over-reaction to normally occurring skin bacteria, but the main triggers are:
> exposure to sunlight
> drinking hot liquids or alcohol
> eating spicy foods
> menopause
> steroidal anti-inflammatory use on face
> emotional stress
List factors associated with development of Acne Vulgaris
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> Genetic predisposition
Overactivity of sebaceous glands leading to blocked ducts
Production of hormone androgen -puberty- leading to more sebum production
Presence of bacterium that triggers inflammation
Environmental factors - some medications, hair or skin products
Compare and contrast Acne and Boils:
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Boils/Acne
Pattern of appearance
Virulence
Symptoms
Communicability
Special precautions
Compare & contrast Acne & Boils: 6 marks
Boils / Acne
Pattern of appearance - 1 lesion at a time or small group / Spread over large areas often face, neck, back
Virulence - Aggressive bacteria attack healthy tissue / Less aggressive bacteria take advantage of hospitable sites on body
Symptoms - Extremely painful / Mildly painful
Communicability - More easily than acne / Only with prolonged contact
Special precautions - Local contraindications, may be general contraindications if signs of general infection are present / Local contraindication no other precautions necessary
What is dermatitis?
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An umbrella term meaning skin inflammation that is not infectious
What is eczema and what causes it?
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Eczema is a hypersensitivity reaction where WBCs inappropriately respond to non dangerous stimuli, releasing molecules like histamine which create an inflammatory response
> Genetic predisposition
Weakened skin, leading to high risk of damage
Imbalance in the types of WBCs, resulting in too many inflammatory chemicals
Flares may be triggered by local irritation - from rough textures, detergents, harsh chemicals, extreme temperatures, excessive sweating
What is contact dermatitis and what causes it?
Distinguish between Irritant and Allergic contact dermatitis.
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Contact dermatitis is skin inflammation caused by an externally applied irritant or allergen.
Irritant contact dermatitis can arise from contact with a substance that would effect anyone, including harsh cleaners, acids, alkalis or continued friction. Removal of the irritant ceases symptoms.
Allergic contact dermatitis differs as the causal agent creates an allergic response in the skin and does so only in those with the allergy.
Triggers include nickel (in jewellery), adhesive on medical dressings, latex, some perfumes and dyes.
Tends to develop several hours after exposure.
What is Psoriasis and how would you recognize it in a patient?
What are the common trigger factors for psoriasis?
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Psoriasis is a chronic skin disease where cells which normally replicate every 28-32 days are replaced every 3-4 days. Instead of sloughing off they accumulate into itchy, scaly plaques, usually on the trunk, elbows and knees.
Red circular-ish lesions often with silvery scale on top, with well defined edges.
It is an autoimmune disease. Runs in cycles of flare and remission. Can be associated with rheumatic conditions.
Trigger factors can include: > Emotional stress > Bacterial and viral infections > Reactions to medications > Weather, especially dry cold weather > Skin injuries > Smoking > Hormonal fluctuations
What is Herpes Simplex and how would you recognize it in a patient?
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Herpes Simplex is a viral infection resulting in painful blisters on a red base. Prior to blisters appearing a person may experience several days of itching, tingling or pain.
Blisters are usually located around the mouth in Type 1 or oral herpes, commonly known as ‘cold sores’. Or around the genitals in Type 2 or genital herpes.
Blisters usually crust over and disappear within 2 weeks. Genital herpes may also be associated with fever, muscular aches, swelling in inguinal lymph node and difficult or painful urination.
What is Herpes Zoster and how might a person with it present?
What might trigger an attack of shingles?
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Herpes Zoster is an infection of the nervous system by Varicella zoster. The virus targets the ends of sensory neurons.
The 1st infection results in chicken pox. The virus then remains dormant in the body and can resurge as shingles when the immune system is weakened.
There are painful, itchy blisters, in chickenpox they can be all over the body, but in shingles they appear as a line along a dermatone - the area of skin supplied by a spinal nerve, along the trunk, buttocks or upper leg. Nearly always unilateral.
Pain is often the first symptom in shingles and can continue long after the blisters disappear.
Triggers may include stress, old age, impaired immunity because of other disease.
Describe two common presentations of Athlete’s foot (Tinea pedis)
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1 - Burning and itching often between 3rd & 4th toes. Weeping blisters, cracking peeling skin. Possibility of secondary infection.
2 - Dry scaly, itchy lesions on the heel and sole of the foot - ‘moccasin distribution’
What are warts and verrucae?
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Warts are small benign growths caused by varieties of the Human Papilloma Virus that invade keratinocytes in the skin and some mucus membranes.
Common warts - verruca vulgaris - usually appear on hands, knees and elbows.
Plantar warts - myrmecia - are warts that grow on the soles of the feet.
What is a burn? List 3 things other than heat that can cause burns.
What bodily functions might be compromised by a severe burn?
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Damage to the skin that kills cells.
Chemicals
Radiation
Electricity
all burn the skin
Regulation of temperature
Control of fluid loss
Protection from microbial invasion
What are varicose veins and why do they occur?
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Varicose veins are distended, often ropey and twisted superficial veins usually in the legs.
They are caused by damage to the internal valves in the veins. The valves are meant to ensure blood only goes back towards the heart and when they don’t work blood backs up or pools along the vein and it becomes distended and generally weakened. When one valve is damaged the backing up blood can put pressure on the next valve down and so on.
Valves can be damaged by wear and tear, being on your feet many hours weakens veins or a mechanical obstruction to returning blood like too tight knee socks or knee brace.
Systemic congestion from kidneys or liver problems can contribute.
Varicose veins may itch or cause throbbing pain and contribute to oedema.
What are piles and what are the risk factors for piles?
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Piles, or haemorrhoids, are swellings containing enlarged blood vessels inside or around the rectum and anus. They may not cause symptoms but they can cause:
Bleeding after defecation which is usually bright red, a lump outside the anus, soreness, redness and swelling around the anus.
They are associated with increased pressure in the blood vessels around the anus, causing them to become swollen and inflamed.
Straining to defecate while constipated is thought to be a common cause.
Other risk factors are:
> Overweight or obesity
> Age - supporting tissues weaken with age
> Pregnancy and childbirth
> Family history
> Persistent cough or repeated vomiting
> Sitting down for long periods
Explain the causes of ulcers and bedsores
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A leg ulcer is a chronic sore that can take weeks (4-6) to heal.
A venous leg ulcer can develop from minor injury like a scratch or insect bite, if there is underlying circulation problem in the leg veins. Pressure in veins increases and causes damage to the tiny capillaries in the skin making it fragile. Fragile skin easily breaks and can form an ulcer.
Pressure ulcers or bed sores are injuries to the skin and underlying tissue, usually caused by prolonged pressure on the skin. Affecting people mainly confined to bed, chair or wheelchair for long periods.
Low mobility through age, illness, surgery or paralysis can all increase risk of an ulcer forming.
Obesity, incontinence, poor diet and medical conditions that affect blood supply can make skin more fragile, or cause movement problems eg diabetes, kidney failure, heart failure, MS or Parkinson’s.
