Skin Disorder (Exam 3) Flashcards
Fungal Transmission
Implantation: Tineas
Inhalation: Cryptococcal
Taking antibiotics: candidiasis
Fungal infections more common in
Elderly and immuno-compromised
Vascular indwelling catheter, organ transplant recipients and patients receiving chemo
Superficial Fungal Infections
Dermatophytes
Fungi that cause superficial skin infections
Fungal disorders/infections are know as
Mycoses
When caused by dermatophytes the mycoses are
Tinea
When caused by candida albicans mycoses are called
candidiasis
Two most common superficial fungal infections
Cadidiasis
Tineas
Infect hair, skin, and nails
Superficial Fungal Infection: Treatment
-Treated with topical antifungal preparations
-Systemic antifungals needed for extensive areas or for treatment failures (PO OR IV)
Types of common Fungi
- Yeast = Candida albicans
- superficial dermatophytes = Tineas (live on keratnized tissue)
Tineas names based on location of body
Corporois - Ringworm
Pedis - Athletes foot
Versicolor - Upper chest, back, and arms
Capitis - Hair
Cruis - Ringworm of groin
Tinea Pedis
-Dry scaling prutic lesions
-May only affect skin in the web spaces between the toes
Tinea Pedis: Risk factors
Coming into contact with infected skin or fungus in environment
Locker room and college dorms
Tinea Pedis: Treatment
Topical antifungal in most cases
Resistant: Oral or IV
Tinea Capitis
Can affect scalp, eyebrows, or eyelashes
-Scaly erythematous lesions and hair loss
-May cause permanent alopecia (baldness)
-is the most common pediatric dermatophyte
Tinea Capitis: Treatment
Oral systemic antifungals twice a day for 4-6 weeks
Tinea Versicolor
Fungus that affects the skin of the upper back or arms
Caused by overgrowth of the yeast that live on our skin
Tinea Versicolor: Risk Factors
Hot climate, sweating a lot, oily skin, weakened immune system, NOT contagious
Candidiasis
Thrush or yeast infections
Candidiasis Albicans: Risk factors
Immunosuppression (iatrogenic, acquired), antibiotic use
Candidiasis: Appearance
May appear as white lesions in mouth
Beefy red with satellite lesions in intertriginous areas (skin folds)
Systemic Fungal Infections
-Require aggressive treatment with oral or iv antifungals
-Affects internal organs
Systemic Fungal Infections of the Lungs
-Histoplasmosis
-Blastomycosis
-Pneumocystis
Systemic Fungal Infections: Lungs and meninges
Cryptococcosis
Pigmented Lesions
-Melasma
-Vitiligo
Melasma
-dark macules on the face
-Most common in pregnant women (Mask of pregnancy)
Melasma: treatment
-Avoid sun
-Bleaching creams with hydroquinone
-Tretinoin/Retin-A (vitamine A derivative)
Vitiligo
-Acquired conditions characterized by abnormalites in the production of melanin
-Pigment disappears from a patch of skin
-Occur suddenly before or around the age of 21
Viral Skin Infections
Herpes Zoster: Shingles
Herpes Zoster: Shingles
-Varicella zoster virus lies dormant on a dermatome segment after infection with chickenpox
-Virus becomes reactivated by immunosuppresion, stress, or illness
Hepres Zoster: Prodrome
-Burning/Tingling along dermatome and then rash develops with vesicles that dry and crust over
Herpes Zoster: Charateristics
-Vesicles on red base that follow along dermatomal distribution-asymmetric (does not cross midline)
-Usually extremely painful and take 2-3 weeks to clear
-Most contagious when vesicles are weeping
Herpes Zoster: Treatment
Anti-virals
Herpes Zoster: Complication
Post-herpetic neuralgia persistent pain in the area where the rash was
Chronic Pain
How to prevent post herpetic neuralgia
SHINGLES VACCINE
Bacterial Skin Infections
-Impetigo
-Abscess
-Furuncle
-Cellulitis
-MRSA (staph)
Impetigo
-Organism carried in the nose: Staphlyococci and Streptococci
-Acute and CONTAGIOUS
-Appearance: Vesicles pustules, honey-colored crust on red base
Impetigo: Treatment
Bactroban: Topical antibacterial
Abscess
-Skin inflamed and red with collection of pus
-Area often raised with palpable borders
-Tender
-May drain purulent discharge or fell fluctuant (Fluid-Filled)
Abscess: Treatment
Incision and drainage with antibiotics
Furuncle and Carbuncle
Furuncle: is a bacterial infection of hair follicle (Ingrown hair)
Carbuncle: Painful, deep swelling of the skin caused by bacteria. MORE HAIRS INVOLVED
Cellulitis
-bacterial infection of skin and surrounding tissues
-May be an initial injury or wound that becomes infected and spreads to surrounding healthy tissue
-May be caused by animal or insect bite
-Often occurs in lower extremities
Is cellulitis contagious?
