Skin Change Flashcards
What are the 6 Ps in acute limb ischemia?
- Paraesthesia
- Perishing cold
- Pulselesness
- Pain
- Paralysis
- Pallor
*arterial occlusion –> amputation if not tx quickly
*area is described as “waxy” when touched
What do superficial varicosities indicate?
venous congestion due to valves not closing properly
*both this and edema can indicate poor venous return due to incompetent valves
What does systemic HTN do to venous return?
leads to poor return
What is the physical appearance of stasis dermatitis?
- reddish/brownish/purplish discoloration; over time can thicken skin
- due to hemosiderin deposits from RBC breakdown
- occurs with stasis of venous circulation
What is the term to describe edema with stasis dermatitis?
“brawny” edema
While rounding on your 100 y/o HF pt, you notice marked erythema of her left LE. It is warm to touch, and there is associated swelling. You also note skin weeping, but do not see an apparent open sore. What is the dx?
Cellulitis - inflammation of skin and subcutaneous tissue (most often infectious)
What do you see on the foot of someone with bacterial endocarditis? hand?
- Janeway lesion on the big toe
- Osler nodes on toes (1mm - over 1cm; can also be seen on hand/fingers)
- splinter hemorrhages on fingers - microemboli
What are the arrows pointing to?
- Xanthelasma palpebrum
- Most common form of Xanthoma
What is shown in this picture?
- Eruptive Xanthomas on shoulder (hyperlipidemia)
- arrow indicates an “umbilicated lesion” (dent in center of papule)
*can look like molluscum contagiosum (viral infection)
What do you see?
clubbing - chronic pulmonary disease
*peripheral hypoxia may be part of the trigger
What are some risk factors for central/peripheral vascular diseases?
- Nicotine/Tobacco use of any kind
- Vaping substances or toxic interactions
- Sedentary lifestyle
- Obesity
- Dietary indiscretion – high salt, high fat, low fiber
- Hypertension
- Hyperlipidemia
- Diabetes
- Alcohol excess
- Family History
- Genetic predisposition
*Peripheral disease = the extremities
*Central disease = affecting the aorta, IVC, major organ vessels
Life style modifications
- Smoking cessation
- Exercise
- Weight loss
- Support hose
- Compression hose
- Psychosocial support – multidisciplinary approach
- Follow-up regularly
What do we see with evaluation after walking, palliative factors, and provocative facorts with vascular claudication? what about neurogenic claudication?
