Exam #1: Geriatric Dermatology Flashcards
What is benign senile purpura?
Thinning of the capillaries of the arm & lower extremities leading to small areas of bleeding without trauma
- Universal
- Benign
What is intertrigo?
This is an inflammation (rash) of the body folds
- Moisture is trapped between the skin folds
- Cell maceration occurs
- Inflammatory cascade initiated
*****Filled with fluid leading to breakdown that can be complicated with secondary fungal infection
How is intertrigo prevented?
1) Separate the tissue planes
2) Wash twice a day with soap & water
3) Hydrocortizone cream
4) Lotramin (Fungus)
5) Powder to keep dry
An elderly female s/p left mastectomy presents with an erythematous rash with well defined borders. She has a fever & appears ill. What is her most likely diagnosis?
Erysipelas
What is Norwegian Scabies?
Scabies above the head & neck
*****Scabies is called “The Great Imitator”
What is Shingles?
Herpes Zoster
What is the most significant complication of Shingles?
Post-herpetic neuralgia= pain syndrome remains even when the rash is gone
*****Treat with anti-virals to attempt to prevent this
How do you treat the pain of Shingles?
1) Tylenol
2) Anti-neuropathic i.e. Gabapentin or Lyrica
3) PRN Opiate i.e. tramadol
What is Lichen Simplex Chronicus?
This is a skin disorder characterized by chronic itching and scratching–seen in areas that a patient can easily reach & seen in the face of dementia
*****Psychogenic etiology that is associated with anixeity or OCD
How is Lichen Simplex Chronicus treated?
- Topical corticosteroid cream
- Antipsychotic meds for demented patients
What are the two main agents used to treat dermatologic disorders topically?
Low potency 1% corticosteroid cream
- Use on face or genitals
Moderate potency 0.1% triamcinolone cream
You are asked to consult on an elderly patient in nursing home. In attempting to bathe the patient, nurses noticed that the patinet’s “legs had turned black.” What is this?
Stasis dermatitis= vasodilation & seepage w/ hemosiderin
How is stasis dermatitis treated?
1) Moisture
2) Lotion to keep the moisture in
3) Steroid cream
4) Support hose
What is eczema craquele?
Eczema= inflamed skin w/ cracks in the skin due to sun exposure
What is actinic keratosis?
Actinic= sun exposure Keratosis= inflammatory response
**At risk for squamous cell carcinoma
What are liver spots?
Senile lentigines
**Accumulation of melanin that is NOT related to the liver pathology, this is a misnomer
What is angular chelitis associated with?
Drooling leading to intertrigo of the angles of the mouth
*****Often seen in patients with PD
What does actinic chelitis precipitate?
Squamous cell carcinoma
What is chondrodermatitis nodularis helicis?
Caused by localized trauma–skin trapped against the cartilage during sleeping
What is the most common vesicular bullous disease in geriatrics?
Bullous pemphigoid
Acute or chronic autoimmune skin disease, involving the formation of blisters, more appropriately known as bullae, at the space between the skin layers epidermis and dermis. It is classified as a type II hypersensitivity reaction, with the formation of anti-hemidesmosome antibodies formed.
What do you need to remember in cases of bullous pemphigoid?
1) Ensure that the patient is NOT ill
2) Punch biopsy
3) Corticosteroid treatment
What is seborrheic keratosis?
Universal & beign waxy lesions seen in old age
What is the formal term for a skin tag?
Acrochordon
What are the characteristics of basal cell carcinoma?
- Flat/ raised
- Red
- Bleeds when scratched
What are “rat bite ulcers” associated with?
Squamous cell carcinoma
What is Rosacea?
Skin lesion that is sometimes referred to as “adult acne”
- Redness
- Dilated redness
What is necrobiosis lipoidica diabeticorum?
Rash associated with DM
