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Specialty Medicine > Geriatric skin Conditions > Flashcards

Geriatric skin Conditions Flashcards

1
Q

What happens to lipid content of the skin with aging? What are the effects of this? (2)

A

Decreased:

  • Drier and rougher
  • Decreased barrier function
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2
Q

With aging, the interdigitations of the dermis/epidermis flatten. What are the 4 major results of this?

A
  • Reduced contact between epidermis and dermis
  • Decreased nutrient transfer
  • Increased skin fragility
  • Easy bruising
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3
Q

What accounts for the slower wound healing of old people?

A

Slower turnover of epidermal cells

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4
Q

What is the effect of reduced numbers of langerhans cells with aging?

A

Decreased immune surveillance

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5
Q

What causes the wrinkling with aging (2)?

A
  • Loss of elastin

- Decrease in ground substance (collagen, elastin etc)

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6
Q

What causes the decreased hair density with aging?

A

Shortened duration of anagen, and increased duration of telogen (resting phase)

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7
Q

What are the two UV rays that cause the most damage?

A

UVA and UVB

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8
Q

What are the signs of photodamaged skin?

A
  • Mottling
  • Hyperpigmentation
  • Telangiectasias
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9
Q

What are the drugs that are proved to reduce wrinkling?

A

Retinoids–topical tretinoin at high concentration for long periods

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10
Q

What are the three main effects of topical retinoids on the skin?

A
  • Increases thickness of superficial skin
  • Reduces pigment changes
  • Increases collagen synthesis
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11
Q

What is the concept behind derm surgeries?

A

damage epidermis to allow for dermis to heal again in a better fashion

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12
Q

What is seborrheic dermatitis? Where on the body is it usually found? s/sx?

A

Erythematous, greasy, peely dandruffy type of condition that often occurs in the hairline or nasolabial folds. Sometimes pruritic.

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13
Q

What disease is seborrheic dermatitis more common in?

A

PD

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14
Q

True or false: seborrheic dermatitis is only an acute condition

A

False–chronic, incurable condition, but can easily be controlled

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15
Q

What is the treatment for seborrheic dermatitis?

A

Mild topical corticosteroids for acute phase, then medicated shampoos that act against yeast

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16
Q

What is rosacea? What part of the body is it usually found on?

A

Diffuse erythema and erythematous papules on the face, forehead, and chin

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17
Q

What happens to the nose with Rosacea?

A

Rhinophyma

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18
Q

What ages are affected with rosacea?

A

all ages

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19
Q

What is the common symptom of rosacea?

A

Recurrent facial flushing

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20
Q

What is the cause of rosacea?

A

Idippathic

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21
Q

What is the treatment for rosacea?

A
  • Avoid irritants
  • oral Abx for flares
  • topical abx for mild cases
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22
Q

What is the treatment for refractory rosacea?

A

oral isotretinoin

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23
Q

What is the treatment for the erythema and telangiectasias seen with rosacea?

A

Lasers!!

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24
Q

What is xerosis?

A

Dryness of the skin

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25
Q

What is eczema craquele?

A

Dry, erythematous fissured skin that is itchy

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26
Q

What condition do you get on your hands every year? What causes it?

A

Eczema craquele

You’re way too dry

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27
Q

What is the treatment for eczema craquele?

A

Wet it and avoid hot showers

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28
Q

What is an emollient?

A

Moisturizing agent

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29
Q

What is neurodermatitis (lichen simplex chronicus)?

A

Chronic itching of the skin causes it to thicken, and become more pruritic. Vicious cycle

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30
Q

What is the treatment for neurodermatitis (lichen simplex chronicus)? (3)

A
  • Potent topical corticosteroids
  • Emollients
  • Behavioral modification
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31
Q

What is intertrigo? What usually causes it?

A

Irritative condition of the skin between intertriginous areas

Usually caused by candida

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32
Q

What are the signs of intertrigo?

A

Moist erythema, maceration, and superficial erosion

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33
Q

Why is intertrigo more common in older adults?

A

More folds

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34
Q

What is the treatment for intertrigo?

A

Keep area dry

use typical antifungals PRN

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35
Q

What are the skin findings of bullous pemphigoid?

A

Large, tense blisters NOT on an erythematous base

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36
Q

What is the age range of BP?

A

60+

37
Q

True or false: BP is usually self limiting

A

True, but lasts months to years

38
Q

What are the antibodies that are formed in BP?

A

hemidesmosomes

39
Q

What is the age range that is typically affected with pemphigus vulgaris?

A

Middle aged folk

40
Q

What is the difference between the blisters of BP and PV?

A 
BP = tense and firm
PV = flaccid and easily ruptured
41
Q

Which has oral lesions: BP or PV?

A

PV

42
Q

What is immunofluorescence pattern of BP and PV?

A 
BP = BM
PV = Intradermal
43
Q

which is an epidermal problem, and which is along the dermis/epidermis: BP and PV?

A 
BP = dermis/ epidermis
PV = intradermal
44
Q

Which has more uniform blisters: BP or PV?

A

PV

45
Q

What is the treatment for Bullous pemphigoid?

A
  • Topical corticosteroids or calcineurin inhibitors

- Systemic steroids if more severe

46
Q

What is the MOA of calcineurin inhibitors?

