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Skin Midterm > Intro to dermatology > Flashcards

Intro to dermatology Flashcards

1
Q

What is the definition of dermatosis

A

any disease of the skin

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2
Q

What is the definition of dermatitis

A

inflammation of the skin

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3
Q

What is the definition of intertriginous

A

2 skin areas may touch or rub together (axilla of the arm, skin folds of the breast, between fingers)

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4
Q

What is the definition of oleaginous

A

oily or greasy

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5
Q

what does O/W mean

A

oil in water

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6
Q

what does W/O mean

A

water in oil

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7
Q

What is the largest organ system in the human body

A

the skin

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8
Q

what is the purpose of skin on our body

A
  1. provide protective barrier

2. maintain water balance

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9
Q

what are the two types of protective barriers of the skin

A
  1. physically

2. immunologically

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10
Q

what does the epidermis consist of

A

stratified squamous epithelium; keratinocytes; basement membrane

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11
Q

what is the function of the epidermis

A

protection; synthesize keratin; maintain water balance

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12
Q

what is the outermost layer of the epidermis

A

stratum corneum

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13
Q

what does the stratum corneum consist of

A

Corneocytes - “dead” cells, non-nucleated, flattened keratinocytes

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14
Q

What is the function of the stratum corneum

A

provides a barrier - skins 1st line of defense

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15
Q

what does the stratum granulosum consist of

A

lipids

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16
Q

what is the function of stratum granulosum

A

waterproof barrier

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17
Q

what does the stratum spinosum consist of

A

Langerhans cells

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18
Q

what is the function of stratum spinosum

A

antigen specific immune response

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19
Q

what does the stratum basale consist of

A

melanocytes

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20
Q

what is the function of stratum basale

A

produce melanin (UV protection), cell mitosis

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21
Q

What does the dermis consist of

A

collagen, elastin, sweat glands, hair follicles, sebaceous glands, arrector pili muscles, nerves, blood vessels, fibroblasts, macrophages, mast cells

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22
Q

what is the function of the dermis

A

provides structure, pliability, and tensile strength; thermoregulation; produce immune response

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23
Q

what does subcutaneous tissue consist of

A

adipose tissue, nerves, blood vessels

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24
Q

what is the function of subcutaneous tissue

A

insulation, absorbs shock, provides energy supply

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25
Q

Are pediatric patients skin thick or thin

A

thin

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26
Q

How would you describe an elderly patients skin

A

thin, dry, more friable

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27
Q

What are the 7 critical skin functions

A
  1. Protection
  2. Regulates body temperature
  3. Maintains hydration
  4. Sensory
  5. Vitamin D absorption and production
  6. Wound repair
  7. immune response
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28
Q

what are the 3 things dermatoses arise from

A
  1. inability or over-ability to repair
  2. hypoactive or hyperactive immune response
  3. effects of repair and/or the immune response
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29
Q

What some key questions to ask when gathering information about skin

A
  1. What are the symptoms
  2. what makes it better/worse?
  3. what remedies have you tried?
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30
Q

what are the 4 different types of flat lesions

A
  1. erythema
  2. erythroderma
  3. macule
  4. patch
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31
Q

What is an erythema flat lesion

A

pink to red coloring of the skin; blanches (see handprint)

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32
Q

what is a erythroderma flat lesion

A

erythema that covers 90% of the body (see handprint)

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33
Q

what is a macule flat lesion

A

change in color from surrounding skin (< 0.5 cm)

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34
Q

what is a patch flat lesion

A

similar to macule but > 0.5 cm; may have slight scaling

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35
Q

What are the 7 different types of raised lesions

A
  1. comedo
  2. cyst
  3. nodule
  4. papule
  5. plaque
  6. tumor
  7. wheal
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36
Q

what is a comedo

A

blocked hair follicle; may be open or closed

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37
Q

what is a cyst

A

fluid or semi solid filled sac lined with epithelium

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38
Q

what is a nodule

A

solid, round, palpable lesion > 0.5 cm

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39
Q

what is a papule

A

small, solid lesion < 0.5 cm

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40
Q

what is a plaque

A

large, solid, flat topped lesion with large surface area (> 0.5 cm)

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41
Q

what is a tumor

A

any mass ( may be included under nodule)

42
Q

what is a wheal

A

papule or plaque with associated swelling and possible redness and/or pallor

43
Q

what are the 4 types of depressed lesions

A
  1. atrophy
  2. burrow
  3. erosion
  4. ulcer
44
Q

what is atrophy

A

shrinking of the skin; may occur in epidermis or dermis

45
Q

what is a burrow lesion

A

wavy tunnel in epidermis from parasites

46
Q

what is an erosion lesion

A

moist circumscribed lesion; loss of epithelium

47
Q

what is an ulcer

A

destruction of epidermis and top portion of dermis

48
Q

what are the 6 different surface changes you may see on the skin

A
  1. crusts
  2. excoriations
  3. fissure
  4. keratoderma
  5. lichenification
  6. scale (desquamation)
49
Q

what are crusts

A

hardened deposits formed when serum, blood or purulent exudates dry on the skin

50
Q

what are excoriations

A

erosions typically caused by scratching

51
Q

what are fissures

A

linear break in skin from increased tension or decreased elasticity (cracks)

52
Q

what is keratoderma

A

excessive hyperkeratosis resulting in yellow scales

53
Q

what is lichenification

A

thickening of the skin with increased markings (typically caused by rubbing)

54
Q

what is scale (desquamation)

