Integumentary

Question 1

Skin Cancer risk factors?

Answer 1

• Fair skin
• Blonde or red hair, blue eyes
• Outdoor sunbathing
• Indoor tanning
• Living near the equator or high altitudes
• Outdoor occupation or outdoor recreation
• History of skin cancer

Question 2

What is Actinic Keratosis?

Answer 2

• aka solar keratosis
• Most common precancerous skin lesions
• Affect most of the older white population
• Sun exposure key factor
• Impossible to tell from squamous cell cancer
  
  • Treatment should be aggressive

Question 3

What does Actinic Keratosis look like?

Answer 3

Rough, dry, or scaly patch of skin; wartlike surface

Question 4

What is Basal Cell Carcinoma?

Answer 4

• Most common type of skin cancer
• Least deadly
• Low incidence of metastasis
• Middle-aged to older adults

Question 5

What does Basal Cell Carcinoma look like?

Answer 5

• Shiny, skin colored bump that’s translucent.
• Tiny blood vessels might be visible, though they may be difficult to see on brown skin.

Question 6

What is Squamous Cell Carcinoma?

Answer 6

• Aggressive and potential to metastasize
• Main risk factors sun exposure and immunosuppression after organ transplant
• Pipe, cigar, and cigarette smoking contribute to SCC on mouth and lips

Question 7

What does Squamous Cell Carcinoma look like?

Answer 7

• It appears as a firm nodule, which can either have a crust or a depressed area in the center.
• The margins are indurated, and the lesion is fixed to the deeper tissue of the area.

Question 8

What does Malignant Melanoma treatment depend on?

Answer 8

• Site of original tumor
• Stage of the cancer

Question 9

Malignant Melanoma treatment?

Answer 9

Includes surgical excision and adjuvant therapy after surgery.

• Immunotherapy
  
  • Cytokines
  • PD-1 inhibitors
  • CTLA-4 inhibitors
• Targeted therapy
  
  • BRAF and MEK inhibitors
• Radiation therapy to treat LN and brain metastasis

Question 10

What is Cellulitis?

Answer 10

Non-necrotizing cellulitis occurs when microorganisms, especially streptococcal and staphylococcal species, find a portal of entry through breaches in skin integrity.

Question 11

Cellulitis manifestations?

Answer 11

Cellulitis is identified by rapidly spreading erythema, warmth, localized pain, and edema with possible inflammation of regional lymph nodes.

Question 12

How to care for patient with Cellulitis?

Answer 12

• Antibiotic therapy directed against staphylococci and streptococci is usually effective.
• Wound care as prescribed
• Watch out for cues of impaired circulation
  
  • wedding bands, tight socks

Question 13

What to monitor for with Cellulitis?

Answer 13

• Hypotension, tachycardia, hyperthermia or hypothermia, disorientation, lethargy, and disproportionate pain can indicate worsening infection or sepsis.
• It is important to establish a baseline of the appearance of the wound or skin to help guide treatment.
  
  • Usually providers will draw a circle around the infection to assess if it is getting smaller