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NURS 623 Exam 1 > Secondary Skin Lesions > Flashcards

Secondary Skin Lesions Flashcards

1
Q

Excoriations

A

scratches, abrasions

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2
Q

Atrophy

A

thinning or translucent (striae)

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3
Q

Scale

A

flat/flaky (seborrheic dermatitis) crust – dried exudate

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4
Q

Fissure

A

linear crack epidermis to dermis (cheilosis)

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5
Q

Erosion

A

rupture of burn blister

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6
Q

Ulcer

A

depressed lesion

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7
Q

Scar

A

fibrous tissue with trauma

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8
Q

Keloid

A

sharply elevated bulky scar

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9
Q

Lipoma

A

benign subcutaneous tumor consisting of adipose tissue. (Usually older adults, asymptomatic)

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10
Q

Eczema (Atopic dermatitis) Presentation

A

Primary symptom – pruritis.
Skin lesion range from mild erythema to severe lichenification. Presents as red patches with white scales on top.

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11
Q

Eczema (Atopic dermatitis) Treatment

A

Moisturizers. Avoid triggers. Topical steroids or immune modulators. Oral antihistamine at night.

If wet: Burow’s solution, saline, or silver nitrate to dry out.

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12
Q

Acne Presentation

A

Vulgaris: Located on face, chest, back, and upper outer arms.
* Mild = total lesions <30, noninflammatory. Comedones with small papules.
* Moderate = total lesions 30-125, inflammation. Papules & pustules with yellow/green tops.
* Severe = lesions > 125, nodulocystic acne.

Rosacea: Chronic, central face, persistent erythema telangiectasia, erythematous papules.

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13
Q

Acne Treatment

A

Vulgaris: Tretinoin, topical vs. systemic antibiotics, Isotretinoin, BCP

Rosacea: Avoid triggers, topical flagyl (may take 6-8 wks), PO tetracycline, minocycline, or doxycycline

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14
Q

Impetigo Presentation

A

Honey crusted plaques, usually on face
Bullous: begin as small vesicles that rupture easily with serous fluid turning into crust
Nonbullous, vesticulopustular: thick, adherent lesions, dirty yellow-colored crust with erythematous margins

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15
Q

Impetigo Treatment

A

Clean lesions. Bactroban TID x 7 days. Antibiotic (Keflex, Augmentin, Cloxacillin). With no treatment, it is self-limiting 2-3 wks

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16
Q

Herpes Zoster (shingles) Presentation

A

Unexplained pain along dermatome. Unilateral vesicular rash along dermatome lasting 3-5 days, up to 30.

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17
Q

Herpes Zoster (shingles) Treatment

A

Famcyclovir, Acyclovir, Valacyclovir.
Prednisone taper.
Vaccine.

18
Q

Herpes Simplex Presentation

A

Oral or genital, can be asymptomatic. Tenderness, pain, mild paresthesia’s, or burning before onset. Prodrome can include headache, fever, muscle ache, lymphadenopathy, local pain. Grouped vesicles on erythematous base.

19
Q

Herpes Simplex Treatment

A

No cure.
Oral: lip ointment Blistex. OTC Abreva. Denavir for extensive lesions.
Genital: Valacyclovir and famciclovir better choices

20
Q

Actinic Keratosis (precursor to SCC) Presentation

A

Most common precancerous growth. Fair-skinned pts aged > 40, sun exposure, men.
* Head, lips, ears, neck, hands, forearms.
* Primary lesions macules or papules poorly circumscribed. Small papules 0.5-2 mm flesh color or hyperpigmented.
* Secondary lesions erythematous, scaly with uneven surface. Pruritic, tender, or stinging, sandpaper feel.

21
Q

Actinic Keratosis (precursor to SCC) Treatment

A

Topical therapy (5-FU) creams: Efudex, Carac
Surgical destruction (cryotherapy)

22
Q

Melanoma (malignant) Presentation

A

Suddenly appears as new dark spot on skin. ABCDE:
* asymmetrical lesion
* irregular border, notching,
* varied color, can be mix of blue, red, tan, brown, black, and white
* diameter > 6 mm
* evolution of lesion

23
Q

Melanoma (malignant) Treatment

A

Depends on stage. Biological therapy, Chemotherapy, Radiation, Surgery.

