Skin Flashcards
What are the layers of the skin?
- epidermis
- dermis
- hypodermis
Are skin disorders common?
Yes
Are skin disorders diverse?
Yes
Is skin an organ?
Yes
Is the skin a complex organ?
Yes
Is the skin the largest organ?
Yes
Which layer of skin: water resistant
Epidermis
What is the epidermis made up of?
- 4-5 sublayers
- closely packed cells
What is the dermis made up of?
-Contains connective tissues
What is the hypodermis made up of?
- subcutaneous tissue
- connective tissue
- blood vessels
- nerve cells
What is the function of the epidermis?
- First line of defense
- cell renewal
What is the function of the dermis?
-Houses the bodies:
- hair follicles
- sweat glands
- blood vessels
What is the function of the hypodermis?
-Where fat is deposited and stored
Bulla
- Circumscribed
- Collection of free fluid
- > 1 cm
Macule
- Circumscribed
- flat
- distinguished from surrounding skin by color
- < 5mm
Nodule
- circular
- elevated
- solid lesion
- > 1 cm
Patch
- circumscribed
- flat
- discoloration
- > 1cm
Papule
- Elevated
- Dome shaped
- flat topped
- < 5mm
Plaque
- Elevated
- flat
- topped
- > 5mm
Pustule
- Discrete
- pus filled
- raised
Vesicle
- Fluid filled raised
- < 5mm
Wheal
- Itchy
- transient
- elevated
- variable blanching and erythema
- dermal edema
Scale
- epidermal thickening
- flakes
- compacted layers
Crust
-dried serum or exudate
Fissure
-crack or split
As a clinician what is important to do regarding skin lesions?
write a description of a rash that you see on a client
Why is it important to write an accurate description of a skin lesion as a clinician?
When follow up occurs- another provider after you should be able to read your note and visibly see it in their head before they even see the client
What is a tip to help accurately identify skin lesions?
print off a list of skin lesions and descriptions and keep it with you at your desk
Example # 1:
- Group of multiple fluid filled lesions
- Each less than 5 mm
- To the left chest wall,
- Errathematous base
- Entire rash is the size of a silver dollar,
- Fluid filled lesions follow t4 and t5 dermatomes and do not cross the midline of the chest
- What is the name of the lesion?
- What is the Diagnosis?
- Why do you know this is the diagnosis?
- Vesicle
- Shingles
- Dermatomes and not crossing midline
What is the similarities/differences between a Vesicle, bulla and blister?
-vesicle= < 5mm
-bulla>5mm
blister= common name for both
What is the differences between a Vesicle, bulla and blister?
- vesicle= < 5mm
- bulla/blister= >5mm
Example # 2:
- Discrete
- Pus filled
- Raised
What is the lesion?
- Pustule
Example # 3:
- Flat
- Distinguished from surrounding skin color
- 5 mm in diameter or less
- non palpable
What lesion is it?
-Macule
How are macule and papule different?
Papule is elevated/dome and palpable
Excoriation
- Traumatic lesion
- breaking the epidermis
- causing a raw linear area
Impetigo
One of the most common bacterial infections of the skin
Who gets Impetigo?
Primarily seen in children
Is Impetigo contagious?
Very
What is the causative organism for Impetigo?
Staph aureus
Progression of impetigo
- Begins as a single small macule which rapidly evolves into a larger lesion
- sores rupture and ooze for a few days
What does Impetigo look like?
honey-colored crust of dried serum
Where do sores of impetigo typically form?
around the nose and mouth
Can impetigo spread to other parts of the body?
by touching the rash
How does impetigo spread?
by touching rash or using items that touched the rash
As a clinician what is important to teach parents about?