A
47
Q

What causes scabies?

A

Sarcoptes scabiei

48
Q

What are the bites like with scaries?

A

Linear (“breakfast, lunch, and dinner bites”), and pruritic

49
Q

What is the treatment for pruritic jaundice?

A

Cholestyramine (bile acid sequestrants)

50
Q

What is the treatment for pruritis, if you cannot find an underlying cause?

A

Topical corticosteroids or emollients

51
Q

What are cutaneous horns? Are they malignant?

A

Proliferation of keratinocytes

usually benign, but may represent underlying pathology

52
Q

What is the treatment for a cutaneous horn?

A

Excisional bx

53
Q

What is stasis dermatitis?

A

an early sign of chronic venous insufficiency of the legs, triggered by chronic venous HTN and incompetent valves

54
Q

Where is stasis dermatitis usually seen on the body?

A

Medial supramalleolar areas

55
Q

What are the risks of untreated stasis dermatitis?

A

Ulceration and pruritis

56
Q

What is the treatment of stasis dermatitis? (3)

A
  • Compression
  • Leg elevation at rest
  • emollient and topical steroids
57
Q

What are the skin findings of stasis dermatitis?

A

Erythematous and edematous legs, with dusky appearance, and possibly ulcers

58
Q

Which tend to be serous, and which hemorrhagic: PV or BP

A 
BP = hemorrhagic
PV = serous
59
Q

Why are there skin changes with stasis dermatitis?

A

Pressure from veins on small dermal capillaries decreases blood supply to the skin

60
Q

What usually causes stasis dermatitis?

A

Vascular disease

61
Q

What are the s/sx of venous leg disease, compared to arterial?

A

Venous = limb heaviness, aching, swelling that is made worse with standing for long periods

Arterial = claudication, loss of hair, cool extremitis

62
Q

What are the risk factors for venous leg disease?

A

Age
Obesity
h/o DVTs

63
Q

What are the risk factors for arterial disease of the leg?

A 
Age over 40
Cigarettes
DM
HTN
Hyperlipidemia
64
Q

Where are the location of venous leg ulcers, as compared to arterial?

A

Venous = Along the course of the long saphenous vein (medial)

Arterial = over bony prominences

65
Q

What are the complications from onychomycosis?

A
  • Nail bed ulcerations

- Dm pts = route for bacterial infx

66
Q

What is the treatment for onychomycosis? (3)

A
  • Oral terbinafine
  • Fluconazole
  • Itraconazole
67
Q

What are the issues with systemic treatment for onychomycosis in older adults?

A
  • Long duration
  • High potential for drug interactions
  • Hepatotoxic
68
Q

What are the skin findings of zoster?

A

Tiny serous pustules on an erythematous base

69
Q

What is the treatment for shingles? (3) MOA?

A
  • Acyclovir
  • Valacyclovir
  • Famciclovir

Converted by thymidine kinase, to then inhibit HSV specific DNA polymerases

70
Q

What is hutchinson’s sign?

A

Herpes vesicles on the tip of the nose==represents involvement of the nasocilliary branch

71
Q

What is the difference in the rash of intertrigo and candidiasis?

A

Candidiasis has peripheral satellite pustules

72
Q

How do you diagnose candidiasis?

A

KOH prep

73
Q

What is the treatment for candidiasis?

A
  • Keep skin dry
  • Improve hygiene
  • Topical azoles
74
Q

What is the treatment for scabies?

A

Ivermectin

burn everything

75
Q

What is the treatment for body louse?

A

Pyrethrin

76
Q

What are seborrheic keratoses?

A

Benign growths in older adults, that appear are tan, gray, or black plaques with a “stuck-on” appearance

77
Q

What are the differences between seborrheic keratoses and melanoma?

A
  • Melanomas are single vs multiple for seborrheic keratoses

- Chronic condition for seborrheic keratoses

78
Q

What are cherry angiomas?

A

Acquired cutaneous vascular proliferations that appear as round to oval, bright red papules

79
Q

What are cherry angiomas composed of? Are these malignant?

A

Dilated and congested capillaries and postcapillary venules

benign

80
Q

What is actinic keratosis? What causes it? Is it malignant?

A
  • Rough, scaly, red-brown macules on sun exposed skin that are usually poorly circumscribed
  • Sun exposure caused
  • Premalignant lesion
81
Q

What is the treatment for actinic keratosis?

A
  • Cryotherapy
  • Topical acids
  • 5FU
82
Q

What are the usual skin findings of SCC?

A

Chronic, erythematous papules, plaques, or nodules with scaling, crusting, or ulceration

83
Q

Where does SCC tend to occur on the body?

A

In chronically sun-exposed areas

84
Q

What is the issue with SSC on the lip?

A

Increased propensity to metastasize relative to location elsewhere

85
Q

What is the treatment for SCC?

A

Cut it out

86
Q

What are the typical skin findings for BCC?

A

Pearly papule that is ulcerated and has a characteristic rolled border

87
Q

What is the issue with melanoma?

A

Mets early

88
Q

What is the treatment for melanoma?

A
  • cut it out
  • Lymph node dissection
  • Chemo/XRT PRN
89
Q

What are the characteristics of melanomas?

A

Small, Irregular lesion with variations in pigment that grows quickly

Specialty Medicine (36 decks)

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