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
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
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
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
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
7
Q
What is the treatment of Hyperhidrosis?
A
- Debridement of callus and fissures if necessary
- Skin care advice
- Topical therapy
- Referral to dermatologist
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
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
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
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