Integument Flashcards
lesions that develop as direct result of disease process
primary
lesions that evolve from primary lesions or develop as a consequence
secondary
flat, distinct, discolored area <10mm; no change in thickness/texture of skin
macule
larger macule
patch
elevated macule; <10mm; can be palpated
papule
firm papule extending into dermis or SQ
nodule
clear fluid filled blister; <10mm
vesicle
clear fluid filled blister; >10mm
bullae
vesicle containing pus
pustule
lesion - elevated; caused by localized edema; pruritic; red
wheal/hive
area of fibrosis replacing normal skin after injury
scar
heaped up accumulation of horny epithelium
scale
dried serum, blood, pus
crust/scab
open areas of skin resulting from loss of part/all of epidermis
erosion
loss of epidermis & at least part of dermis
ulcer
thinning of skin; dry and wrinkled like tissue paper
atrophy
foci of small, permanently dilated vessels; sun damage areas
telangiectase
palpable; >10mm; elevated or depressed; flat topped or rounded
plaque
nonblanchable punctate foci of hemorrhage; <3mm
petechiae
3-10mm petechiae; may be palpable
purpura
>10mm area of hemorrhage; may be palpable
ecchymosis/bruise
straight lesion
linear
ring like lesions with central clearing
annular
circular/coin shaped lesions
nummular
bullseye lesion
target
linear, branched and curving aspects of a lesion
serpiginous
lacy/networked lesion
reticulated
grouped papules/vesicles
herpetiform lesions
clustered in dermatomal distribution - one side of body
zosteriform lesions
irregular, pebbly, rough surfaced lesions
verrucuous
thickening of skin c accentuation of normal skin markings
lichenification
lichenification secondary to…
itching - eczema, psoriasis
deep thickening of skin
induration
induration is a red flag for…
cancer
lesion with central indentation
umbilicated
yellowish, waxy lesions
xanthomas
primary intention healing
minimal tissue loss - approximation of skin, healing after suturing
secondary intention healing
need more tissue replacement - open wounds, ulcers
4 stages of wound healing
homeostasis
inflammation/regeneration
proliferative/resolution
remodeling/repair
problems associated with scar formation
loss of function
contractures & obstructions
hypertrophic scar tissue (keloids)
ulceration
dysfunctional collagen synthesis
keloid scars
wound disruption - it pops out of the stitches (ew)
dehisence
skin contracts, limiting ROM
contracture
6 causes of burns
thermal
chemical/caustic
radiation
electrical
light
friction
_____ pts at risk for radiation burns
cancer
what to look for with electrical wounds
entrance & exit wounds
cardiac issues
- Epidermis burned
- Erythema; painful; dry; no blisters
- Ex sunburn
superficial partial thickness (1st degree)
- Epidermis & part of dermis burned
- Inflammation; edema; erythema; blisters; white or splotchy skin; pain; scarring
deep partial thickness (2nd degree)
- Burn to all skin layers and often underlying tissue
- Painless (burned through all nerves); skin appears white, black, brown, charred, leathery
- Presence of eschar
full thickness (3rd degree)
use _______ to estimate % of body burned
rule of 9s
burn to ___% or more of body considered severe
20%
burns with highest risk of infection
deep partial thickness/2nd degree
goal of severe burn healing
wound debridement & closure in a manner that promotes survival
most common inflammatory disease of skin
eczema
eczema is a Type __ hypersensitivity and Ig_ mediated
1
E
tx eczema
avoid triggers
keep skin moisturized
most noxious sx of eczema
severe pruritus
contact dermatitis is a type ___ hypersensitivity and ____ mediated
4
T cell
examples of contact dermatitis
poison ivy
nickel allergy
dermatitis caused by prolonged exposure to urine & feces
diaper dermatitis
diaper dermatitis may secondarily cause a ____ infection
candida
tx diaper dermatitis
- Frequent diaper changes
- Regular exposure of skin to air
- Superabsorbant diapers
- Petroleum or zinc oxide
- Antifungal meds if C. albicans present
Chronic, relapsing & remitting, proliferataive inflammatory disorder of skin
psoriasis
epidermal turnover rises from 14-20 days to 3-4 days
psoriasis
silvery plaque formation sx of…
psoriasis
tx psoriasis
antirheumatic meds
ointments
lupus is a type ___ hypersensitivity
