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Skin disorders Flashcards

1
Q

Eczema ➔

A

Dermatitis

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2
Q

Bacterial Infections ➔

A

Cellulitis, Impetigo, Abscess

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3
Q

Viral Infections ➔

A

Herpes & Warts

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4
Q

Tick Borne Illnesses ➔

A

Lyme Disease & Rocky Mountain Spotted Fever

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5
Q

Parasitic Infections ➔

A

Scabies & Lice

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6
Q

Fungal Infections ➔

A

Ringworm & Athlete’s Foot

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7
Q

Yeast ➔

A

Candidiasis

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8
Q

Immune Disorders ➔

A

Psoriasis, Lupus, Scleroderma

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9
Q

7 common types of eczema =

A

atopic dermatitis
dyshidrotic dermatitis
stasis dermatitis
contact dermatitis
hand dermatitis
neurodermatisis
nummular eczema

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10
Q

atopic dermatitis

A

most common

inflammation that includes rash, itching, and dryness

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11
Q

dyshidrotic dermatitis

A

tiny blisters that can itch severely on the hands and feet

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12
Q

stasis dermatitis

A

discoloration common to the ankle area and lower limbs

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13
Q

contact dermatitis

A

irritation or an allergic rash after touching something

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14
Q

hand dermatitis

A

chapped skin, dark patches, scales, and more on the hands

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15
Q

neurodermatisis

A

stress-linked intensely itchy patches that come and go

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16
Q

nummular eczema

A

round and itchy spots often appearing on injured dry skin

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17
Q

Eczema =

A

Inflammatory skin conditions = itching, redness, skin lesions

Patient education is key to break the “itch-scratch” cycle

autoimmune disorder

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18
Q

Eczema: Contributing causes & trigger, which can limit activities and comfort

A

skin lesions
celiac disease
gluten sensitivity
circulation impairment
pain
edema
allergies
illness
diet/nutrition
contact with rough materials
dry skin/air
environmental irritants
water (hot)
extreme heat or cold
fragrances, air fresheners
stress

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19
Q

EcZema: Diagnosis

A

No laboratory tests

Clinical features: appearance, itchiness, spread of lesions

Differential Diagnosis -> refer to medical provider

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20
Q

Eczema: Stages

A

Three stages of the disease ➔ acute, subacute, chronic ➔ can occur in infancy, childhood, adult

Often a relapsing stage as well

Most common skin problem, affects 10% of US population

Acute: red, oozing, crusting rash, extensive erosions, exudate

Subacute: erythematous skin, scaling scattered plaque

Chronic: thickened skin, fibrotic papules, post inflammatory pigment changes

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21
Q

Eczema: Signs/Symptoms

A

itching which may be severe, especially at night

small, raised bumps, which may leak fluid and crust over when scratched

rash, most common on face, back of knees, wrists, hands, and feet

thickened, cracked, or scaly skin

change in skin pigmentation making affected area lighter or darker

red to brownish-gray colored patches

areas with loss of hair and skin color changes

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22
Q

Eczema: Precautions

A

Physical modalities
Avoid use of rubbing alcohol

Latex gloves (other materials too, therabands), fragrances, laundry detergents, lotions and soaps

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23
Q

Eczema: functional limitations

A

Inability to tolerate stress; cold, dry air, or allergens without rash, itching, and dry skin

Limitation of the use of some modalities

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24
Q

Contact Dermatitis =

A

inflammation that occurs when substances touching the skin cause irritation or an allergic reaction (90% OF ALL OCCUPATIONAL SKIN CONDITIONS)

