Skin Disorders Flashcards
1
Q
General
A
- diagnose them early
- diagnose them correctly
- protect other athletes
2
Q
Skin
A
Melanin
- variations may be due to anatomic physiologic or pathophysiologic changes in skin blood flow
Normal skin appearance
- altered by external and internal factors
3
Q
Cellulitis
A
- infectious inflammation of deep skin structures
- red, swollen, blotchy
4
Q
Primary Skin Lesions
A
- haven’t broken through the skin
- macule, papule, plaque, nodule
- tumor, cyst
- wheal, vesicle, bulla, pustule
5
Q
Secondary Skin Lesions
A
- has broken through skin
- more severe
- scale, crust, fissure, erosion
- ulcer, scar
6
Q
Skin Trauma
A
mechanical forces that cause injury
- friction
- compression
- shearing
- stretching
- scraping
- tearing
- avulsing
- puncturing
7
Q
Friction and Pressure
A
hyperkeratosis (like a callous)
- friction and pressure over bony protuberances
Signs/Symptoms
- thickening of skin, ovular, elongated, and brown
- painful with pressure
8
Q
Management of Hyperkeratosis
A
- emery boards/pumice
- moisturizer (skin lube)
- padding
9
Q
Soft/Hard corns
A
- pressure from improperly fitting shoes and anatomic abnomalities
10
Q
Signs and Symptoms of soft/hard corns
A
Soft - thickening of the skin, white skin and can be painful, between 4th and 5th toes, result of pressure and perspiration
Hard - typically on the tops of the toes
- surgical removal if painful
- padding, keep feet clean/dry, wear appropriate shoes
11
Q
Excessive Perspiration (hyperhidrosis)
A
- syrup-like perspiration
- increases risk of irritation
- use of astringent such as alcohol/absorbent powder
- astringent is a vasoconstrictor
12
Q
Chafing of Skin
A
- occurs in pt. that are obese or heavy limbed
- result of friction and maceration of skin from heat/moisture
- causing oozing wounds
- crust and crack
- clean w/soap and water
- hydrocortisone cream
- keep skin dry/clean, friction free
13
Q
Xerotic (dry) skin
A
- exposure to cold, excessive bathing, decreased humidity
- redness & scaling, itching
- hydration, use tepid water to bathe, moisturizers
- super glue to prevent further splitting
14
Q
Skin bruises
A
result of blunt trauma, causes disruption of superficial blood vessels and results in black and blue discoloration
- treat w/ PRICE
15
Q
Bacterial Infections (staphylococcus)
A
- bacteria that appears in clumps on skin and/or upper respiratory tract
- treated w/anti-biotics
16
Q
Bacterial Infections (Streptococcus)
A
- chain bacteria often associated with systemic disease and skin infections
- treated w/anti-biotics
17
Q
Bacterial Infections (bacillus)
A
- spore forming, aerobic and occasionally mobile
- can cause systemic damage
- treated w/anti-biotics
18
Q
Methicillin-Resistant Staphylococcus Aureus (MRSA)
A
- often occurs in individuals that are already sick, hospitalized, have open wounds or burns
- easily transmitted via superficial abrasions and minor skin trauma
19
Q
Signs/Symptoms, management for MRSA
A
- redness, swelling, tenderness
- antibiotics (higher dose)
- treatment lasts several weeks
- refer any suspected case of MRSA
- inform athletes/clean facility
- let doctor and health nurses know
20
Q
Impetigo Contagiosa
A
- caused by strep, staph or combo of the two
- VERY contagious
21
Q
S/S and management of Impetigo Contagiosa
A
- gets crusty
- keep them away from everyone else
- mild itching and soreness followed by eruption of small vesicles and pustules that rupture and crust
- generally develops in body folds that are subject to friction
- cleansing and topical antibacterial agents, systemic antibiotics
22
Q
Furuncles (boils)
A
- infection of hair follicle that results in pustule formation
- generally result of a staph infection
23
Q
S/S and management of Furnuncles
A
- pustule becomes reddened, enlarged, and hard from internal pressure
- pain/tenderness increase w/pressure
- most will mature and rupture
- protection from additional irritation
- antibiotics
- keep pt. from contact w/team members while draining
24
Q
Carbuncles
A
- similiar to boils
- larger/deeper than boils
- several openings in skin
- may produce fever and elevation of WBC count
- discharges yellowish pus
- surgical drainage and antibiotics
- warm compress to draw it out
25
Q
Folliculitis
A
- inflammation of hair follicle
- can be caused by friction
- non-infectious or infectious agents = cause
26
Q
PFB
A
pseudofolliculitis
- ingrown hair
27
Q
Folliculitis signs & symptoms
A
- redness around follicle that is followed by development of papule or pustule at the hair follicle
- followed by development of crust
- moist heat is used to increase circulation
- anti-biotics
- alopecia (baldness) can be caused if infection causes scarring
28
Q
Hidradenitis Suppurativa
A
- inflammation of hair follicle resulting in secondary blockage of the apocrine gland
- chronic inflammatory condition of sweat glands
- small papule to deep dermal inflammation
- avoid antiperspirants, deodorants and shaving creams
- medicated soaps/antibiotics
29
Q
Acne Vulgaris
A
- inflammatory disease of the hair follicle and the sebaceous glands
- *could be hormones
- white/black/red heads, pustules or cysts
- possible scarring if deep enough
- topical/systemic agents
- mild soaps recc.
