Exam 3 - Skin Disorders

Question 1

fungal transmission

Answer 1

• implantation: tineas
• inhalation: cryptococcal
• taking antibiotics: candidiasis
• more common in elderly and immune-compromised
• vascular indwelling catheters, transplant recipients

Question 2

superficial fungal infections

Answer 2

• dermatophytes: fungi that cause superficial skin infections
• mycoses: fungal disorders/infections
• hair, skin, nails
• treatment: usually topical antifungals, sometimes systemic antifungals

Question 3

common types of fungi

Answer 3

• yeast = candida albicans
• superficial dermatophytes = tineas

Question 4

tinea pedis

Answer 4

• athlete’s foot
• dry, scaling pruritic lesions (web space in toes)
• risk: coming into contact with infected skin or fungus in environment
• prevention: shower shoes, cleaning tub/shower
• treatment: topical antifungals, oral or IV if extreme

Question 5

tinea capitis

Answer 5

• cradle cap
• scalp, eyebrows, eyelashes
• scaly erythematous lesions and hair loss
• can cause permanent alopecia
• treatment: PO systemic anti-fungals bid for 4-6 weeks
• topicals are not effective

Question 6

tinea versicolor

Answer 6

• upper chest, back, arms
• caused by a yeast that lives naturally on skin but occurs when there is an overgrowth of yeast
• not contagious
• risk: hot climate, sweating, oily skin, weakened immune system
• characteristics: acidic bleach, discoloration
• treatment: topical anti-fungals including shampoos (selsum blue)

Question 7

candidiasis - thrush/yeast infections

Answer 7

• risk factors: immunosuppression, antibiotic use
• appearance: white lesions in the mouth or beefy red with satellite lesions in skin folds
• treatment: topical anti-fungal agents

Question 8

systemic fungal infections

Answer 8

• aggressive treatment with PO/IV anti-fungals
• affect internal organs: intestines, urinary tract, lungs, brain
• affecting lungs: histoplasmosis, blastomycosis, pneumocystis
• affecting lungs and meninges: cryptococcosis

Question 9

melasma

Answer 9

• dark macules on the face
• more common in women: mask of pregnancy, oral contraceptives
• treatment: avoid sun, bleaching creams with hydroquinone, tretinoin/retin-A

Question 10

vitiligo

Answer 10

• acquired condition, abnormalities in the production of melanin
• pigment disappears from a patch of skin around or before age 21
• affected areas spread
• cause is unknown
• no treatment

Question 11

herpes zoster - shingles

Answer 11

• viral skin infection
• virus lies dormant after chickenpox and reactivated as shingles
• reactivated by: immunosuppression, stress, illness
• prodrome: burning/tingling and then a rash
• characteristics: vesicles on red base that follow along dermatomal distribution-asymmetric
• painful, clears in 2-3 weeks, usually over 50, most contagious when vesicles are weeping
• treatment: anti-virals
• complication: post-herpetic neuralgia persistent pain in the area where the rash was

Question 12

impetigo

Answer 12

• bacterial skin infection
• carried in the nose
• staphylococci and streptococci
• acute and contagious
• appearance: vesicles, pustules, honey-colored crust on red base
• treatment: topical antibacterial

Question 13

abscess

Answer 13

• bacterial skin infection
• skin inflamed and red with collection of pus
• area often raised with palpable borders, tender
• may drain purulent discharge or feel fluid-filled
• treatment: incision and drainage, antibiotics

Question 14

furuncle

Answer 14

• bacterial infection of hair follicle

Question 15

carbuncle

Answer 15

• painful, deep swelling of the skin caused by bacteria

Question 16

cellulitis

Answer 16

• bacterial infection of skin and surrounding tissues (staph or strep)
• may be an initial injury or wound that becomes infected and spreads to surrounding healthy tissue
• animal or insect bites
• often in lower extremities
• not contagious: may become serious by spreading to lymph nodes and blood stream
• appearance: red, painful, swollen and warm to the touch
• blisters may form
• treatment: PO systemic antibiotics, IV depending on severity

Question 17

MRSA

Answer 17

• caused by a type of staph bacteria that is resistant to many antibiotics
• hospital acquired: invasive procedures
• community acquired: painful boil, person to person
• high risk: wrestlers, child care workers, crowded conditions
• symptoms: warm to touch, purulent discharge, fever, abscess
• potentially life threatening
• treatment:
  hospital acquired: IV vancomycin or Zyvox
  community acquired: Bactrim or dicloxacillin
• bactroban nasal ointment prior to surgery

Question 18

actinic keratosis

Answer 18

• precancerous lesion
• benign lesion, due to damage by sun UV rays
• common in lighter skin
• rough, scaly, red plaques

Question 19

solar lentigos

Answer 19

• precancerous lesions
• benign lesions
• liver/age spots

Question 20

three major types of skin cancer

Answer 20

• basal cell
• squamous cell
• melanoma

Question 21

basil cell carcinoma

Answer 21

• most common but least malignant
• lighter skin tones
• increased risk with sun exposure
• most curable: usually non-metastasizing, slow growing skin tumor
• characteristics: nodular for that begins as a small, flesh-colored or pink dome shaped bump

Question 22

squamous cell carcinoma

Answer 22

• 2nd most frequent skin cancer
• sun exposure
• curable with early treatment
• can spread to lymph nodes or internal organs
• characteristics: red and scaling, ulcerations

Question 23

melanoma

Answer 23

• cancer of the melanocytes
• malignant cells grow on skin and grows radically and vertically
• can also form in eyes and under the nails
• risk: family history, red/blonde hair, blistering sunburns before 20, three or more years of outdoor job as a teen
• most deadly form of skin cancer
• nodular form is the most aggressive

Question 24

ABCDE

Answer 24

• A: asymmetrical
• B: borders
• C: color
• D: diameter
• E: evolving

Question 25

eczema

Answer 25

• group of skin conditions that cause the skin to become inflamed or irritated
• not contagious
• atopic is the most common type
• characteristics: pruritic, rash, lesions can ooze and crust over, worsened by heat, cold, detergents, stress
• treatment: relieve itching/prevent, lotions and creams, cold compress, OTC hydrocortisone, immune modulator medications

Question 26

psoriasis

Answer 26

• long term, chronic
• begins in young adulthood
• not contagious
• etiology: over-active immune system, may be autoimmune
• link between psoriasis, obesity, caridovascular disease
• characteristics: skin cells grow too quickly, thick, white, silvery or have red patches of skin
• treatment: keep skin moist, UV light phototherapy, corticosteroid creams, topical medications