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25
Seborrheic Dermatitis =
common skin disorder occurring in areas of concentrated sebaceous glands causing greasy, scaly, itchy red skin ➔ scalp, ears, eyebrows, chest (aka: cradle cap, dandruff if on scalp), NOT contagious
26
Atopic Dermatitis:
chronic, relapsing, and inflammatory condition that results in itchy, inflamed, irritated skin, hereditary tendency, common with asthma and hay fever
27
Dermatitis: possible impairments/consequences
Skin integrity Circulation Pain Sensation Gait Joint ROM Muscle strength Functional mobility Self-care
28
Dermatitis not treated by PT =
PT should be able to recognize the condition: Observe Document Refer as needed
29
Dermatitis: Movement related goals secondary to the condition
Ability to perform physical tasks Pt education ➔ recurrence of condition, secondary impairments, self management Pain reduction Soft tissue swelling, inflammation reduction Increase tolerance to positions & activities; monitor use of splints/braces as appropriate Facilitate wound healing ➔ decrease complications associated with soft tissue & circulatory disorders
30
Dermatitis: Intervention and Goals Depending on severity and setting/role, may need to:
Change dressings Apply topical agents Apply compression therapies Fit orthotics/prosthetics appropriately (e.g. modify type of prosthetic socks-refer to prosthetist)
31
Dermatitis: common Referrals and treatment
PCP Immunologist Dermatologist Patient education to eliminate triggers Topical or systemic therapy ➔ Corticosteroid, immunosuppressants, antihistamines Daily care ➔ mild soaps, lotions, cooler showers
32
Dermatitis: tests & measures to document
Pigmentation Shape & size of skin involvement Presence of rash, blistering, ecchymosis, hair growth, signs of infection Skin temperature Tissue mobility Capillary refill, palpation of pulses ➔ circulation Volume & girth measurements ➔ edema Pain ➔ VAS scale Gait Sensation Joint ROM Strength Functional mobility
33
Dermatitis: prognosis
Contact dermatitis usually clears up without complication within 2 -3 weeks ➔ may return with re-exposure to irritant Seborrheic dermatitis & atopic dermatitis are chronic conditions that are likely to recur
34
Dermatitis: ICD – 10 Codes
Preferred Practice Pattern: 7B Impaired Integumentary Integrity Associated with Superficial Skin Involvement
35
Bacterial infection
Infectious agent enters through portals in the skin ➔ wounds, abrasions, punctures
36
Bacterial skin infection: cellulitis
bacterial infection of the skin: presents with poorly demarcated erythema, edema, warmth, and tenderness Common diagnosis: often difficult to diagnose & difficult to treat Medical Management: antibiotics, elevation, cool & wet dressing Untreated ➔ spreads quickly, lymphangitis, gangrene, abscess & sepsis Higher Risk for older adults, malnutrition, diabetic wounds, lymphedema, steroid therapy
37
cellulitis diagnosis:
Mark outer boundaries Refer to PCP or ED depending on severity and speed of spreading
38
Bacterial infection: impetigo
Superficial skin infection caused by staph or strep Common in US Clinical Manifestation ➔ inflammation, small pus-filled vesicles, itching Highly contagious ➔ common in infants/children and older adults Requires immediate medical attention Treated w/ antibiotics; isolate from public
39
Bacterial infection: skin abscess
Cavity containing pus surrounded by inflamed tissue Result of localized infection Commonly caused by staph infection Medical management ➔ drain that thing! Antibiotics
40
Bacterial infection: skin abscess risk factors:
People who live in crowded conditions, have poor hygiene or chronic skin diseases, or whose nasal passages contain Staphylococcus are more likely to have repeat episodes of folliculitis or skin abscesses
41
Herpes Type 1 ➔
itching and soreness followed by eruption of skin on face and mouth ‘cold sore’ Spread by contact Treatment: antiviral therapy, no close contact when lesions are present
42
Herpes Type 2 ➔
Vesicular genital eruption Spread by sexual contact
43
Herpes Zoster ➔
aka “Shingles” Caused by varicella-zoster (chicken pox virus) ➔ virus reactivated after laying dormant for years Associated with pain & tingling of affected spinal or cranial nerves Fever, chills, malaise, GI disturbances
44
Viral infections: Herpes 1, Herpes 2 & herpes Zoster Treatment:
antivirals, corticosteroids for skin inflammation Contagious to individuals who have not had chickenpox (e.g. grandchildren, daycare) Contraindications: heat & ultrasound
45
Viral infection: warts
Human papilloma virus (HPV) Transmission: direct contact Common warts: skin ➔ hands Plantar wart: pressure points on feet Treatment: cryotherapy, acids, electrodessication, OTC meds
46
Lyme disease:
Bacterial infection transmitted to humans by ticks Common risk-locations in the US: northeast coast, Wisconsin & Minnesota, and norther California & southern Oregon Dx: characteristic clinical findings (above) and culture of B. burgdorferi
47
Lyme disease: Clinical Manifestation:
red bump, ‘bulls-eye’ rash flu-like symptoms ➔ myalgia, arthralgia, fever, headache, fatigue, motor or sensory radiculoneuritis, neck stiffness cardiac symptoms ➔ fluctuating degree of atrioventricular block, myopericarditis, mild left ventricular dysfunction, cardiomegaly or fatal pancarditis
48
