Skin Diseases

Question 1

nevus

Answer 1

or mole, is a benign growth of the pigment-forming cells classified according to their location within the layers of the skin.

Question 2

Malignant melanoma

Answer 2

a tumor arising in melanocytes, the cells producing melanin. Melanoma causes the majority of skin cancer deaths.

Question 3

The incidence of skin cancer:

Answer 3

· Light-skinned races
· Individuals older than 60 years of age
· Outdoor workers
· Higher altitudes

Question 4

Basal Cell Carcinoma

Answer 4

locally invasive cancer arising from epidermal basal cells, most common type, but least deadly

Question 5

Clinical Manifestations of Melanoma

Answer 5

· Often occurs on lower legs in women and trunk and head of men
· Often deep brown or black
· Irregular color, surface, and border
· Variegated color, including red, white, blue, black, gray, brown
· Flat or elevate, eroded or ulcerated
· Often <1cm in size

Question 6

Clinical Manifestations of Basal Cell Carcinoma

Answer 6

· Small, slowly enlarging popular
· Borders semitranslucent or pearly with overlying telangiectasia
· Erosion, ulceration and depression of center
Superficial erythematous, pearly, sharply defined, barely elevated papules

Question 7

diagnostics for skin cancer

Answer 7

Biopsy is a critical tool for determining type of lesion

Question 8

ABCDE

Answer 8

· Asymmetry (symmetrical or asymmetrical)
· Border (borders even or borders uneven)
· Color (one color or multiple colors)
· Diameter (smaller than ¼ inch or larger than ¼ inch)
· Evolving (ordinary mole or changing in size, shape and color)

Question 9

Management for skin cancer

Answer 9

· Keep a record or “body map” of skin lesions.
· Inspect his or her body monthly for new lesions and for changes in any existing lesions by performing thorough total skin self-examination (TSSE).
· Monthly TSSE is critically important for patients who have already had a melanoma lesion.
· Often a partner is needed to help evaluate skin spots or lesions on the back.
· Some people find taking pictures of their skin on a regular basis makes identifying changes easier.

Question 10

Treatment of Melanoma

Answer 10

· Wide surgical excision and possible sentinel lymph node evaluation
· Possible use of adjuvant therapy after surgery if lesion >1.5 mm in depth
· Correlation between survival rate and depth of invasion
· Poor prognosis unless diagnosed and treated early
· Spreading by local extension, regional lymphatic vessels, and bloodstream

Question 11

surgical intervention for skin cancer

Answer 11

· Cryosurgery
· Curettage and electrodesiccation
· Excision
· Mohs’ surgery
· Wide excision

Question 12

nonsurgical intervention for skin cancer

Answer 12

· Drug therapy
Radiation therapy

Question 13

cryosurgery

Answer 13

use of cold temperatures to destroy tissue

Question 14

curettage and electrodesiccation

Answer 14

A combination procedure of curettage that involves scraping away abnormal tissue and electrodesiccation, which involves destroying the tumor base with a low-voltage electrode.

Question 15

patient teachimg for skin cancer

Answer 15

Teach every patient to evaluate all skin lesions using the ABCDE guide for melanoma and to consult his or her health care provider to examine any lesion having unusual characteristics
Encourage all patients to reduce sun exposure and exposure to ultraviolet (UV) light.

Question 16

Clinical Manifestations of HSV

Answer 16

· First episode
o Symptoms occurring 2 days to 2 weeks after contact
o Painful local reaction
o Single or grouped vesicles on erythematous base
o Systemic symptoms (fever, malaise)
· Recurrent
o Recurrence in similar spot
o Characteristic grouped vesicles on erythematous base

Question 17

Clinical Manifestations of Herpes Zoster (Shingles)

Answer 17

· Linear distribution along a dermatome of grouped vesicles and pustules on erythematous base resembling chickenpox
· Usually unilateral on trunk, face, and lumbosacral areas
· Burning, pain, and neuralgia preceding outbreak
· Mild to severe pain during outbreak

Question 18

Treatment for HSV

Answer 18

· Soothing, moist compress, petroleum jelly to lesions
· Antiviral agents (acyclovir)

Question 19

Treatment for Herpes Zoster Topical:

Answer 19

Zoster Topical:
o Wet compresses, silver sulfadiazine (Silvadene) to ruptured vesicles

Question 20

Treatment for Herpes Zoster Systemic:

Answer 20

o Antiviral agents within 72 hr to prevent postherpetic neuralgia
o Analgesia. Mild sedation at bedtime
o Gabapentin (Neurontin) to treat postherpetic neuralgia
o Usually heals without complications, but scarring and postherpetic neuralgia possible
o Vaccine (Zostavax) to prevent shingles for adults ≥50 yr

Question 21

Psoriasis

Answer 21

autoimmune disease, skin lesion often appears as red scaling papules, merge to form plaques, can be rounded with adherent silver scales that bleed easily;

Question 22

what body parts is psoriasis commonly on

Answer 22

scalp, elbows, knees, palms, soles, and fingernails

Question 23

clinical manifestations of psoriasis

Answer 23

· Sharply demarcated silvery scaling plaques on reddish skin often on the scalp, elbows, knees, palms, soles, and fingernails
· Itching, burning, pain
· Localized or generalized intermittent or continuous
Symptoms vary in intensity from mild to severe

Question 24

goal for psoriasis

Answer 24

Goal to reduce inflammation and suppress rapid turnover of epidermal cells. No cure, but control is possible

Question 25

drug therapy for psoriasis

Answer 25

antibiotics, corticosteroids and antihistamines

Question 26

Topical treatments for psoriasis

Answer 26

· Corticosteroids, tar, salicylic acid,
· Intralesional injection of corticosteroids for chronic plaques

Question 27

Systemic treatments for psoriasis

Answer 27

· Natural or artificial UVB. PUVA (UVA with topical or systemic photosensitizer
· Antimetabolite (methotrexate)
· Immunosuppressant (cyclosporine)
Biologic therapy (adalimumab [Humira], etanercept [Enbrel], infliximab [Remicade],