skin diseases Flashcards
Psoriasis
D/S Chronic appearance of discrete pink, red lesions surmounted by silvery scaling
E/T Unknown; genetic, autoimmune; precipitating factors include hormonal changes
S/S High rate of skin-cell turnover produces thick, flaky scaling; encrusted on scalp, chest, buttocks, extremities; pruritus
D/X Skin observation, skin biopsy
T/X No cure; palliative treatment; removal of scales; ultraviolet light, coal tar, steroid creams, low- dosage antihistamines, oatmeal baths, open, wet dressings
P/P Controllable; remissions, exacerbations occur frequently/None known
Urticaria (Hives)
D/S Episodic inflammatory reaction of capillaries beneath localized skin area
E/T Usually following ingestion of certain foods; allergic reactions to stings, inhalants
S/S Eruption of pale, raised skin wheals; erythema; lesions resolve rapidly; intense itching
D/X Medical history and observation; sensitization testing
T/X Remove offending stimuli; antihistamines, epinephrine, hydrocortisone cream
P/P Good/Avoid causative agents
Acne Vulgaris
D/S Inflammatory disease of sebaceous glands, hair follicles; comedos, papules, pustules; most common in adolescents
E/T Unknown; heredity; hormonal imbalance
S/S Acne plug forms as comedo and then ruptures or leaks, spreading contents to dermis; inflammation, scars
D/X Observation, medical history
T/X Strong antibacterial solution, oral antibiotics; cleansing and peeling agents
P/P Persistent, often emotionally upsetting; prolonged treatment; possibly permanent scarring and disfigurement/None known
Alopecia
D/S Absence or loss of hair, especially on head
E/T Certain systemic, endocrine, nutritional disorders, dermatitis; certain drugs, chemotherapy, radiation; unrelated to any pathology, especially in men
S/S Gradually over advancing age; or suddenly
D/X Visual examination
T/X Depends on cause; for scarring, no treatment; spontaneous growth may occur; minoxidil preparations may help; surgery
P/P Depends on cause; alopecia due to scarring is permanent/None known
Impetigo
D/S Contagious superficial skin infection marked by vesicles, bullae that become pustular, rupture, and form yellow crusts
E/T Streptococcus, Staphylococcus; predisposing factors include poor hygiene, malnutrition, anemia
S/S Lesions begin as macules, vesicles, pustules; pruritus; thick, yellow crust forms; erythema, ulcerations, scarring
D/X Visual observation; Gram’s stain of vesicle fluid under microscope
T/X Antibiotics; cleansing 2 to 3 times per day
P/P Good/Good hygiene, avoidance of infected persons
Furuncles and Carbuncles
D/S Furuncle: Boil, abscess involving entire hair follicle, adjacent subcutaneous tissue
Carbuncle: Several furuncles with multiple drainage sinuses
Hairy parts of body
E/T Staphylococcus; predisposing factors include diabetes, nephritis, debilitation, infected wound
S/S Affected skin extremely tender, painful, swollen; abscess enlarges, softens, and opens discharging pus, necrotic material; erythema, edema, mild fever
D/X Visual observation; slight leukocytosis
T/X Cleanse site with soap, water; apply hot, wet compresses; give antibiotics; perform surgical incision and débridement
P/P Recur for months/years; complications include bacteremia/Maintain good personal hygiene; prevent infections
Pediculosis
D/S Skin infestation with lice, a parasitic insect; pediculosis corporis, capitis, pubis
E/T Lice feed on human blood, lay eggs/nits in body hair, clothing; eggs hatch, feed, mature; louse bite injects toxin in skin; transmitted by infected clothing, hats, combs, bed sheets, towels; through sexual intercourse
S/S Intense pruritus, evidence of nits on hair shafts, clothing, skin; gross excoriation of skin patches, pyoderma, rashes, wheals
D/X Visual examination; nits on hair, skin, clothing
T/X Washing clothing; using special shampoo, creams, lotions
P/P Excellent with treatment/Practice good hygiene; avoid contact with infested persons; do not share combs, brushes, clothing
