Hydration Disorders Flashcards

1
Q

What are characteristics of Sweat Glands?

A
  • Play a key role in the thermoregulation of the skin
  • 3 types of sweat glands
  • Innervated by sympathetic (Cholinergic) nerve fibres (fight or flight) - particulary acetycholine
  • Induced by cholinergic drugs and blocked by anticholinergic drugs
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2
Q

What is the function of sweat?

A
  • Cools the skin as it evaporates
  • Excretes waste products
  • Provides the epidermis with water to hydrate the skin
  • Provides a protective anti-microbial substance
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3
Q

What is hyperhidrosis?

A
  • Excessive production of sweat from the eccrine glands
    *
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4
Q

What is the aetiology of Hyperhidrosis?

A
  • Adolescence
  • Stress
  • Menopause
  • Obesity
  • Endocrine disorder
    • Hyperthyroidism
    • Diabetes
  • CNS disorder
    • Effect on sympathetic (cholinergic) nerve fibres
    • Alcoholism
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5
Q

What is the pathology of Hyperhidrosis?

A
  • Secondary to a central cortical problem rather than eccrine pathology
  • Patients are capable of producing up to 10L of sweat per day
  • Excess production of sweat and lack of evaporation can result in maceration of the skin
  • Effects epidermal barrier function
  • Skin unable to withstand stress
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6
Q

What are clinical features/observations of Hyperhidrosis?

A
  • Can increase stresses and forces across the foot which can lead to:
    • Blistering
    • Peeling of the skin
    • ‘bubbly’ soft callus
    • Fissures - fungal/bacterial infections
    • Burning pain/discomfort
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7
Q

What is the treatment of Hyperhidrosis?

A
  • Debridement of callus and fissures if necessary
  • Skin care advice
  • Topical therapy
  • Referral to dermatologist
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8
Q

What topical therapies are used to treat Hyperhidrosis?

A
  • Astringents
    • Surgical spirits
    • Silver nitrate <20% solution
    • Salicylic acid 3%
  • Aluminium chloride solution
    *
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9
Q

What is Pitted Keratolysis

A

Superficial bacterial infection that affects the soles of the feet

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10
Q

What are clinical characteristics/obversations of Pitted Keratolysis?

A
  • Whitish skin and clusters of punched out pits
  • Coalesce (formed together) crater like regions
  • Hyperhidrosis
  • Punctuate erosions
  • Tender on weight-bearing area
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11
Q

What is the aetiology of Pitted Keratolysis?

A
  • Associated with hyperhidrosis
  • Bacteria:
    • Corynebacteria
    • Dermatophilus congolensis
    • Kytococcus sedentarius
    • actinomyces
    • streptomyces
  • Pitting is due to the destruction of stratum corneum due to protease enzyme produced by bacteria
  • Malodour due to sulfur compounds produced
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12
Q

What is the treatment of Pitted Keratolysis?

A
  • removal of causative organism, and hyperhidrosis treatment
  • Topical antibiotics:
    • Erythromycin
    • clindamycin
    • fusidic acid
    • benzoyl peroxide
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