Skin Flashcards
What are the layers of the skin
Corneum Lucidum Granulosum Spinosum Basalis
Californians Like Girls in String Bikinis
Wha is the pressure threshold for skin pressure injury
60mmHg
When lying, the sacral pressure is ____ mmHg
150
When sitting the ischial pressure is ___ mmHg
300
When lying, what are the dependent areas of the skin?
back of the head scapupa spinous process elbow sacrum posterior calf heel
This solar radiation is responsible for acute and chronic skin effects
UVB
This type of infection is due to exposure to a body of salt water
Type III
due to V. vulnificus
[diagnose]
common in obese, smokers
painful, affecting the apocrine gland bearing areas (axilla, perineum, inframammary gland, inguinal folds)
Tender, deep nodules that expand, coalesce, spontaneously drain, form persistent sinus tract
Hidradenitis suppurativa / Acne inversa
[Hurley Classification for H. suppurativa]
single/multiple nodules without sinus tract or scarring
Stage I
Tx: Clindamycin
[Hurley Classification for H. suppurativa]
abscess, sinus tract, scarring
Stage II
clindamycin
[Hurley Classification for H. suppurativa]
diffuse, interconnected sinus tracts and abscesses
Stage III
Tx: Radicala excision, laser treatment, biologic agents
[diagnose]
presents as nodules and spread to form draining tracts following dental extraction
(+) sulfur granules
Actinomycosis
Tx: penicillin and surgical debridement
[diagnose]
rapidly enlarging necrotic lesion with undetermined border surrounding erythema
associated with IBD, RA, hema malignancy, IgA gammopathy
pyoderma gangrenosum
Tx: steroirds, cyclosporine
[SSSS vs TEN]
exotoxin affecting the granular layer
SSSS
[SSSS vs TEN]
immune mediated affecting the dermoepidermal junction
TEN
[diagnose]
“stuck on” yellow or light brown, papules/plaques with velvety, greasy texture
seborrheic keratoses
[diagnose]
arise in sun-exposed areas. premalignant lesion to SCC, atypical appearing keratinocytes
Actinic Keratosis (solar keratosis)
[nevi]
occur in a swimming trunk distrubution
giant hairy nevi (congenital)
[Nevi: acquired/congenital]
premalignant to melanoma
congenital
[diagnose]
benign neoplasm of the extremity
arise from the neuromyoarterial apparatus with blue, subungual discoloration associated with severe pain, point tenderness and cold sensitivity
glomus tumor
nonmelanoma skin cancers are typically a disease of the ___ skinned people
fair-skinned
[diagnose]
most common type of skin cancer
basal cell CA
most common subtype of basal cell CA
nodular (rodent ulcer)
most aggressive subtype of basal cell CA
morpheaform
the most common malignant eyelid tumor
basal cell CA
most common upper lip CA
basal cell CA
[diagnose: basal cell CA type]
waxy, pearly appearing papule with raised, well-demarcated border
crusting that bleeds with minor trauma, telangectasia over the translucent surface or central ulceration
nodular BCC
[diagnose: basal cell CA type]
waxy, pearly appearing papule with raised, well-demarcated border
crusting that bleeds with minor trauma, telangectasia over the translucent surface or central ulceration
With increased content of brown or black pigment
common in darker skinned people
pigmented BCC
[diagnose: basal cell CA type]
marked bluish or gray cystic nodules
cystic BCC
[diagnose: basal cell CA type]
scaly, patch-like or papule form that varies in color from pink to red or brown
superficial BCC
[diagnose: basal cell CA type]
Well-defined border, less prone to ulceration, aggressive varian
micronodular BCC
[diagnose: basal cell CA type]
ill-defined borders that extend beyond clinically visible margins
scar-like appearance in a plaque or papule formation that can be mistaken for scar tissue
ulceration, bleeding, crusting are uncommon
morpheaform and infiltrating BCC
Skin CA associated to exposures to arsenic, tar, polycyclic aromatic hydrocarbons
squamous cell CA
[diagnosis]
arise from the basal layer of the dermis in association with an area of pre-existing skin damage
squamous cell CA
[diagnosis]
enlarging bumps that may have irregular or reddened surface
shallow ulcer with heaped up edges
squamous cell CA
[diagnosis]
skin CA associated with cranial nerve dysfunction
squamous cell CA
[biopsy]
preferred techniques for nonmelanoma skin CA
shave or incisional biopsy
staging of these cancers are not affected by the depth of the lesion
BCC and SCC
vigilance biopsy is important in these lesions
- old burn wounds
- chronic nonhealing wounds
- scars
how many sunburns in early life has been associated with a doubled risk of developing malignant melanoma after life
five or more
Xeroderma pigmentosum is a risk factor for this skin CA
malignant melanoma
melanocytes are derived from what tissues
neural crest tissues
[diagnosis: melanoma subtypes]
these generally arise in a preexisting nevus, most common subtype of malignant melanoma
superficial spreading, malignant melanoma
[diagnosis: melanoma subtypes]
worst prognosis due to the prominence if vertical gorwuth
nodular type malignant melanoma
[diagnosis: melanoma subtypes]
older patient, slowly growing, large (>3cm), flat lesions
lentigo maligna
[diagnosis: melanoma subtypes]
located in the subungual regions and glaborous skin or palms and soles
acral lentigenous
[diagnosis: melanoma subtypes]
rare but aggresive subtype
propensity toward perineural invasion and recurrence
desmoplastic
[malignant melanoma]
most common site of metastasis
lung, liver
[malignant melanoma]
most common non-cutaneous site
ocular
[malignant melanoma]
with the worst prognosis
mucosal melanomas
[treatment of nonmelanoma skin CA}
for low-risk BCC and SCC of the trunk or extremity
excision with postoperative margin assessment (POMA)
4-6mm margins
[treatment of nonmelanoma skin CA}
for face, ears, and areas where preservation of uninvolved tissues is critical for cosmesis and function; for irregularly shaped tumors to ensure clear margins
Mohs Surgery
excision with complete circumferential and peripheral deep margin assessment or intraoperative frozen section
[treatment of nonmelanoma skin CA}
for small, superficial lesions, high recurrence rates
curettage and electrodessication
visible tumor, 2-4mm margin
[treatment of nonmelanoma skin CA}
precancerous lesions and very small, superficial BCC and SCC
cryosurgery
[treatment of nonmelanoma skin CA}
for extensive lesions precluding surgical resection
Radiation
50-60 Gy delivered over 4-6 weeks
Cite the ABCDE rule in diagnosing malignant melanoma
Asymmetry Border Irregularity Color variation Diameter Evolution
[biopsy: malignant melanoma]
for cosmetically sensitive areas
incisional or punch biopsy
[biopsy: malignant melanoma]
best diagnostic when an enlarged lymph node is palated
FNAB
[Clark Stage]
Papillary dermis + Reticular dermis
Clark IV
[Clark Stage]
papillary dermis + reticular dermis + SQ
Clark V
[Clark Stage]
melanoma in situ
Clark I
contrast used in Sentinel Lymph node biopsy
methylene blue or isosulfan blue
drug of choice for isolated limb perfusion technique
melphalan
