Skin and Soft Tissues Flashcards
What is the keratinocyte transit time
40 - 56 days
Factors that increase melanin production
- uv radiation
- estrogen
- adrenocorticotropic hormone
- melanocyte stimulating hormone
Also known as skin macrophages
langerhan’s cell - produce MHC II
These are sweat producing glands located over the entire body but are concentrated in the palms, soles, axillae and forehead
eccrine glands
pheromone producing glands found in the axillae and anogenital region
appocrine glands
IVF extravasation is considered what type of burn
chemical burn
most common cause of extravasation in adults
chemotherapeutic drugs
most common site of extravasation in adults
dorsum of the hand
most common cause of extravasation in infants causing necrosis
high concentration dextrose
What causes pressure injury
1 hour of 60 mmHg pressure
Normal pressure values
arteriole - 32 mmHg capillary - 20 mmHg venule - 12 mmHg Sitting - 300 mmHg Hospital Bed - 150 mHg
Most important protective factor from UV related damage
melanin
most common form of radiation exposure
solar or uv radiation
treatment of cellulitis
oral antibiotics
treatment of folliculitis
adequate hygiene
treatment of furuncle
- warm water to hasten liquefaction and rupture
2. incision and drainage
treatment of carbuncle
- incision and drainage
It is a defect of the terminal follicular epithelium which leads to blockage of appocrine glands
hidradenitis suppurative
treatment of hidradenitis suppurative
acute - warm compress, antibiotics, open drainage
chronic - wide excision with closure using skin graft or local flap
It is a granulomatous suppurative bacterial disease and deep cutaneous infection that present as nodules and spread to form draining tracts. Pathognomonic is positive SULFUR granules within purulent specimen
actinomycosis
treatment of actinomycosis
penicillin or sulfonamide
It is a rapidly enlarginc, destructive, cutaneous necrotic lesion with undermined border and surrounding erythema; associated with a systemic disease 50% of the time
pyoderma gangrenosum
Histopathology reveals cleavage plane in the GRANULAR layer of the epidermis
SSS
Histopathology reveals structural defect at DERMOEPIDERMAL JUNCTION similar to a 2nd degree burn
SJS/TEN
Most common location of dermoid cyst
eyebrow
-results from trapping of epithelium during fetal midline closure
most common location of trichilemmal (pilar) cyst
scalp
-this cyst has NO granular layer
Another name for achrochordon
skin tags
usual location of dermatofibroma
legs and flanks
tx: excision
most common cutaneous lesion in infancy
hemangioma
Flat dull red lesion often located on the trigeminal distribution on the face trunk or extremities
capillary malformation/ port wine stain
assoc: sturge webber syndrome
this is associated w ith von recklinghausen ‘s disease
neurofibroma
These are solitary tumors arising from cells of the peripheral nerve sheath
neurileoma
These are neural tumors that are solitary lesions of the skin or more commonly of the tongue
granular cell tumor
most common type of skin cancer
basal cell carcinoma
most common type of basal cell carcinom
nodulocystic/noduloulcerative
characteristic lesion of the nodulocystic type of BCC
rodent ulcer - rolled, pearly borders surrounding a central ulcer
Treatment of basal cell carcinoma
- <2 mm - curettage, electrodeiccation, laser vaporization
2. large tumors - surgical excision with 0.5 cm to 1 cm margin
Treatment of basal/squamous cell carcinoma located in the cheek, nose or lips
MOH’s surgery
Where does basal cell carcinoma arise from
pluripotent basal epithelial cells of EPIDERMIS
Where does squamous cell carcinoma arise from
epidermal keratinocytes
name of in situ lesion of squamous cell carcinoma
- bowens disease
2. erythroplasia of queyrat - penis
What are the ulcers called in burn scars
Marjolin’s ulcer
treatment of squamous cell carcinoma
- excision with 1 cm margin
2. regional LN excision if with palpable nodes or chronic wounds
Malignant melanoma arise from
melanocytes
what is the premalignant lesion of malignant melanoma
dysplastic nevi
most common location of malignant melanoma
skin
Subtypes of malignant melanoma
- superficial spreading
- nodular
- lentigo maligna
- acral lentiginous
Most common subtype of malignant melanoma
superficial spreading
Subtype of malignant melanoma with worse prognosis
acaral lentiginous
subtype of malignant melanoma with best prognosis
lentigo maligna
Treatment of malignant melanoma
- melanoma in situ/lentigo maligna in face: 0.5 cm margin
- 1 mm or less: 1 cm margin
- 1 to 4 mm: 2 cm margin
- more than 4 or (+) satellosis: 3 - 5 cm margin
It is a primary neuroendocrine carcinoma of the skin
Merkel Cell carcinom
Treatment of merkel cell carcinom
wide local resection with 3 cm margin + prophylactic LN dissection + adjuvant radiation
These are rubbery bluish nodules that occupy primarily on the extremities, skin and viscera
kaposi sarcoma
modulate cold sensation
krause’ end bulb
modulate sensitivity to warmth
ruffini’s endings
modulate sensation of pressure
pacinian corpuscle
modulate tactile sensation
meissner’s corpuscles
modulate thermoregulation nerve
autonomic endings