Lyme disease - Physical Therapy Intervention
Management of muscle and joint pain Management of fatigue Manual Techniques Exercise Prescription Requires an Integrative Approach to treatment
49
Scabies:
mites burrow into the skin and lay eggs; cause inflammation & itching Treatment: scabicides (topical and oral meds) Critical complication is septicemia Resource poor and tropical areas-most common very contagious
50
Lice:
head, body, genitals; bite marks, redness, & nits Treatment: shampoo with permethrin; removal of nits very contagious
51
Ringworm ➔
involves hair, skin, and nails dermatophytosis or tinea Ring shaped patches with vesicles ➔ itchy Transmission: direct skin-skin contact Treatment: topical or oral antifungal
52
Athlete’s Foot ➔
foot typically between the toes Itching, inflammation, erythema, pain, pruritus Transmission: direct contact Treatment: antifungal cream
53
Candidiasis ➔
yeast common in skin folds due to excessive moisture Clinical Manifestation Oral ➔ “thrush”; oral patches, redness, soreness Genital ➔ erythema, inflammation, itching, burning with urination, pain, discharge Topical ➔ redness, rash, soreness Treatment: antifungals, silver infused dressing for skin folds
54
Immune disorders: psoriasis
Overview: skin disease that causes red, itchy scaly patches ➔ most common on the knees, elbows, trunk & scalp Common chronic condition ➔ no cure, management only; flare ups common Pathogenesis: The life cycle of skin cells greatly accelerates ➔ leads to a build up of dead cells on the epidermis Referral to PCP ➔ if condition is undiagnosed or is increasing in severity
55
Immune disorders: psoriasis S/S:
Red patches of skin covered with thick, silvery scales Small scaling spots ➔ more typical in children Dry, cracked skin ➔ may bleed or itch Itching, burning Thickened, pitted or ridged nails Swollen & stiff joints ➔ psoriatic arthritis
56
psoriasis Etiology & Risk factors:
Etiology: hereditary, associated immune disorders Risk Factors: family history, stress, smoking
57
psoriasis triggers & complications:
Triggers: Infection, weather, injury to skin, stress, smoking, heavy alcohol consumption, certain medications, rapid withdrawal of corticosteroids Complications: psoriatic arthritis, eye conditions, obesity, type II DM, HTN, CVD, other autoimmune diseases Exacerbations and remissions are common
58
Plaque psoriasis ➔
most common, elbows, knees, lower back & scalp
59
Nail psoriasis ➔
Fingernails & toenails
60
Guttate psoriasis ➔
young adults & children, triggered by bacterial infection
61
Inverse psoriasis ➔
skin folds of the groin, buttocks & breasts, fungal infection triggers
62
Pustular psoriasis ➔
rare, defined pus-filled lesions
63
Erythrodermic psoriasis ➔
least common, can cover entire body
64
Psoriatic arthritis ➔
swollen, painful joints, varies in severity
65
psoriasis treatment:
Treatment: topical corticosteroids, immunosuppressants, stress reduction Daily skin care ➔ mild nonfragrant soaps, lotions, avoid irritants (e.g. brisk drying, excessive sunlight, chlorine)
66
Immune disorders: lupus erythematosus
Chronic progressive autoimmune inflammatory disorder ➔ connective tissue Characteristic red rash & scaly plaques Discoid lupus erythematosus (DLE): affects only skin; scarring of face, ears, scalp; flares with sun exposure Systemic lupus erythematosus (SLE): affects organs Treatment: no cure; topical corticosteroid for skin; salicylates for fever and joint pain; immunosuppressants for severe symptoms
67
Immune disorders: scleroderma
Autoimmune connective tissue & rheumatic disease ➔ causes inflammation in the skin & body ➔ leads to tight, hard skin Can affect one area or it can be systemic
68
Immune disorders: scleroderma Two main types:
Localized scleroderma ➔ skin and structures directly under the skin Systemic scleroderma ➔ affects many systems of the body, most serious type, can damage blood vessels & internal organs
69
scleroderma Signs/Symptoms
Localized: Patches in firm, oval shapes Lines of thickened/different colored skin ➔ esp. arms, legs Systemic: Rapid or gradual onset Organ dysfunction Fatigue
70
Scleroderma risk factors:
Gender: women > men (hormone differences?) Age: usually appears between 30 – 50 Race: All races/ethnic groups, most severe in African American Genetics: more likely to develop if a close relative has scleroderma Environment: exposure to viruses, chemicals may play a role Immune System Changes: potential overproduction of collagen
71
scleroderma Diagnosis
Medical history: current and past symptoms Physical exam No single test for scleroderma
72
scleroderma Treatment
Based on scleroderma type and body areas affected Medication ➔ decrease swelling, manage pain, control secondary symptoms Regular dental care ➔ causes dry mouth & damage oral connective tissue ➔ magnifies tooth decay Physical Therapy ➔ pain management, muscle strength, activity management/strategies, ROM (e.g. hand function), exercise rx for anti-inflammatory benefits
73
scleroderma Patient Education
Warmth: dress in layers, gloves, socks Avoid extreme cold temperatures No smoking! Sunscreen Moisturizers Humidifiers Avoid hot baths & showers Avoid harsh soaps & cleaners Exercise regularly Regular dental visits Support groups ➔ educate family and friends Mental health support

Integ Final (16 decks)

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