PCC - Integumentary: Skin, Hair and Nails Flashcards
1
Q
SE
A
Side Effect
2
Q
CFU
A
Colony forming units
3
Q
LAD
A
lymphadenopathy
4
Q
ICD
A
irritant contact dermatitis
5
Q
ACD
A
allergic contact dermatitis
6
Q
BSA
A
body surface area
7
Q
Overview of Integumentary System: Purpose
A
- protection against injury
- barrier to sunlight, microorganisms
- maintains temperature
- regulates fluid loss
- synthesis of ______
- senses external environment
8
Q
Integumentary Layers to know:
A
- epidermis
- basement membrane
- dermis
9
Q
Contains other structures
A
- sweat glands
- sebaceous glands
- hair follicles
- nails
10
Q
Integumentary Disease Types
A
- infectious
- pustular
- allergic or irritant
- cancer
- external damage
- age related
11
Q
Integumentary Diseases: Infectious
A
- superficial fungal infections
- bacterial infections
- viral infections
12
Q
superficial fungal infections
A
- tinea
- candida
13
Q
Bacterial infections
A
- staphylococcus aureus
- streptococcus sp.
14
Q
Tinea
A
- tinea capitis
- tinea corporus (ring worm)
- tinea pedis (Athlete’s foot)
- tinea unguium (onychomycisis)
- tinea curis (jock itch)
15
Q
candida albicans
A
candida albicans
16
Q
Fungal Infection Risk Factors
A
- immunocompromised patients
- trauma to skin
- diabetes mellitus
- impaired circulation
- poor nutrition or hygiene
- occlusive wear
- humid climates
17
Q
Tinea Fungal Infections
A
Fungi are free-living plant-like organisms
May be part of normal flora
Infections are primarily of the dermatophytoses group
- Trichophyton (most common)
- Microsporum
- Epidermophyton
Usually cause superficial infections
-Restricted to epidermis, hair, and nails
Typically treated with topical agents
-Severity, type, and location may require systemic agents
18
Q
Tinea capitis
A
- pathophysiology (fungal infection of scalp)
- epidemiology (mostly affects children)
- presentation (itching, alopecia, scaling, mild erythema, possible hair loss)
- complications (if untreated, may progress to kerion)
- diagnosis (should be done before treatment initiation)
- goals of treatment (eradicate fungal infection, restore normal hair growth and appearance)
19
Q
Tinea Unguium
A
- fungal infection of the finger or toe nail
- primarily adults
- superficial white appearance + cracked brittle thickened nails
- bacterial infections under the nail bed = complications
- goals of therapy: eradicate infection
- treatment = avoid trauma to nails (requires systemic treatment (referral)
20
Q
Tinea Corporus, Cruris, and Pedis (Can be treated by us!)
A
- fungal infection of the body, groin, or foot
- tinea pedis is the most common
- corporus: red, round lesion; crurus: itching, red lesion in groin
- complications: if untreated, may spread
- goals of therapy: eradicate fungal infection
- non-pharmacologic: avoid occlusive footwear; dry between toes after bathing
21
Q
Tinea infections: Treat or Refer
A
- treat if: localized to one area; first treatment
- refer if: exudate or pus; unguium or capitis infection, failed initial self-treatment; face, mucosa, or genitalia involved;diabetes; immunocompromised; signs of systemic infection
22
Q
Candida Infections
A
- superficial candida albicans infection of body folds
- decreased immune function
- red rash with well-defined borders; white plaques; cheesy discharge
- if untreated may be transferred
- eradication or infection
- vaginal: topicical antifungal; requires referral; may be systemic or topical
- treat if vaginal
- refer if suspicion of non-vaginal candida infection; complicated vaginal candidiasis
23
Q
Bacterial Infections Overview
A
Bacteria are part of normal skin flora
Infection may occur by pathogenic bacteria or opportunistic infection with normal flora
Common bacterial strains:
- Staphylococcus aureus (methicillin-susceptible or methicillin-resistant)
- Streptococcus species
24
Q
Impetigo
A
- pathophysiology: superficial bacterial infection; staphylococcus or streptococcus
- epidemiology: infants and children
- presentation” vesicles or pustules that burst; honey colored crust
