Integument Flashcards
what is cellulitis?
bacterial infection of deeper dermis and subsequent layer
what bacteria is common in cellulitis?
strep pyogenes or staph aureus
what is strep pyogenes ? staph aureus?
strep pyogenes is an aerobic bacteria and opportunistic (proliferates early)
staph aureus appears in low # on the skin. it is normal flora in nasal passages
what is the transmission of cellulitis?
through compromised skin (wound)
usually legs, then hands and pinna
what are some manifestations of cellulitis?
erythema, warmth, edema fever, and pain
how else can bacteria from cellulitis spread?
through tissue spaces and can affect lymphatic system
what are 3 risks of cellulitis?
compromised physical barrier, immunocompromised, elderlly
treatment for cellulitis?
complications?
mild: oral abx
severe: IV abx
recurrence
lymphangitis (inflame of lymphatic vessels) can become systemic (septicaemia, bacteria), gangrene
what is psoriasis?
chronic inflm disorder where the basal cells haven’t divded normally and instead of shedding, they stack on the surface and form scaly patches.
Et of psoriasis?
idiopathic
genetic component of 30%
autoimmunity (HLA, MHC)
what is the patho of psoriasis?
its a t cell autoimmune response
skin trauma –> t cells activated –>mediators (might be why accelerated epidermal cell cycle) abnormal growth of keratinocytes and blood vessels (mediators also alter growth of blood vessels)
influx of inflm cells
incease epidermal cell turnover (3-4 days)
patterns of remissions and exacerbations
what exacerbates psoriasis?
stress, trauma, infection, drugs
manifestations of psoriasis?
psoriatic patches (scaly)
- elbows,
- knees
- scalp
- sacral region
nail dystrophy and pitting (related to the keratin- 30-50% of pt have this) psoriatic arthritis (distal joints) swelling and deformity of distal joints
what is the treatment for psoriasis?
think severe as well.
no cure
Topical Vit D
o Modulates keratinocytes & regulates T cells
topical steroids
topical retinoids (anti inflm and modulates keratoniocutes
severe:
methotrexate, cyclosporine (immunosuppressive)
Phototherapy (controlled exposure to ultra violet rays - suppress the cell cycle and reduce divans of the cells)
-topical application of TAR
-biologic agents - tumor necrosis factor (brings apoptosis
how much of canada has skin cancer?
1/3
what are the 3 types of skin cancer?
basal cell carcinoma 90%
squamous cell carcinoma 90%
malignant melanoma
what is the name for a pre cancerous lesion
actinic keratosis (actinic is radiation and keratosis is the lesion from radiation)
what is the cure rate for skin cancer?
95%
Et of skin cancer?
inc sun exposure skin damage is cumulative nevus and plural is nevi - skin tags age inversely proportional to the melatonin in the skin
basal cell carcinoma
common? area? fast or slow? lesion shape? mets or invasion? dx?
common form basal cell origin (lower layers of epidermis slow on exposed areas (mostly head, face, neck) dome shaped/nodular lesion local invasion and destr no mets usually no pain biopsy for dx
squamous cell carcinoma? originate where? slow or fast? lesion? infiltrate or invade anywhere? mets?
- Origin in epid keratinocytes
- Exposed areas
- Faster growing
- Poorly defined (lesion)
- Variable appearance (ulers, nodules, papulars)
- May infiltrate local strs (deeper layers of skin and subq affected muscles, nerves, bvessels, adipose, etx)
- Mets to local lymph node
what is melaginant melanoma?
origin?
area?
manifestations?
• Melanocyte origin (melanin –produce pigment of skin) • Worst form o Inc progressive o Mets • Exposed & non exposed surfaces • Main features o Lesion changes (month) • Doubling in size (3-8 mth) • Color change • Irregular border • Pruritus • Bleeding • Crusting • Ulceration mets to bone, brain, lung, liver
tx for skin cancer?
early detection
sx excision
