E3 Skin disorders Flashcards
Fungal transmission
- Implementation (gets under skin after injury): Tineas
- Inhalation: cryptococcal
- Taking Antibiotics: candidiasis
Fungal infections are more common in
the elderly & immuno-compromised
Can proliferate more easily in pts with vascular indwelling catheters, organ transplant recipients, and pts receiving chemo
Types of Superficial fungal skin lesions
- Tinea pedis
- Tinea captitis
- Tinea veriscolor
- Candidiasis
Superficial fungal infections are caused by
mycoses or dematophytes
Treatment of Superficial fungal infections
TOPICAL antifungal preparations
Types of common fungi
- Yeast= Candida albicans
- Superficial dermatophytes= Tineas (live on keratinized tissues of skin, hair, nails)
What is Tinea Pedis and its characteristics
Athletes foot
-Dry, scaling pruritic lesions
-May only affect skin in the web space between toes
Risk factors and prevention of Tinea Pedis
Coming into contact with infected skin or fungus in environment
Use of shower shoes
Cleaning Shower after each use
Keep feet dry
Treatment of Tinea Pedis
TOPICAL antifungals in most cses
Systemic antifungals: Oral or IV
What is Tinea Capitis and its Characteristics?
Cradle cap (common in infants)
-Can affect scalp, eyebrows, eyelashes
-Scaly erythematous lesions and hair loss
-Most common pediatric dermatophyte
Treatment of Tinea Capitis
PO system anti-fungals bid for 4-6 weeks
Topicals are NOT effective
What is Tinea versicolor?
-A ring worm that affects the skin of the upper chest, back, and arms
-Caused by a type of yeast that grows out of control
What is the characteristics and risk facors of Tinea versicolor?
Acidic bleach from the growing yeast causes skin discoloration (patches that are white, pink, red, or brown)
Risk factors: Hot climate, sweating alot, oily skin, weakened immune system, not contagious
Treatment of Tinea veriscolor?
TOPICAL antifungals including shampoos such as selsum blue
What is Candidisasis: Thrush/yeast infections? and its appearance?
-Yeast under fat folds, breast, panasis, groin
-Very common in hospitalized, HIV, Chemo, organ transplant pts
-May appear as white lesions in mouth
-Beefy red with satellite lesions in intertriginous areas (skin on skin areas)
Risk factors and treatment of Candidiasis?
Immunosuppression or antibiotic use
TOPICAL anti-fungal agent
What is Tinea corporsis?
Ringworm of the body
What is Tinea Cruris?
Ring worm of the groin
Systemic fungal infections require
aggressive treatments with oral/ parental antifungals
Systemic fungal infections affect
Internal organs: intestines, urinary tract, lungs, brain
Lungs: histoplasmosis, blastomycosis, pneumocytosis
Lungs & Meninges: cryptococcis
*-osis endings means fungal infection
Herpes zoster is also known as
Shingles
Varicella zoster virus lies dormant on a _____ segment after infection with ______
dermatome
chickenpox
Varicella zoster becomes reactivated bu
immunosuppressants, stress, or illness
Prodrome of Varicella zoster
-Burning/tingling along dermatome and then rash develops with vesicle that dry and crust over
Characteristics of Varicella zoster
Vesicles on red base that follow along dermatomal distribution-asymmetric (does not cross midline)
-Extremely painful
-Clears on 2-3 weeks
-Occurs age >50 if chickenpox hx
-Most contagious when vesicles are weeping
Treatment and complications of Varicella zoster
Anti-virals (PO or IV)
Complications: Post-herpetic neuralgia persistant pain in the area where the rash was
Bacterial skin infections (5)
- Impetigo
- Abscess
- Furuncle
- Cellulitis
- MRSA
What is Impretigo?
Appearance?
Contagiousness?
Treatment?
-Organism carried in the nose (Causative agents: staphylococci & streptococci)
-Acute & contagious
-Appearance: vesicles, pustules, honey-colored crust on red base
-Treatment :Topical antibacterial-bactroban
What is an abscess?
Appearance?
Treatment?
-Skin inflamed & red w/ collection of pus
-Area often raised with palpable borders
-Tender
-May drain purulent discharge or feel ‘fluctuant’ (fluid filled)
-Treatment: incision & drainage & antibiotics (not topical)
What is Furuncle?
Treatment?
a bacterial infection of hair follicle
Treatment: Incision & Drainage & Antibiotics (Not topical)
What is Carbuncle?
Treatment?
a painful, deep, swelling of the skin caused by bacteria
Treatment: Incision & Drainage & Antibiotics (Not topical)
What causes cellulitis?
