OLC Skin Tissue (Quiz 3) Flashcards
Xerosis
- Dry, scaly, rough skin that is usually on extremities
- winter months, long tub baths, excessive washing with soap
- one of the most common problems
Intertrigo
- nonspecific rash of opposing skin surfaces
- often seen in distal stump of amputees
- may be from friction, heat, moisure, natural occlusion
What pathologies must be considered with intertrigo
psoriasis, infection, seborrheic dermatitis, atopic dermatitis, lichen planus
Intertrigo Treatment
- barrier cream
- remove eliciting factors (ie keep clean and dry)
Bacterial Infection
- most commonly caused by staphylococci or streptococci
- bacteria invade or colonize damaged skin which generalyl causes inflammation, pain, purulence
Fungal Infection
- dermatophytes
- causes well demarcated red scaly patch that is classically annular with central clearing
Candidiasis
opportunistic yeast infection that elicits an inflammatory response causing a beefy red appearance with satellite lesions
Infectious Folliculitis
infection of hair follicle, which typically causes an erythematous papule, pustule, or crust
Infectious folliculitis predisposing factors
- shaving or extracting hair
- moisture
- DM
- occlusion from prosthesis, sleeve, sock, liner, tight clothing
Volume Change
may result in: poor interface fit, malalignment, environmental conditions, loading, function
Verrucous hyperpasia complications
- infection
- further proximal amputations
- ulcerations
- squamous cell carcinoma
Verrucous Hyperplasia
warty appearing condition of distal residual limb that is relatively asymptomatic in the absence of complications
Verrucous hyperplasia treatment
- proper prosthetic fit
- compression
- volume management
Negative Pressure hyperemia
exquisitely painful erythematous patch of vascular and/or lymphatic fluid on the distal residual limb
Negative pressure hyperemia predisposing factors
- volume change proximally preventing distal contact
- poor fit prosthesis
- negative pressure “suction” or “vacuum”
Decubitis Ulcers
- mechanical pressure over a bony prominence
- patients with amputations also have focal pressure and shearing forces of the prosthesis
Decubitis Ulcer Stages
Stage 1: intact non-blanchable erythematous skin
Stage 2: erosion involving epidermis and/or dermis
Stage 3: full skin loss, subcutaneous tissue not through fascia
Stage 4: full skin loss, may have muscle or bone involvement
Possible Causes of Scars
- trauma
- surgical
- systemic disease
- spontaneous
Process of Scar Formation
- inflammation
- angiogenesis
- fibroblastic
- maturation
Inflamation
- vasodilation: increased phagocystosis
- pain, red, heat, swelling
Fibroblastic
- wound closure, fibroblast proliferation, and collagen synthesis
- early cross linking of collagen
Angiogenesis
- begins in first 24 hours
- degradation of basement membrane
- endothelial cell proliferation, migration
Maturation
- reduction in wound size, continued re-arrangement of collagen
- increased cross links, increased strength
Hypertrophic Scar
- overgrowth of fibrous connective tissue within the borders of initial trauma
- thick dermal layer, increased immature colalgen
Keloid Scar
- overgrowth of fibrous connective tissue beyond the borders of initial trauma
- increased vascular density
- thick dermal layer
- immature collagen
- broad, dull, pink bundles
Scar Treatment
- corticosteroid
- cryosurgery
- laser treatment
- surgical excision
- external beam radiation
- orthovoltage radiation
- silicone creams
