Skin Diseases Flashcards
Psoriasis Description
A chronic, noninfectious inflammatory skin disease marked by the appearance of discrete pink of red lesions surmounted by a characteristic silvery scaling
Psoriasis Etiology
Occurs more frequently between 15 and 50. Cause is unknown, however it appears to be autoimmune disorder. Hereditary component. Flares may be proceeded by trauma, infections, hormone changes, pregnancy, stress, etc.
2 peaks of onset: 20-30 (75%), 50-60 (25%)
Signs/ Symptoms
5 types. The only type we will discuss is plaque psoriasis (inflamed raised red lesions covered in white scaly patches). Found typically on extensor surfaces: elbows, knees, scalp and back
Thick, flaky, silvery scaling; affected areas appear dry, cracked and encrusted
Psoriasis Signs/ Symptoms
5 types. plaque psoriasis (inflamed raised red lesions covered in white scaly patches). Found typically on extensor surfaces: elbows, knees, scalp and back Thick, flaky, silvery scaling; affected areas appear dry, cracked and encrusted
Psoriasis Diagnostic Procedures
Observation of the skin, careful medical history, skin biopsy.
Treatment
Mild to moderate: Topical corticosteroids, emollients, exposure to UV light (phototherapy); non-steroidal creams; Careful skin hygiene
Moderate to Severe: Phototherapy, Retinoids (regulate epithelial cell growth), methotrexate
Complementary Therapy
Foods high in omega-3 fatty acids and vitamin supplements
Prognosis
Controllable, remissions and exacerbations frequently occur
Psoriasis Diagnostic Procedures
Observation of the skin, careful medical history, skin biopsy.
Psoriasis Treatment
Mild to moderate: Topical corticosteroids, emollients, exposure to UV light (phototherapy); non-steroidal creams; Careful skin hygiene
Moderate to Severe: Phototherapy, Retinoids (regulate epithelial cell growth), methotrexate
Complementary Therapy
Foods high in omega-3 fatty acids and vitamin supplements
Prognosis
Controllable, remissions and exacerbations frequently occur
Psoriasis Complementary Therapy
Foods high in omega-3 fatty acids and vitamin supplements
Psoriasis Prognosis
Controllable, remissions and exacerbations frequently occur
Urticaria (Hives) Description
Inflammatory reaction of capillaries beneath a localized area of skin
Etiology
Five I’s: Infection, Insects/infestations, Ingestion, Inhalation, Injection
Frequently results following ingestion of certain foods or allergic reactions to insect stings; heat, cold, water and sunlight exposure
Signs/Symptoms
Pale, superficial, well-defined, raised wheals on the skin possibly surrounded by erythema; intense itching
Urticaria Etiology
Five I’s: Infection, Insects/infestations, Ingestion, Inhalation, Injection
Frequently results following ingestion of certain foods or allergic reactions to insect stings; heat, cold, water and sunlight exposure
Signs/Symptoms
Pale, superficial, well-defined, raised wheals on the skin possibly surrounded by erythema; intense itching
Urticaria
Signs/Symptoms
Pale, superficial, well-defined, raised wheals on the skin possibly surrounded by erythema; intense itching
Urticaria Diagnostic Procedure
Medical history, sensitization testing Treatment Avoidance of allergen Antihistamines, hydrocortisone creams and lotions, systemic steroids, epinephrine. Prognosis Repeated exposure may lead to anaphylactic reaction Prevention Avoid causative agents
Urticaria Diagnostic Procedure
Medical history, sensitization testing
Urticaria Treatment
Avoidance of allergen
Antihistamines, hydrocortisone creams and lotions, systemic steroids, epinephrine.
Prognosis
Repeated exposure may lead to anaphylactic reaction
Prevention
Avoid causative agents
Urticaria treatment
Avoidance of allergen
Antihistamines, hydrocortisone creams and lotions, systemic steroids, epinephrine.
Prognosis
Repeated exposure may lead to anaphylactic reaction
Prevention
Avoid causative agents
Urticaria Prognosis
Repeated exposure may lead to anaphylactic reaction
Prevention
Avoid causative agents
Urticaria
Prevention
Avoid causative agents
Acne Vulgaris Description
60-70% of Americans.
Inflammatory disease of sebaceous glands and hair follicles; characterized by comedones, papules and pustules
Open or closed comedone
Etiology
Genetic predisposition, certain drugs, emotional stress, hormonal factors, occlusion and pressure on the skin. Not caused by specific foods.
