Other systems: Integumentary Pathology Flashcards
Arterial Insufficiency Ulcer
Inadequate perfusion of oxygenated blood in the affected tissue. Occur with atherosclerosis or arterial embolism
PAD main contributing factor - narrowing of arterial vessels that impedes delivery of oxygenated blood to tissues (atherosclerosis, HTN, obesity, DM, smoking
LOWER 1/3 of LE (lateral malleoli, toes, dorsum of foot
- irregular wound edges
- min bleeding
- discoloration of nails, nail beds, surrounding skin.
Doppler US
Limb related pain is most commonly positional, occurring when limb is in a non-dependent position or with activity that results in intermittent claudication
ABI
Full thickness Burn
immediate cellular damage, tissue death
Complete destruction of epidermis, dermis, hair follicle, nerve endings, subcutaneous fat layer.
Deep red, black or white coloring, eschar formation and necrotic cells
- Edema present at injury
- No sensation
Initial stages: thermoregulation impairment, SOB, electrolyte disturbances, poor urine output, variation in level consciousness
Autograph usually required
Partial thickness burn
Superficial (epidermis and upper dermis) or Deep (complete destruction of dermis)
Extremely painful
Superficial: Red color that will blanch when touched and then returned to red (capillary refill and damage to deeper vessels). Blisters and superficial moisture
- Re-epitilize in 5-21 days no scar
Deep: no blanching w/ cellular necrosis. POssible contracture with deep burns
- 25-35 days scar
Celulitis
Bacterial noncontagious skin infection occurring in the dermal and subcutaneous layers. Most commonly associated with staphylococcus (also pneumococcus, pseudomonas, clostridium).
Signs - localized redness, skin too warm or hot to touch, local abscess, ulceration, fever, chills, malaise
High risk for immunocompromised or weakened immune system
Antibiotics for treatment, rule out DVT or contact dermatitis
Contact Dermatitis
Superficial irritation of skin from localized irritation (poison ivy, latex, soap, jewelry sensitivity)
Intense itching, burning, red skin, edema may occur
Treatment - ID and topical steroid
Eczema
Dermatitis, group of disorders that cause chronic skin inflammation due to immune system abnormality, allergic reaction
Red/brown-grey itching , lichenified skin plaques
Topical or corticosteroid treatment to oral antibiotics
Cold compress may help, stress management techniques
Gangrene
Dry - loss of vascular supply resulting in localized tissue death. Fingers, toes, limbs, most likely affected. Not painful when hardened.
Occurs with blood vessel disease - DM or atherosclerosis. Develops blood flow to an affected area as a result of poor circulation.
Dark brown non viable tissue turns into a hardened mass. Cold and numb skin that has pain.
Herpes Zoster
Varicella zoster= Chickenpox in children and herpes zoster in adults
Outbreak with weakened immune system - attacks and damages nerve fibers
Characterized as a blister or rash
Unilateral painful itching (nerve fibers affected) with inflammation, pain redness and warmth. Pain tends to be throbbing, crushing. Blistered rash with fever chillings and fatigue
Neuropathic Ulcer
Peripheral neuropathy, athlerlosclerotic changes, and pressure. Mostly with DM population.
Impacts both motor and sensory
Common sites: heel, tips of toes, plantar surface of metatarsal heads, bunions.
ABI unreliable
Treatment: Manage contributing factors, pharmacological interventions. Platelet derived growth factor,
Onchomycosis
Fungal infection of toenails and nailbeds. divided into subtypes
Risk factors - manis/pedis
Yellow or brown nail discoloration. Hyperkeratosis and hypertrophy of nail to detach from nailbed.
Manual debridement is primary intervention.
Plaque Psoriasis
Chronic autoimmune disease of skin and most common type. T cells trigger inflammation and produce accelerated rate of skin cell growth. Creates red patches of surface of skin. Raised blotches with itching and flaking
Genetic predisposition. Triggers include injury, sunlight, stress, excessive alc, HIV, infection, smoking, certain meds
Pressure Ulcer
Unrelieved pressure deprives tissues of oxygen causes ISCHEMIA, Cell Death, tissue necrosis. Unrelieved pressure >32 mmHg of pressure for more than 2 hours
Greatest areas of risk: occiput, heels, greater troch, ischial tuberosities, sacrum, epicondyles
Tina Pedis
Athletes foot - superficial fungal infection - epidermis thickening and scaly skin appearance. Multiplies in warm/moist environment.
Risk factors include wearing closed toed shoes with no airflow, prolonged periods of moisture/wetness, excessive sweating, possessing small nail or skin abrasions.
Itching, redness, peeling skin between toes, pain and odor.
Treatment: topicals antibiotics, make sure to dry feet when bathing
Venous insufficiency Ulcer
Venous HTN secondary to valve incompetence (DVT damage). Distension of capillary beds that impedes exchange of nutrients and O2
Damage to epidermis only
MEDIAL surface of lower leg mid calf and malleolus. Usually LARGER and MORE SHALLOW. IRREGULAR wound borders
Moist layer of white yellow slough
Mod - Heavy exudate
Pain RELIEF with ELEVATION or COMPRESSION
NO ABI
Treatment: Graded compression, unna boot, garments, bandage