-Bacterial infection of skin & surrounding tissues (usually staph or strep bacteria)
-May be an initial injury or wound that becomes infected
-May be caused by animal or insect bite
-Lower extremities usually
Appearance, Contagiousness, & treatment of cellulitis?
Red, painful, swollen, warm to touch (Blisters may form)
Not contagious- may become serious & spread to lymph nodes & blood stream
Treatment: PO or IV (not topical)
What is MRSA caused by?
-type of staph bacteria that is resistant to many antibiotics
-Hospital acquired- invasive procedures, surgeries, IV tubing, artificial joints
-Community acquired begins as painful boil (transmitted from person to person)
High risk: high school wrestlers, child care workers, crowded living conditions
Symptoms of MRSA
warm to touch, purulent drainage, fever, abscess
Bacteria can burrow deep into the body, life threatening infections of bone, joints, surgical wounds, bloodstream, heart valves, lungs
Treatment of MRSA
Hospital acquired- IV vancomycin or Zyvox (not topical)
Community aquired- Bactrim or dicloxacillin (PO)
Prophylaxis- Bactroban nasal ointment prior to surgery
Skin Cancers (3)
- Basal cells- most common, but least often malignant
- Squamous cell- 2nd most common, can metastasize to remote areas
- Melanoma-Rarer, but high rates of metastasis
Precancerous lesions (2)- describe
- Actinic keratosis- due to UV rays, common in fair skin, rough, scaly, red plaques
- Solar lentigos- liver/age spots, fair skin
Skin cancer increases with ______
before age 50 _____ are more likely to have melanoma but after age 50 ______ are more likely
Age
Women
Men
______ are 20x more likely to be diagnosed with skin cancers but ______ are 4x more likely to be diagnosed after the cancer has progressed
Caucasians
African Americans
ABCDEEs of mole assessment
Asymmetry
Border
Color
Diameter
Evolving
Elevation
Basal cell carcinoma
-Most common skin cancer in white-skinned people, Most curable, non-metastasizing
-Increased risk w/ sun exposure
-Characteristics: nodular form that begins small, flesh-colored or pink dome shaped bump
Squamous cell carcinoma
-2nd most frequent, curable with early treatment, can metastasize to lymph nodes or internal organs
-Increase risk w/ sun exposure
-Characteristics: red & scaling, keratotic, elevated lesion with irregular border, shallow chronic ulcer
-Horizontal spread
What is Melanoma
-Cancer of the melanocytes
-Malignant cells grow on the skin: radially spreading in the epidermis & vertically spreading deep into the dermis
-Late sign: spread internally, in the eyes, and under the nails
Risk factors of Melanoma
Early & extreme sun exposure
-Family hx
-Caucasian male
-Blonde/ Red hair
-Freckling on back
-3 or more sunburn blistering before age 20
-3 or more years of outdoor job as teen
ABCDE of melanoma
A: Vary in size & shape
B: Irregular
C: Varies
D: >6mm
E: mole or skin lesion that looks different from the rest or is changing in shape, color, size
What is Eczema? Is it contagious
-Group of skin conditions that cause the skin to become inflamed or irritated
-Not contagious
-Atopic is most common
-Affects 10-20% of infants & 3% of kids/ adults
Characteristics/ Symptoms of eczema?
-Pruritis
-Rash on face/back of knee/wrist/hands/feet
-Skin very dry/thickened/scaly
-Lesions may appear reddish then turn burn
-Can ooze & crust over
-Exacerbated by heat, cold detergents, Upper resp infection, stress
Treatment of Eczema
-Relieve itching/prevent infection
-Lotions & creams to keep moist
-Cold compresses
-OTC hydrocortisone cream or prescription strength
-Immune modulator meds
-TOPICAL
What is Psoriasis? Is it contagious?
-Long term, chronic
-Begins in Young Adults
-NOT contagious
-Affects 1-3% of popu.
-Over-active immune system may be autoimmune
-Link w/ obesity & cardiovascular disease
Characteristics of Psoriasis?
Skin cells grow quickly causing skin to be thick, white, silvery or have red patches of skin –> plaque
Normal skin cells grow ____ and flake off about every ____
gradually
4 weeks
Treatment of psoriasis
-Keep skin moist
-UV light phototherapy
-Corticosteroid creams/lotions
-TOPICAL meds
-Immune modulating meds
What skin disorders can be treated topically?
-Tineas pedis
-Tinea versicolor
-Candidiasis
-Impetigo
-Eczema
-Psoriasis
What skin disorders can NOT be treated topically
-Tinea capitis
-Abscess
-Furuncle & Carbuncle
-Cellulitis
-MRSA
-Herpes Zoster: Shingles
Superficial melanoma spreading type = __%
70
Nodular form melanoma is the most _______
aggressive