Signs/Symptoms
Rupture of the acne plug, inflammation and acne pustules; scars if chronic irritation continues over time
Acne Vulgaris Etiology
Genetic predisposition, certain drugs, emotional stress, hormonal factors, occlusion and pressure on the skin. Not caused by specific foods.
Signs/Symptoms
Rupture of the acne plug, inflammation and acne pustules; scars if chronic irritation continues over time
Acne Vulgaris Signs/Symptoms
Rupture of the acne plug, inflammation and acne pustules; scars if chronic irritation continues over time
Acne Vulgaris Diagnostic Procedures
Medical history and observation of lesions
Acne Vulgaris Treatment
Goals:
reduce bacterial count, decrease sebaceous gland activity, prevent the follicle from becoming inflamed; antibacterial solution applied to the skin (Benzoyl Peroxide), orally administered antibiotics, or both
Acne Vulgaris Proactiv Solution:
Active Ingredient: benzoyl peroxide 2.5% Price: $20.00-60.00
Acne Vulgaris Oxy Acne Treatment: Active Ingredient:
benzoyl peroxide 10% Price: ~$ 5.99
Rosacea Description
Chronic inflammatory condition that causes erythema, flushing or redness, and formation of red pustules on the face.
Absence of comedones.
Rosacea Etiology
Genetic predisposition (fair-skinned adults) and environmental factors
Signs/Symptoms
Flushing of cheeks, forehead, nose or chin; small red pustules form; nose may enlarge
3 phases: 1. Pre-rosacea (blush or flush easily) 2. Vascular rosacea (skin becomes sensitive and small vessels on cheeks and nose swell 3. Inflammatory rosacea (small red pustules on cheeks, nose, forehead and chin
Rosacea
Signs/Symptoms
Flushing of cheeks, forehead, nose or chin; small red pustules form; nose may enlarge
Rosacea Phases
- Pre-rosacea (blush or flush easily)
- Vascular rosacea (skin becomes sensitive and small vessels on cheeks and nose swell
- Inflammatory rosacea (small red pustules on cheeks, nose, forehead and chin
Rosacea Diagnostic Procedures
Physical examination and medical history
Rosacea Treatment Goal
reduction of inflammation using topical creams or lotions containing tretinoin, benzoyl peroxide, and azelaic acid; oral antibiotics (doxycycline, tetracycline, erythromycin, minocycline) . Intense pulsed light/broad band light therapy.
Rosacea Prevention
Reduce flare-ups by wearing sunscreen, protect face from wind, avoid overheating, use gentle facial cleansers and refrain from drinking alcoh
Keratosis Pilaris Description
Painless, skin-colored bumps that may redden and form rough patches of skin
Etiology
Usually before age 10, worsens with puberty
Signs/Symptoms
Small, evenly spaced papules on upper arms, thighs, buttocks and sometimes the face
Keratosis Pilaris Etiology
Usually before age 10, worsens with puberty
Keratosis Pilaris Signs/Symptoms
Small, evenly spaced papules on upper arms, thighs, buttocks and sometimes the face
Keratosis Pilaris Diagnostic Procedures
Dermatologist consultation, physical examination
Keratosis Pilaris Treatment
Removal of built-up keratin; lotions, creams or ointments; topical steroids
Alopecia Areata Description
Absence or loss of hair
Scarring Alopecia-fibrosis, loss of hair follicles, inflammation
Non-scarring Alopecia-hair shafts are gone but hair follicles are preserved
Etiology
Abnormal immune response
Signs/Symptoms
May occur gradually with advancing age or may be sudden
Alopecia Areata Etiology
Abnormal immune response
Alopecia Areata Signs/Symptoms
May occur gradually with advancing age or may be sudden
Alopecia Areata Diagnostic Procedures
Visual examination, detailed health history, examination of skin/oral mucosa and biopsy
Scarring Alopecia-Treatment
no treatment
Non-scarring Alopecia treatment-
Minoxidil to treat male pattern baldness, surgical redistribution of hair follicles
Alopecia Prognosis