- wash hands
- do not reuse towels
How is impetigo treated
antibiotics
Uticaria
Hives
What type of reaction is urticaria classified as?
immediate (type 1) hypersensitivity reaction
Patho of urticaria
- binding of immunoglobulin E antibodies using Fc receptor to the mast cell
- Antigens trigger mast cell degranulation
- Dermal microvascular hyperpermeability
How can you know if you have a hive?
if you press the center it should turn white
Causes and risk factor of Urticaria
- allergens
- stress/anxiety
- exercise
- perspiration
- illness
- pressure/scratching
- chemicals
- cold/sun
- vibration
Types of Eczema dermatitis
- Allergic contact dermatitis
- Atopic dermatitis
- Photoeczematous Dermatitis
What causes Allergic contact dermatitis?
topical exposure to an allergen
What type of reaction causes Allergic contact dermatitis?
delayed hypersensitivity reaction
What is an example of Allergic contact dermatitis?
poison ivy dermatitis
What is Atopic dermatitis ?
- Skin with increased permeability to substances to which it is exposed
- such as potential antigens
What does Atopic dermatitis
look like?
- Itchy
- red
- swollen
- cracked
Where does Atopic dermatitis commonly occur?
- knees
- elbows
- neck
- hands
- cheeks
- scalp
what causes Photoeczematous Dermatitis?
Abnormal reaction to UV or visible light
What is an example of Photoeczematous Dermatitis?
a rash from photosensitivity to the sun
What does Psorasis look like?
- demarcated
- pink to salmon colored
- plaque
- loosely adherent thick silvery-white scales
Where is Psoriasis typically found?
- elbows
- knees
- scalp
Psoriasis vs. Eczema: Duration
- Psoriasis: Chronic/lifelong
- Eczema: Comes and goes
Psoriasis vs. Eczema: Population
- Psoriasis: Adults
- Eczema: Children
Psoriasis vs. Eczema: Cause
- Psoriasis: Hereditary
- Eczema: Environmental
Psoriasis vs. Eczema: Characteristic feature
- Psoriasis: thick, silvery scales
- Eczema: red, inflamed skin
Keloid
A tumor-like mass
Why does a keloid form?
abnormal/overgrowth in scar tissue repair of the injured skin
Who had this growing up
EC elbow after accident
Who is more prone to getting keloids?
african americans
Cause of keloids
genetic factor involved
Nevi
mole
Dysplastic Nevi
- larger than most acquired nevi
- have a tendency to occur on body surfaces exposed and not exposed to the sun
What is important to remember about Familial Dysplastic Nevus Syndrome?
Associated with increased lifetime risk of developing melanoma
Basal Cell Carcinoma
Usually non-metastatic tumor
Who gets Basal Cell Carcinoma?
Commonly found on light skinned people with history of sun exposure
Appearance of Basal Cell Carcinoma
Pearly papule with telangiesctasia
Location of Basal Cell Carcinoma
Frequently seen on the head/face and neck
Which layer are basal cells found on?
bottom layer of the 5 sublayers of epidermis
Patho of Basal Cell Carcinoma
- Bottom layer of the 5 sublayers of epidermis
- This is where cells grow and divide to replace the cells on the outermost layer that are constantly shedding
- In turn these cells become flatter when moving up tot he surface which is when they become squamous cells
What condition can Basal Cell Carcinoma resemble?
eczema
Telangiectasia
essentially spider veins
What is Squamous Cell Carcinoma?
Hyperkeratotic lesion with crusting and ulceration
is Squamous Cell Carcinoma
or basal cell carcinoma more likely to spread?
Squamous Cell Carcinoma
Who gets Squamous Cell Carcinoma?
Commonly found on light skinned people with history of sun exposure
Where is Squamous Cell Carcinoma formed?
the outermost sublayer of the epidermis
Is Squamous Cell Carcinoma or basal cell carcinoma more important to identify? Why?
- Squamous Cell Carcinoma
- Can be fatal
Melanoma
Skin cancer
What is more deadly: Squamous Cell Carcinoma or Melanoma?
Melanoma
How is Melanoma treated?
Surgically
What is the most important clinical sign of melanoma?
change in the color or size of a pigmented lesion
ABCs of Melanoma
A- asymmetrical shape B -boarder irregular C- color (multiple) D- diameter (>6mm) E- evolution (or change)