REFER!!!!

24
Q

Basal cell cancer Presentation

A

Slow-growing, rarely metastasize. 50-60 year old. Usually head and neck but can be anywhere. Flesh color, pearly domed nodule with overlaying telangiectatic vessels, pinkish patch of skin. Later stage central ulcer and crusting. PUTON acronym.

25
Q

Basal cell cancer Treatment

A

Simple excision:
Electrodesiccation and curettage
Cryosurgery
Laser surgery
Mohs microsurgery – highest cure

26
Q

Squamous cell cancer
(SCC) Presentation

A
  • Rapid growing. NO SUN – nodular, opaque, sun exposed, ulcerating, non-distinct borders.
  • Firm, scaly, rough, later bleeds.
  • Does not heal
  • Hyperpigmented
27
Q

Squamous cell cancer
(SCC) Treatment

A

Electrodesiccation and curettage
Mohs surgery – most effective

28
Q

Tinea corporis
(Ringworm of body) Treatment

A

Miconazole 2% cream BID x4 weeks, Clotrimazole 1%, Terbafine 1%

29
Q

Tinea corporis
(Ringworm of body) Dx

A

Hx of erythematous round and elevated pruritic lesion that grows in size & starts to clear in the center

30
Q

Tinea capitus (ringworm of head) Presentation

A

Children common. Painless bald spot, may have kerion that looks like honeycomb, inflammation. Boggy mass containing broken hairs and oozing purulent material from follicular orifices

31
Q

Tinea capitus (ringworm of head) Treatment

A

Systemic antifungals – Griseofulvin BID for 2-4 months or 2 weeks after negative cultures. Teratogenic – use 2nd method of contraception.
OR terbinafine cream

32
Q

Tinea versicolor (skin, AKA pityriasis versicolor) Presentation

A

Round or oval lesions of hypo or hyperpigmentation macule, located mainly on back chest, arms, sometimes neck/face. Sometimes very fine scales seen. Agent P oribiculare causes round, pityrosporum ovale causes oval

33
Q

Tinea versicolor (skin, AKA pityriasis versicolor) Treatment

A

Clotrimazole 1% cream and solution BID up to 4 weeks

34
Q

Lupus Presentation

A

More common women, AA.
Fatigue, joint pain, myalgia, photosensitive, butterfly malar rash, thrombocytopenia, gastritis, systolic murmur

35
Q

Lupus Treatment

A

Symptom control, NSAIDS, severe cases get immunosuppressants

36
Q

Pityriasis rosea Presentation

A

Salmon-colored macule initially, may be mistaken for ringworm. Next several weeks = generalized exanthem with mild to moderate pruritis, Christmas tree

37
Q

Pityriasis rosea Treatment

A

Self-limited, sunlight may help, symptomatic control for itching

38
Q

Seborrheic dermatitis Presentation

A

One of most common in adult and elderly, Parkinsons, HIV – check for if severe. Scaly, greasy rash – skin is pink, edematous, and covered with yellow to brown scales and One of most common in adult and elderly, Parkinsons, HIV – check for if severe. Scaly, greasy rash – skin is pink, edematous, and covered with yellow to brown scales and crusts. Scalp, forehead, eyebrows, area around nose/ears. Common in infancy – cradle cap.

39
Q

Seborrheic dermatitis Treatment

A

OTC dandruff shampoo leave on 5-7 mins.
Resistant form may require shampoo 2.5 selenium sulfide, ketoconazole, or detoconazole. For superinfection Cephalexin 7-10 d. Not contagious

40
Q

Folliculitis Presentation

A

Staphylococcus. Multiple small papules on erythematous base, can be large yellow white tender pustules in adults. Common in places hair is present, widespread is characteristic, bumpy rash, no itching.

40
Q

Folliculitis

A

Only if becomes infected. Large lesions cleansed with weak soap solution, followed by soaking with saline or aluminum subacetate BID. TAO can be used BID for 5 days. Oral ABT 1st gen cephalo. if resistant

NURS 623 Exam 1 (6 decks)

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