Decubitus Ulcers
D/S Localized area of dead skin, subcutaneous tissue
E/T Impairment of blood supply to affected area as a result of persistent pressure; prolonged immobilization of unconscious, paralyzed clients; weak circulation; more common in elderly clients
S/S Shiny, reddened skin, usually over bony prominence; small blisters, erosions, necrosis, ulceration; if infected, foul smelling, purulent; pain
D/X Visual examination; wound culture and sensitivity testing
T/X Alleviating skin pressure; excellent skin hygiene; keeping skin clean, dry; topical antibiotic; surgery
P/P The sooner the treatment, the better the prognosis; healing slow, tedious/Frequent repositioning; gentle massage of pressure areas
Dermatophytoses
D/S Chronic superficial fungal infection; tinea capitis, corporis, unguium, pedis, cruris
E/T Fungus; transmitted by direct contact with fungus or its spores
S/S Capitis/Scalp: Persistent, contagious, often epidemic infection; round, gray, scaly
Corporis/Ringworm: Exposed skin surfaces, domestic animals, cats; ringed, scaled with small vesicles
S/S Unguium/Nails: Tip of one or more toenails; lusterless, brittle, hypertrophic
Pedis/Athletes foot: Intense, persistent itching; burning, stinging, pain; sole inflamed, exfoliation, fissuring
Cruris/Jock itch: Red, raised, sharply defined, itching lesions of groin
D/X Depends on location, appearance of lesion; culture lesion, perform skin tests, examine under Wood’s light
T/X Apply topical fungicidal agent (oral sometimes used); keep skin dry, clean
P/P Tend to be chronic, persistent; requires scrupulous management/Maintain proper hygiene
Corns and Calluses
D/S Corns: Indurations, thickenings of stratum corneum of skin; central keratinous core
Calluses: Localized hyperplasia of stratum corneum; lesion with indefinite border
S/S Tenderness, pain; corns have glassy core, smaller and more clearly defined; more painful
D/X Physical examination (PE), medical historyT/X Relieving pressure or friction points along skin; surgical débridement; local injections of corticosteroids; pads
P/P Good if cause is removed/Wear well-fitting shoes, avoid trauma to feet
Warts
D/S Verrucae, circumscribed, elevated skin lesions resulting from hypertrophy of epidermis; solitary or clustered; exposed areas of fingers, hands; more common in children
E/T Papilloma viral infection; direct contact or autoinoculation
S/S Size, shape, appearance vary widely; tenderness, itching
D/X Visual examination
T/X Surgical excision; cryosurgery, keratolytic agents; immunotherapy; tedious, painful
P/P Spontaneous cure in 50% of cases; may resist any treatment; recurrence; secondary infection, scarring/Avoid wart contact
Discoid Lupus Erythematosus
D/S Connective tissue disorder; superficial, localized inflammation of skin
E/T Unknown; autoimmune defect; more common in women
S/S Macules, papules, plugged follicles, atrophic areas on face, neck, upper extremities; lesions are dusky red, well localized, and covered by dry, horny, adherent scales
D/X Clinical picture, rash; differentiate from systemic lupus erythematosus (SLE)
T/X Topical or injected corticosteroid cream; avoiding extreme fatigue, stress, overexposure to sunlight, fluorescent lighting
P/P Chronic but successfully controlled; good if SLE does not develop/None known
Scleroderma
D/S Systemic sclerosis; progressive, chronic, system disease; diffuse fibrosis of skin, internal organs; morphea (skin) and systemic (skin and internal organs)
E/T Unknown; autoimmune; women aged 30 to 50
S/S Raynaud’s phenomenon; pain, stiffness, swelling of fingers, joints; thick, shiny, taut skin; contractures; gastrointestinal (GI) signs and symptoms
D/X Typical cutaneous clinical picture; hand, chest, GI x-rays; urinalysis (UA); skin biopsy
T/X Palliative; chemotherapy with immunosuppressive drugs; vasodilators, antihypertensive drugs; physical therapy
P/P Variable; systemic form more serious with death resulting from renal, cardiac, pulmonary failure/None known