Depends on the cause, alopecia due to scarring is permanent
Alopecia Prevention
None
Folliculitits Description
Infected hair follicle
Furuncle
abscess involving the entire hair follicle and adjacent subcutaneous tissue
Carbuncle description
Several furuncles developing in adjoining hair follicles with multiple drainage sinuses
Folliculitis/Furuncles/Carbuncles Etiology
Infection by staphylococcal bacteria
Folliculitis/Furuncles/Carbuncles Signs/Symptoms
Affected area may be extremely painful, tender and swollen; abscess may eventually enlarge, soften and open discharging pus and necrotic material; erythema and edema may persist for days or weeks
Folliculitis/ Furuncles/ Carbuncles Diagnostic Procedures
Made on basis of appearance of characteristic lesion; slight leukocytosis; gram stains of purulent content reveal causative organism
Folliculitis/Furuncles/Carbuncles Treatment
Boil should never be squeezed; clean infected area with soap and water; hot compresses should be applied; antibiotic agents frequently prescribed; surgical incision and drainage
Folliculitis/Furuncles/Carbuncles Prognosis
The condition may recur for months or years; complications include bacteremia
Folliculitis/Furuncles/Carbuncles Prevention
Good personal hygiene and prevention of infectious process
Pediculosis Description
Infestation with lice on the body, scalp and pubic area
Pediculosis Etiology
Lice feed on human blood and lay eggs in body hair or clothing
Pediculosis Signs/Symptoms
Intense pruritus and evidence of nits on hair shafts; lice on clothing or skin; excoriation of patches of skin and pyoderma
Pediculosis Diagnostic Procedures
Visual examination
Pediculosis Treatment
Scalp: Permethrin 1% cream rinse;
Body: wash with soap and water; clothing and bedding must be washed or dry cleaned
Pubic: creams, lotions or shampoos
Pediculosis Prognosis
Excellent with treatment but complications include severe pruritus, pyoderma, and dermatitis
Pediculosis Prevention
Good hygiene, avoid contact with infested persons, don’t share combs, brushes or clothing
Dermatophytoses Description
Chronic, superficial fungal infection; tinea capitis (scalp), tinea corporis (body), tinea unguium (nails), tinea pedis (feet) or groin (tinea cruris)
Dermatophytoses Etiology
Caused by several species of fungi, transmitted by direct contact with the fungus or its spores; infection more likely if skin is traumatized
Tinea Capitis-
persistent, contagious infection; slight itching of the scalp
Tinea Corporis-
(ringworm) occurs on exposed skin surfaces; lesions ringed and scaled with small vesicles
Tinea Unguium-
starts at the tip of one or more toenails; nail appears lusterless, brittle, and hypertrophic
Tinea Pedis-
(athlete’s foot) persistent itching-most common symptom; burning, stinging and pain
Tinea Cruris-
(jock itch) may be associated with tinea pedis, occurs among male athletes, characterized by red, raised , itching lesions
Dermatophytoses Diagnostic Procedures
KOH microscopy
Dependent on the location and appearance of the skin lesion; suspected lesions may be cultured to isolate the fungus
Dermatophytoses Treatment
Apply topical fungicidal medication; oral medications may be prescribed; loose-fitting clothing should be worn and changed frequently
Personal hygiene
Dermatophytoses Prognosis
All forms tend to be chronic and persistent
Prevention
Proper hygiene practices
Candidiasis Description
Fungal infection caused by Candida albicans. Look for warm, moist, dark environment,
Candidiasis Etiology
Secretions or excretions
Birth canal
Sexual intercourse
Symptoms
Skin
Scaly, red, papular rash
diaper rash
Sx Mouth (thrush)
Patches on the tongue, mouth or pharynx
Swelling in infants
Sx Vagina
Abnormal discharge
itchy
Candidiasis Diagnostic Procedures
KOH microscopy
Treatment
Hygiene, keep area dry.
