Prentice Ch. 28 - Skin Disorders Flashcards
What is a “Skin Lesion”?
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Primary Lesions
Macule Papule Plaque/patch Nodule Tumor Cyst Wheal Vesicle Bulla Pustule
Secondary Lesions
- result from primary lesions that have been manipulated Scales Crust Fissure Excoriation Erosion Ulcer Scar
Macule
- small, flat, and circular discoloration smaller than a 1/2 inch in diameter
- freckles, flat nevus
Papule
- solid elevation less than 1/2 in in diameter
- Wart
Plaque or Patch
- macule or papule larger than 1/2 inch
- Vitiligo patch
Nodule
- solid mass less than 1/2 inch
- deeper into the dermis or subcutis
- dermatofibroma fibrosis
Tumor
- solid mass larger than 1/2 inch
- cavernous hemangioma (filled with blood vessels)
Cyst
- encapsulated, fluid-filled, lesion in the dermis or subcutis
- epidermoid cyst
Wheal
- Papule or plaque caused by serum collection into the dermis, allergic reactions
- urticaria (hives)
Vesicle
- fluid-filled elevation less than 1/2 inch just below epidermis
- smallpox/chickenpox
Bulla
- like a vesicle but larger
- second degree burn, friction blister
Pustule
- like a vesicle or bulla but contains pus
- acne
Cellulitis
- an inflammation of cells and connective tissue that extend deep into the tissues
Scales
- flakes of skin
- psoriasis
Crust
- dried fluid or exudates on the skin
- Impetigo
Fissure
- Skin Crack
- Chapping
Excoriation
- Superficial scrape
- Abrasion
Erosion
- loss of superficial epidermis
- scratch (superficial)
Ulcer
- destruction of the entire epidermis
- pressure sore
Scar
- healing of the dermis
- vaccination, laceration
Hyperkeratosis
- excessive growth of the horny tissue layer
- caused by excessive rubbing back and forth over the skin, along with abnormal pressure
- causing a thickening
- foot calluses
Hyperkeratosis S&S and Management
- ovular, elongated, brownish, may or may not be painful
- emery files/board
- pumice stones
- moisturizer
- can massage a small amount of lanolin twice a day may help with tissue elasticity.
- donut pad
- double socking
- decrease friction
Blisters
- shearing forces produce a raised area that contains a collection of fluid below or within the epidermis.
Blisters S&S
- pt. feels a hot spot
- can be superficial and contain clear liquid
- or can be deeper causing blood vessels to rupture
- pain is caused by pressure of fluid
Blister Management
- talcum powder
- petroleum jelly
- double socking
- correctly fitting shoes
- second skin
- icing
Soft corns
- caused by abnormal pressure and friction
- “calves mollis”
- result of wearing narrow shoes and having excessive foot perspiration
- usually occurs between the fourth and fifth toes
- circular area of thickened, white, macerated skin
between the toes at the base of proximal head of phalanges
Hard Corns
- calves durus
- most serious type
- caused by pressure of improperly fitting shoes and anatomical abnormalities
- hammertoes usually have hard corns develop on top of them
- local pain and disability with inflammation and thickening of soft tissue
- requires a physicians care
Corns Management
- if pain and inflammation are bad send to doc
- may need surgical removal
- get proper footwear
- Soft corn: proper footwear and put a cottonball in-between the toes; apply ultramide, can also use a foam pad to separate the toes
Excessive Perspiration (Hyperhidrosis)
- syrup like consistency
- increases the possibility of skin irritation
- makes bandages hard to keep on
- makes blisters, callus, and chafing much more likely to occur
Hyperhidrosis management
- astringent (alcohol or absorbent powder)
- iontophoresis
Chafing
- friction
- obese individuals
- heavy limbed people
- repeated skin rubbing in groin and axilla
- can separate the keratin from the granular layer of the epidermis causing oozing wounds
Chafing management
- cleansed once daily with mild soap and lukewarm water and mild soap
- can use burrows for 15-20 mins 3x per day
- to prevent it keep skin dry and clean and friction free
- cotton is your friend
Xerotic (Dry) skin
- usually during the winter months
- dehydration of the stratum corner
- appears dry with redness and scaling
- occurs first on shins, forearms, backs of hands and fcae
- can be itchy
Xerotic skin management
- prevent water loss and replace lost water
- bathing in tepid water
- use moisturizing soaps
- avoid soap on dry areas
- use emollient lotions
- refer to physician if condition worsens
Ingrown Toenails
- large toe is most often affected
- nail grows into the lateral nail fold and enters the skin
- results from lateral pressure of poorly fitting shoes, improper toenail trimming, or trauma
Ingrown toenails S&S
- pain and swelling
- if not treated can become severely inflamed and purulent
Ingrown toenail management
- soak in warm water (105-110) and butadiene for approx 20 mins
- pry the nail out of the skin
- can also lift nail and stick cotton under it to promote proper growth
- if condition is chronic send to doc to get nail cut
- prevention is more prevalent than management
Abrasions
- happens when skin is scraped against a rough surface
- top layer of skin is torn away and exposes capillaries
- can get contaminated with debris
- can get infected
Punctures
- from sharp object
- can get tetanus from it
- go to the hospital
Lacerations
- sharp or pointed object tears tissues
- usually jagged
- can get infected
Incisions
- done by doctor
- cut is smooth
- usually over a bone
Avulsions
- skin is torn from the body, often associated with major bleeding
- avulsed tissue should be placed on moist gauze saturated with saline
- doing this you can stick it into a plastic bag that’s been immersed in cold water and taken to the hospital
Bruises
- consequence of sudden compressive blunt force
- soft tissue is traumatized
- RICE it
Wound Management
- all must be considered contaminated
- shows infection 2-7 days post wound
Bacterial infections
- single celled microorganisms
- 3 major shapes: spherical (cocci) occurs in clumps, doublets or chains and rods (bacilli); and spirochetes (corkscrew shaped)
Staphylococcus
- occurs in clumps on skin and upper respiratory tract
Streptococcus
- appears in long chains
- most are harmless
- scarlet fever, and staphylococci
Bacillus
- spore forming, aerobic, and gram positive, and mobile
- can cause systemic damage
MRSa
- Methicillin resistant Staphylococcus aureus
- happens in people who have aggressive sports where they get abrasions
- bacterial
MRSa S&S
- redness, swelling, tenderness,
- pus forming
MRSa Management
- send to doc
- antibiotics
- longer period and more strong
Impetigo Contagiosa
- very common
- usually presents in children
- presents in summer - fall time
- bacterial
Impetigo S&S
- mild itching
- soreness
- followed by pustules that rupture to form honey-colored crusts
Impetigo Management
- cleansing of crusted area
- topical antibiotic
- usually bactroban
Furuncles (boils)
- infections of the hair follicle that result in a pustule
- bacterial
Furuncles (boils) S&S
- back and neck usually infected
- butt too
- pustule