A

flat plate or flake coming from the stratum corneum

55
Q

what are the 4 different types of fluid filled lesions

A
  1. abscess
  2. bulla
  3. pustule
  4. vesicle
56
Q

what is an abscess

A

deep, puss filled cavity in the dermis or SQ tissue; appears as pink nodule

57
Q

what is a bulla lesion

A

similar to vesicle but > 0.5 cm

58
Q

what is a fluid filled pustule lesion

A

pus filled cavity; may contain bacteria

59
Q

what is a fluid filled vesicle

A

cavity or elevation < 0.5 cm between the epidermal layers or dermis/epidermis

60
Q

what are the 3 purpura/vascular lesions

A
  1. infarct
  2. purpura
  3. telangiectasia
61
Q

what is an infarct

A

dusky, reddish gray macule or plaque caused by skin necrosis due to occlusion of blood vessels

62
Q

what is purpura

A

leaking of blood into the skin; non-blanching redness

  • small purpura = petechiae
  • large purpura = ecchymosis
63
Q

what is telangiectasia

A

red lines or net like patterns caused by dilation of capillaries

64
Q

what would a group of lesions look like

A

clustered

65
Q

what would scattered lesions look like

A

separated; irregular pattern

66
Q

What are some considerations for choosing appropriate agent

A
  1. absorption through stratum corneum
  2. potency
  3. vehicles
  4. age
67
Q

What type of products respond better to oily or wet conditions of the skin

A

drying base product

68
Q

what type of products respond best to dry skin conditions

A

moisturizing product base

69
Q

what are the different types of vehicles

A
  1. ointment
  2. pastes
  3. liquids
  4. aerosols
  5. powder
70
Q

what is the primary use of oleaginous or hydrocarbon bases

A

emollients and skin protectants

71
Q

what is the primary use of absorption bases

A

emollients and skin protectants

72
Q

what is the primary use of water in oil emulsions (ointments and creams)

A

emollient; avoid intertriginous areas

73
Q

what is the primary use of oil in water emulsions (creams)

A

may be used for most areas

74
Q

what is the primary use of water soluble bases

A
  • useful when a high surface concentration is needed

- gels: useful for hairy areas; may contain microspheres of meds

75
Q

what is the primary use for pastes

A

skin protectants, sun blocks

76
Q

what is the primary use for solutions

A

good for scalp or hairy areas

77
Q

what is the primary use for suspensions (lotions)

A

good for large areas

78
Q

what is the primary use for shake lotions

A

useful for weeping/oozing skin where drying is needed

79
Q

what is the primary use of foams

A

goof for scalp or hair areas

80
Q

what is the primary use of aerosols

A

may be preferred for abraded skin

81
Q

what is the primary use of powders

A

absorb moisture and reduce friction; used in intertriginous areas and on feet

82
Q

what is the use of topical corticosteroids

A

relief of inflammation and pruritus of corticosteroid responsive dermatoses

83
Q

What disease states are highly responsive to steroids

A
  1. psoriasis

2. atopic dermatitis

84
Q

what are the less responsive disease states to steroids

A
  1. psoriasis of the nails
  2. insect bites
  3. irritant contact dermatitis
85
Q

What is the MOA of topical corticosteroids

A

exert anti inflammatory, immunosuppressive, antiproliferative and vasoconstrictive effects

86
Q

what is the MOA of anti-inflammatory

A

binds to glucocorticoid receptors in the cytoplasm of keratinocytes and fibroblasts in the dermis and epidermis to form glucocorticoid receptor complex; this complex travels to the nucleus and binds to DNA at the glucocorticoid response element (GRE); regulates inflammatory process by stimulating or inhibiting gene transcription

87
Q

what is the MOA of immunosuppressive

A

inhibits immune response in dermis and epidermis

88
Q

what is the MOA of antiproliferative

A

inhibits IL-1a in fibroblasts to decrease proliferation and inflammation in keratinocytes

89
Q

what is the MOA of vasoconstriction

A

decreases capillary permeability to decrease anti-inflammatory effects and decrease redness

90
Q

what is absorption of topical corticosteroids enhanced by

A
  • increased skin temperature
  • hydration
  • application to inflamed or denuded skin
  • sensitive intertriginous areas
  • skin surfaces with a thin stratum corneum layer
  • use of occlusive dressings
91
Q

Who are low potency drugs recommended for

A
  1. children
  2. large areas
  3. body sites prone to steroid damage
92
Q

How are low potency drugs typically dosed

A

twice daily for 2-4 weeks

93
Q

how are potent drugs usually dosed

A

once daily

94
Q

how pulse doing usually dosed for some chronic skin conditions

A

every other day, once weekly

95
Q

What can most topical corticosteroids lead to

A

local and systemic side effects

96
Q

what metabolic effects can occur when using a topical steroid

A

hyperglycemia and Cushing’s syndrome

97
Q

what are the most common local side effects

A
  1. burning
  2. itching
  3. irritation
  4. erythema
  5. dryness
  6. skin thinning/skin atrophy
98
Q

what are the ultra high corticosteroid

A
  1. halobetasol propionate (Ultavate)
  2. clobetasol propionate (Temovate)
  3. betamethasone dipropionate (Diprolene)
99
Q

what is the medium potency drug

A

triamcinolone acetonide (Kenalog)

100
Q

what is the very low potency drug

A

hydrocortisone (as base) 0.5%, 1%, 2%, 2.5%

Skin Midterm (4 decks)

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