Porth Chapter 61

Question 1

pigmentary skin disorders

Answer 1

Melanocytes:

1. Absence of melanin production, as in​: Vitiligo, Albinism​
2. Increase in melanin: Mongolian spots, Melasma

Question 2

rashes

Answer 2

Temporary eruptions of the skin​; Childhood diseases, heat, diaper irritation, or drug-induced reactions

Question 3

lesions

Answer 3

A traumatic or pathologic loss of normal tissue continuity, structure, or function

Question 4

types of rashes

Answer 4

1. Blanched (white)​
2. Erythematous (reddened)​
3. Hemorrhagic or purpuric (containing blood)​
4. Pigmented

Question 5

ringworm / fungal infections

Answer 5

Superficial fungal infections: Tinea corporis, Tinea faciale, Tinea capitis, Tinea pedis, Tinea unguium, Tinea versicolor, Tinea incognito

Question 6

primary bacterial infections

Answer 6

superficial

1. Impetigo—appears as a small vesicle or pustule or as a large bulla on the face or elsewhere ​
2. Ecthyma—ulcerative form of impetigo

Question 7

secondary bacterial infections

Answer 7

deep cutaneous infections; 1. Infected ulcer ​

2. Cellulitis

Question 8

Human papillomavirus

Answer 8

Verrucae (warts) are common benign papillomas.

Question 9

Herpes simplex virus

Answer 9

Type 1: The organism is spread by respiratory droplets or by direct contact with infected saliva.​
Type 2: Genital herpes

Question 10

Herpes zoster/shingles

Answer 10

Localized vesicular eruption distributed over a dermatomal segment of the skin

Question 11

noninflammatory acne

Answer 11

Comedones; Plugs of material that accumulate in sebaceous glands that open to the skin surface

Question 12

inflammatory acne

Answer 12

Papules, pustules, nodules, and, in severe cases, cysts; Believed to develop from the escape of sebum into the dermis and the irritating effects of the fatty acids contained in the sebum

Question 13

Acne vulgaris

Answer 13

Chronic inflammatory disease of the pilosebaceous unit

Question 14

Acne conglobata

Answer 14

Comedones or cysts have multiple openings, large abscesses, and interconnecting sinuses; Discharge is odoriferous, serous or mucoid, and purulent; Affected persons have anemia with elevated white blood cell counts, sedimentation rates, and neutrophil counts

Question 15

Rosacea

Answer 15

Chronic inflammatory process accompanied by vascular instability with leakage of fluid and inflammatory mediators into the dermis​; Accompanied by gastrointestinal symptoms​

Types​:

1. Erythematotelangiectatic ​
2. Papulopustular ​
3. Ocular ​
4. Phymatous

Question 16

Contact dermatitis

Answer 16

Allergic contact dermatitis results from a cell-mediated, type IV hypersensitivity response.​

Irritant contact dermatitis is caused by chemicals that irritate the skin.

Question 17

Atopic dermatitis

Answer 17

Inflammatory skin disorder that is characterized by poorly defined erythema, edema, vesicles, and weeping at the acute stage ​

Lichenification in the chronic stag

Question 18

Nummular eczema

Answer 18

Coin-shaped papulovesicular patches involving the arms and legs ​

Lichenification and secondary bacterial infections are common.

Question 19

Drug-Induced Skin Eruptions

Answer 19

Systemic drugs cause generalized skin lesions.​

Topical drugs are usually responsible for localized contact dermatitis types of rashes.​

Bullous skin lesions ​

Erythema multiforme minor​

Stevens-Johnson syndrome​

Toxic epidermal necrolysis​

Skin detachment

Question 20

Papulosquamous Dermatoses

Answer 20

Skin disorders characterized by scaling papules and plaques ​

Psoriasis ​

Pityriasis rosea​

Lichens planus

Question 21

Arthropod Infestations

Answer 21

Scabies​

Pediculosis​

Ticks​

Rocky mountain spotted fever​

Lyme disease

Question 22

uvc rays

Answer 22

Short (100 to 289 nm); do not pass through the earth’s atmosphere​

Question 23

uvb rays

Answer 23

290 to 320 nm; responsible for nearly all the skin effects of sunlight​

Question 24

uva rays

Answer 24

321 to 400 nm; can pass through window glass, are more commonly referred to as sun tanning rays​

Question 25

Acute Effects of Ultraviolet Rays of Sunlight

Answer 25

Short-lived and reversible​ Erythema​ Pigmentation​ Injury to Langerhans cells and keratinocytes

Question 26

Chronic Effects of Ultraviolet Rays of Sunlight

Answer 26

Directly damaging skin cells​ Accelerating the effect of aging on skin​ Producing changes that predispose to development of skin cancer

Question 27

sunburn

Answer 27

Excessive exposure of the epidermal and dermal layers of the skin to ultraviolet radiation​ Resulting in an erythematous inflammatory reaction​ Inflammation, blistering, weakness, chills, fever, malaise, and pain often accompany severe forms of sunburn

Question 28

Measures for Protection from the Sun

Answer 28

Avoidance of sun exposure​ Use of protective clothing​ Use of sunscreens​ Chemical agents absorb UVR.​ Physical agents reflect UVR.​ Biological agents reduce inflammation.​ Broad-spectrum suntan lotions protect against both UVA and UVB.