- diagnosis: clinical evaluation
- goals of therapy: eradicate infection
- treatment: typically self-resolving in 3-4 weeks; treatment requires referral
25
Q
Cellulitis
A
- pathophysiology: deeper bacterial infection affecting the dermis and subcutaneous tissue
- presentation: expanding red. swollen tender rash without clearly defined border
- complications: septicemia, nephritis, death
- diagnosis: clinical evaluation
- goals of therapy: eradicate infection; return skin to normal function
- treatment: requires systemic treatment (referral)
- treat if self-treatment options are not available
- refer if suspicion of bacterial infection
26
Q
Integumentary Diseases: Pustular
A
- acne vulgaris
- acne conglobate rosacea
27
Q
Acne Vulgaris
A
- pathophysiology: lesions involving the hair follicle and sebaceous gland
- etiology: genetic factors; production of androgens; increase in ____; presence of propionibacterium acnes
- epidemiology: starts in puberty; may last to 20s or 40s; women more than men
- presentation: inflammatory and non-inflammatory lesions; on face and neck
- complications: scarring’ emotional stress
- diagnosis: clinical diagnosis; microbiologic testing does not affect treatment or outcome
- goals of therapy: treatment of current lesion; prevention of new lesions
- non-pharmacologic: avoid skin irritants; use facial cleanser
- pharmacologic treatment: treatment options depend on level of severity
- treat if mild acne; initial treatment
- refer if failed 6 weeks of self-treatment; moderate to severe acne; presence of exacerbating factors; suspicion of rosacea
28
Q
Acne-self treatment Options
A
Topical Treatment Options:
- Benzoyl peroxide: 2.5% - 10%
- Salicyclic acid: 0.5% - 2%
- Sulfur: 3% - 10%
29
Q
Allergic or Irritant
A
- allergic contact dermatitis
- irritant contact dermatitis
30
Q
Allergic contact dermatitis
A
- pathophysiology: allergic type IV reaction at site of contact; requires an initial “induction” exposure
- etiology: dependent upon allergy; poison ivy, latex, nickel
- presentation: rash limited to area exposed to allergen
- complications: risk for infection if open sores; irritation
- goals of therapy: avoid exposure to allergen; alleviate itching, pain, other symptoms
- treatment: REMOVE OFFENDING AGENT; hydrocortisone cream, aluminum acetate compress
31
Q
Irritant Contact Dermatitis
A
- pathophysiology: inflammation due to irritant exposure
- epidemiology: occupational related; construction, forestry, agriculture are at rish; may be due to cleaning solutions, animal products, pollen, etc
- presentation: dry, cracked, inflamed skin with possible itching or pain; limited to area of exposure
- goals of therapy: alleviate irritation and pain; avoidance of future irritant
- non-pharmacologic therapy: wash with water and mild soap; educate patient on avoidance of future exposure
- pharmacologic therapy: emollients, colloidal oatmeal bath
- treat if irritant contact dermatitis; limited area of inflammation
- refer is less than two years of age; symptoms greater than 2 weeks; involves greater than 20% BSA; swelling; involvement of mucosa or genitalia; persists longer than 7 days with self-traetment; impairs ADL
32
Q
Sunburn (External Damage)
A
- pathophysiology: inflammation due to excessive exposure of UVB
- epidemiology: 35% of adults may experience sunburn in a year
- presentation: red, warm, inflamed skin, may be painful
- complications: prolonged exposure can increase risk of skin cancer
- treatment: cold water rinse, avoid exposure; aloe vera moisturizer
33
Q
Cancer: Basal Cell
A
- Slow-growing
- Primarily on nose
- Requires referral
- Treated with excision, radiation, or topical therapies
34
Q
Cancer: Squamous Cell
A
- Medium-growth
- Sun exposure increases risk
- Requires referral
- Highly curable, treated with excision
35
Q
Cancer: Melanoma
A
- Malignant growth
- Sun exposure increases risk
- Treatment ranges from excision to chemotherapy
36
Q
ABCDE of Skin Cancer
A
- asymmetry
- border that is irregular
- color that is uneven
- diameter
- evolving