Not contagious but may become serious by spreading to lymph nodes and blood stream
Cellulitis: Appearance
Red, painful, swollen, and warm to the touch
Cellulitis: Treatment
PO systemic antibiotics IV depending on severity
MRSA
-Caused by a type of staph bacteria that is resistant to many antibiotics
Community acquired MRSA
Often begins as painful boil
Transmitted from person to person
High-risk = high school wrestlers, child-care workers, and people who live in crowded conditions
MRSA: Symptoms
-Warm to touch with purulent drainage, fever, abscess can develop quickly
-Bacteria can burrow deep into the body potentially life-threatening infections of bones, joints, surgical wounds, blood stream, heart valves, and lungs
MRSA: Treatment Hospital Acquired
IV vancomycin or Zyvox
MRSA: Treatment community
-Bactrim or dicloxacillin
Prophylaxis MRSA
Bactroban nasal ointment prior to surgery
Skin cancers
-Basal cell
-Squamous cell
-Melanoma
Pecancerous Lesions: Actinic Keratosis
-Benign lesions
-Due to damage by sun’s UV rays
-Common in light skin persons
-Rough, Scaly, red plaques
Precancerous Lesions: Solar Lentigos
-Benign Lesions
-Also know as liver/age spots
-Caused with sun exposure
Neoplastic Leasions: 3 Major Types
- Basal Cell- Most common, but least malignant
- Squamous cell- 2nd most common, can metastiasize to remote areas
- Melanoma - rarer, but high rate of metastasis
ABCDE for Cancerous skin lesions
-Assymetry
-Border
-Color
-Diameter
-Evolving
Basal Cell Carcinoma
-Most common skin cancer in people with lighter skin tone
-Most curable- Non metastasizing, slow growing skin tumor
Basal cell carcinoma: Characteristics
-Nodular form that beings as a small, flesh colored or pink dome shaped bump
-Translucent, shiney, pearly nodule
-Eventually will form an ulcer surrounded by a shiny border
Squamous cell carcinome
-2nd most frequent skin cancer
-Catch early and treat early. If not it can spread to lymph nodes or other internal organs
Squamous Cell Carcinoma: Characteristics
-Red and Scaling
-Keratotic, slightly elevated lesion, with an irregular border, usually with shallow chronic ulcer
Melenoma
Cancer of melanocytes
-Malignant cells grown on the skin: Radially spreading in the epidermis and vertically spreading deep into the dermis
-Can form under nails and in the eyes
Melanoma: Risk Factors
-Family history, blond/red hair. presence of freckling on the upper back, history of 2 or more blistering sunburns before age of 20, history of more of 3 or more years of an outdoor job as a teenager
Melanoma Characteristics
SS
Eczema
-Group of skin conditions that cause the skin to become inflamed or irritated
Atopic Eczema
Most common type: Inherited tendency to develop eczema, asthma, and hay fever
Eczema: Characteristics/Symptoms
-Rash on face, back of knees, wrist, hands, feet, skin very dry, thick scaly, lesions may appear reddish and then turn brown, Lesions can ooze and crust over. Can be exacerbated by heat, cold, detergents, URI and stress
Eczema: Treatment
Relieve itching and prevent infection
Lotions and creams
Cold compresses
Hydrocortisone cream
Psoriasis
Long term chronic condition
Begins young
Not contagious
Affects 1-3% of populations
Link between Psoriasis/obesity/cardiovascular diseases
Psoriasis: characterisitics
skin cells grow too quickly causing skin to be thick, white, silvery or have red patches—Plaques
Normal skin cells grow gradually and flake off q 4 weeks
Treatment: Psoriasis
Keep skin moist, UV light, Phototherapy, coricosteriod creams, topical mediations immune modulation mediations