Question 29

Photosensitivity Occurring with Drugs

Answer 29

Definition: exaggerated response to ultraviolet light when the drug is taken in combination with sun exposure​ Examples​: Some anti-infective agents​ Antihistamines​ Antipsychotic agents ​ Diuretics ​ Hypoglycemic agents ​ Nonsteroidal anti-inflammatory drugs

Question 30

First-degree burns

Answer 30

(superficial partial-thickness burns) involve only the outer layers of the epidermis.​

Question 31

Second-degree partial-thickness burns

Answer 31

involve the epidermis and various degrees of the dermis.​

Question 32

Second-degree full-thickness burns

Answer 32

involve the entire epidermis and dermis.​

Question 33

Third-degree full-thickness burns

Answer 33

extend into the subcutaneous tissue and may involve muscle and bone.​

Question 34

Estimation of Total Body Surface Area Involved in Burn

Answer 34

Rule of nines ​ Multiple of 9%​ Perineum 1% ​ Arm 9% ​ Leg 18% ​ Anterior trunk 18% ​ Posterior trunk 18%​ Head 9% Lund and Browder chart ​ American Burn Association classification of burns

Question 35

Systemic Complications of Burn Tissue

Answer 35

Magnitude of the response is proportional to the extent of injury. ​ Hemodynamic instability​ Impaired respiratory function​ Hypermetabolic response​ Major organ dysfunction​ Sepsis

Question 36

Treatment of Burns

Answer 36

Immediately submerge area to cool tissue​ Emergency care​ Resuscitation ​ Stabilization ​ Maintaining cardiac and respiratory function​ Intermediate and long-term treatment is dependent on the extent of the injury.​ Protection from desiccation​ Escharotomy/fasciotomy

Question 37

Pressure Ulcers (Bedsores)

Answer 37

Ischemic lesions of the skin and underlying structures caused by unrelieved pressure ​ Four factors contribute to the development of pressure ulcers. ​ Pressure ​ Shear forces​ Friction ​ Moisture

Question 38

Prevention of Pressure Ulcers (Bedsores)

Answer 38

(1) Identifying at-risk persons who need preventative measures and the specific factors placing them at risk​ (2) Maintaining and improving tissue tolerance to prevent injury​ (3) Protecting against the adverse effects of external mechanical forces (i.e., pressure, friction, and shear) ​ (4) Reducing the incidence of pressure ulcers through educational programs

Question 39

The Development of Skin Cancer

Answer 39

Nevi (moles)—benign tumors of the skin that predispose individual to cancer​ Nevocellular nevi ​ Dysplastic nevus​ Great tendency to transform

Question 40

Malignant melanoma 

Answer 40

Rapidly progressing malignant tumor of the melanocytes

Question 41

Basal cell carcinoma​

Answer 41

Neoplasm of the nonkeratinizing cells of the basal layer of the epidermis; most common skin cancer in white-skinned people

Question 42

Squamous cell carcinomas​

Answer 42

Second most frequently occurring malignant tumors of the outer epidermis​

Question 43

Four Types of Melanomas

Answer 43

Superficial spreading​ Nodular​ Lentigo maligna​ Acral lentiginous

Question 44

Skin Disorders of Infancy

Answer 44

Mongolian spots​ Hemangiomas​ Port-wine stains ​ Nevi Vascular and pigmented birthmarks​ Diaper rash​ Prickly heat​ Cradle cap

Question 45

Skin Manifestations of Common Infectious Disease

Answer 45

Roseola infantum​ Rubella ​ Rubeola (measles)​ Varicella​ Scarlet fever

Question 46

Normal aging changes

Answer 46

Diminution in subcutaneous tissue​ Thinning of epidermal and dermal layers​ Decrease in the number of melanocytes, Langerhans cells, and Merkel cells​ Decrease and thickening of blood vessels

Question 47

Skin Lesions Common among the Elderly 

Answer 47

Skin tags​ Keratoses​ Lentigines​ Vascular lesions