3
- Photosensitivity
- Butterfly rash over nose and cheeks
systemic lupus erythmatosus
local or systemic sclerosis of skin
scleroderma
localized type of scleroderma lacks…
sclerodactyly, Raynaud’s phenomenon, abnormalities of nail bed capillaries, internal organ involvement
Skin is hard, hypopigmented, taut, shiny, tightly connected to underlying tissue
scleroderma
impetigo contagiosum caused by…
staph aureus
staph exfoliatin toxin causes…
disruption of desmosomal adhesion molecules
- Honey-colored crusty lesions on face, around nose and mouth
- High incidence in hot, humid climates
- Highly contagious
impetigo contagiosum
tx impetigo
topical mupirocin or fusidic acid
causes of acne vulgaris
excessive sebum
- Staphylococcus aureus*
- Propionibacterium acnes*
blackheads (open) and whiteheads (closed)
noninflammatory acne
follicular wall rupture in closed comedones - cystic nodules
inflammatory acne
“inverse acne”
hidradenitis supperative
- Armpits, groin - sweat gland locations
- Hyperkeratosis & occlusion of pilosebacious follicular ducts
hidradenitis supperativa
- Virus induces epidermal cell proliferation
- Slightly umbilicated, dome-shaped papules - face, trunk, extremities
- Autoinoculation
molluscum contagiosum
tx molluscum contagiosum
immunomodulatory & antiviral therapy
destructive procedures
Rash or clusters of inflamed, painful vesicles
herpes simplex
most common locations of HSV1 and 2
HSV 1 - oral
HSV 2 - genital
BUT they can each be found in both places
varicella-zoster virus (VZV) causes…
shingles
chickenpox
______ is dermatomal (on one side of body only)
VZV
ringworm
tinea corporis
scalp ringworm
tinea capitis
Candida infection typically in mouth
thrush
scabies caused by mite…
Sarcoptes scabiei
most scabies problems are caused by…
feces of the mites underneath skin
Rash on trunk, extremities - often not on head - papules, vesicles - burrow lines with severe itching
scabies
tx scabies
scabicide cream
linen cleaning
Ivermectin if severe
intrinsic pressure ulcer r/f
immobility; sensory loss; age; disease; malnutrition; incontinence
extrinsic pressure ulcer r/f
pressure; friction/shear; heat; moisture; posture
pressure ulcer prevention strategies
Frequent skin assessment; repositioning; pressure reduction, removal, redistribution; elimination of moisture; moisture barrier
Malfunctioning venous valves - pressure on veins
erythema; pruritus; scaling; petechiae; hyperpigmentation; ulcerations
venous stasis ulcer
vesicle
scale
nodule
bulla
urticaria
hives - Type 1 hypersensitivity to allergens
inflammation of skin vessels
cutaneous vasculitis
2 types of cutaneous hemangioma
- Superficial - “strawberry” - raised vascular lesions - emerge 3-5 weeks after birth - bright red, small capillary projections
- Cavernous - present at birth - spongy purple mass of tissue - larger & more mature vessels
common benign vascular tumor of childhood
cutaneous hemangioma
tx cutaneous hemangioma
beta blockers
benign, rough, scaly benign growth
actinic keratosis
actinic keratosis
common, noncancerous, benign proliferation of cutaneous basal cells
seborrheic keratosis
seborrheic keratosis
most common cancer
grows slowly
firm to touch
metastasis rare
basal cell carcinoma
basal cell carcinoma
second most common skin cancer
fairly slow growing
squamous cell carcinoma
squamous cell carcinoma
Vascular malignancy associated c immunodeficiency
associated c HIV
pruritic, painful, purple brown lesions
Kaposi sarcoma
Kaposi sarcoma
melanoma
r/f for skin cancer
- Fair skin, red hair, light eyes, freckles
- Hx of sunburns - especially blistering sunburns in childhood
- Excessive sun exposure
- Sunny or high-altitude climates
- Moles
- Precancerous skin lesions
- Family hx
- Personal hx
- Weakened immune system
- Exposure to radiation
- Exposure to certain substances (arsenic)
characteristics of an irregular mole
- A - asymmetry
- B - irregular border
- C - change in color
- D - diameter > pencil eraser
- E - evolving
loss of hair
alopecia
female pattern alopecia
Androgen-sensitive & androgenic insensitive
abnormal growth & distribution of hair in a male pattern occurring in women
hirsutism
fungal infection of nail
onychomycosis
infection of nail cuticle
paronychia
hidradenitis supperativa