Antifungal drugs
Candidiasis Prevention/Control
Treatment can prevent thrush in a newborn
Partner treatment
Scabies Description
Skin infection that results from the infestation by the itch mite
Scabies Etiology
Infection caused by the itch mite; mites live in the skin of humans causing chronic infection
Skin to skin contact
Scabies Signs/Symptoms
Intensely itchy. Itching intensifies at night; lesions excoriated and may appear threadlike; appear between fingers, on wrists, on elbows, in the axilla, at the waist, on nipples, buttocks and genitalia
Scabies Diagnostic Procedures
Visual examination. Look for burrows
Treatment
Application of a pediculicide-permethrin 5%; left on for 8 to 12 hours a day for 5 days; Treat all family members. Antipruritics and oral antihistamines may reduce itching
Prognosis
Good; intense scratching may lead to secondary bacterial infection
Prevention
Practice good hygiene
Scabies Prognosis
Good; intense scratching may lead to secondary bacterial infection
Scabies Prevention
Practice good hygiene
Scabies Diagnostic Procedure
Characteristic lesions; yellow crust
Scabies Treatment
Antibiotics: topical and/or oral; Good hygiene
Prognosis
Good
Prevention
Good hygiene and avoidance of infected people
Scabies Prognosis
Good
Scabies Prevention
Good hygiene and avoidance of infected people
Impetigo Description
Contagious skin infection marked by a vesicle or bulla that becomes pustular, ruptures and forms a yellow crust
Impetigo Etiology
Streptococcal or staphylococcal bacteria; predisposing factors: poor hygiene, malnutrition, anemia
Impetigo Signs/Symptoms
Lesions begins as macules, vesicles, and pustules. Primary lesions rupture leaving honey-colored liquid; liquid hardens and thick yellow crust forms over the infected site; most common on the mouth, nose, neck, or extremities
Impetigo Diagnostic Procedure
Characteristic lesions; yellow crust
Impetigo
Treatment
Antibiotics: topical and/or oral; Good hygiene
Impetigo
Prognosis
Good
Impetigo Prevention
Good hygiene and avoidance of infected people
Warts Description
Benign circumscribed, elevated skin lesions resulting from hypertrophy of the epidermis; common, plantar, flat, filiform, or periungual warts
Warts Etiology
Caused by infection from papilloma viruses; usually through direct contact
Warts Signs/Symptoms
Usually asymptomatic except when they occur on weight-bearing areas; tenderness and itching
Warts Diagnostic Procedures
Visual examination
Warts Treatment
Removed with Carbon Dioxide, applied laser therapy, salicylic acid plasters, surgical excision, cryosurgery, keratolytic agents
Warts Prognosis
Spontaneous cures occur 50% of the time; warts may resist treatment; secondary infection and scarring are possible
Warts Prevention
Avoid touching any warts
Vitiligo Description
Melanocytes are destroyed or cease producing melanin which results in depigmentation or white patches on the skin and mucous membranes
Etiology
Genetically determined or autoimmune disorder
Signs/Symptoms
Depigmentation or white spots appear on areas exposed to sunlight such as the face, lips, hands and feet
3 patterns: 1. focal pattern-one or a few areas 2. segmental pattern- affects only one side of the body 3. generalized pattern- symmetrically on both sides of the body
Vitilgo Etiology
Genetically determined or autoimmune disorder
Vitiligo Signs/Symptoms
Depigmentation or white spots appear on areas exposed to sunlight such as the face, lips, hands and feet
3 patterns: 1. focal pattern-one or a few areas 2. segmental pattern- affects only one side of the body 3. generalized pattern- symmetrically on both sides of the body
Vitiligo Diagnostic Procedures
Physical examination, medical history of sunburn, trauma, premature graying, stress or physical illness 2 to 3 months before depigmentation occurred and family history of vitiligo
Vitiligo Treatment
Topical corticosteroids; ultraviolet A therapy; micropigmentation or tattooing
Vitiligo Prognosis
Chronic condition with unpredictable prognosis
Vitiligo Prevention
None
Scleroderma Description
Progressive, chronic, connective tissue disease characterized by diffuse fibrosis of the skin and internal organs; degenerative and fibrotic changes in skin, blood vessels, skeletal muscles and internal organs
Scleroderma Etiology
Appears to be an autoimmune disorder
Scleroderma Signs/Symptoms
Raynaud phenomenon: discoloration of fingers or toes after exposure to change in temperature; followed by pain, stiffness, swelling of fingers and joints; calcium deposits appear in connective tissue; skin becomes thick, shiny and taut; contractures develop, GI symptoms: heartburn, diarrhea, constipation, weight loss, malabsorption
Scleroderma Diagnostic Procedures
Typical cutaneous clinical picture; hand, chest and GI x-rays may show systemic changes
Scleroderma Treatment
Chemotherapy with immunosuppressive drugs; corticosteroids and colchicine; vasodilators and antihypertensive drugs (raynaud phenomenon) digital ulcerations require immediate treatment
Scleroderma Prognosis
Variable; poor with death usually resulting from renal, cardiac, or pulmonary failure