30
Q
Paronychia and Onychia
A
- caused by staph, strep, and/or fungal organisms
- damage to cuticle
Onychia: infection of the nail bed
Paronychia: infection of the lateral nail fold
- rapid onset, painful, bright red swelling
- accumulation of purulent material nail fold
- soak in epsom salts
- topical antibiotic, drainage
31
Q
Tetanus infection (lockjaw)
A
- from stepping on a rusty nail
- acute infection of the CNS and muscles
- stiffness of the jaw and muscles of the neck
- fever
32
Q
Tetanus Management
A
- hospilitation/ICU
- ER
- Immunization
33
Q
Fungal Infections
A
- yeast and molds
- grows best in unsanitary conditions with warmth, moisture, and darkness
- ringworm is most common cause (has a raised border)
34
Q
Tinea of the Scalp (tinea capitis) (ringworm)
A
- begins as a small papule that spreads peripherally
- appears as small grayish scales resulting in scattered balding
- spread through close physical contact
- treatment with systemic anti-fungal agents (topical agents used as well)
35
Q
Tinea of the body (tinea corporis) (ringworm)
A
- itchy red-brown scaling plaque that expands peripherally
- management by topical antifungal cream (***lamasil, tinactin
- cover and protect
- monitor daily
- refer if not resolving
36
Q
Tinea of the nail (tinea unguium/onychomycosis)
A
- fungal infection of the nail
- “athletes foot”
- nail becomes thick, brittle and separated from its bed
- systemic medications are most effective
- surgical removal may be necessary if extremely infected
37
Q
Tinea of the Groin (tinea cruris)
A
- symmetric red-brown scaling plaque with snake-like border
- mild to moderate itching
- will respond to non-prescription medications
- may require additional topical and oral prescriptions
- refer if failure to respond
38
Q
Athlete’s Foot (tinea pedis)
A
- most common form of superficial fungal infection
- extreme itching on soles of feet, between and on top of toes
- appears as dry, scaling patch, or inflammatory papules
Management: topical anti-fungal agents and good foot hygiene
39
Q
Candidiasis (Moniliasis)
A
- yeast like fungus that can produce skin, mucous membrane and internal infections
- beefy red patches with possible satellite pustules
- white macerated border may surround the red area
- deep painful fissures may develop
- use anti fungal agents, keep area dry
- *usually in the mouth
40
Q
Tinea Versicolor
A
- caused by a yeast
- in areas that sebaceous glands actively secrete body oils
- multiple small, circular, pink/brown/white merciless
- chest, abdomen, and neck
- do not tan when exposed to sun
- use selenium shampoo and topical econazole nitrate
- re-pigmentation will occur
41
Q
Viral Infections
A
- ultramicroscopic organisms that require host cells to complete their life cycle
42
Q
Herpes Simplex Labialis, Gladiatorum, and Zoster
A
- highly contagious
- transmitted directly through a lesion or mucus membrane
- resides in the sensory nerve neurilemmal sheath
- recurrent attacks stimulated by sunlight, emotional disturbances, illness, fatigue or infection
43
Q
Herpes Signs & Symptoms
A
- early indication is tingling or hypersensitivity in an infected area 24 hrs after exposure
- local swelling followed by outbreak of vesicles
- pt. may feel ill w/headache, sore throat, swollen lymph glands, and pain in area of lesions
- vesicles usually rupture in 1-3 days willing serous material
- heal in generally 10-14 days
- **athlete should be disqualified from contact during and outbreak. highly contagious
44
Q
Herpes Management
A
- lesions are self limiting- reduce pain and promote early healing
- use of antiviral drugs can reduce recurrence and shorten course of outbreak
- can lead to secondary infection if not managed carefully
45
Q
Herpes Simplex
A
on the face
46
Q
Herpes wrestling
A
- gotta do skin checks before wrestling tournament
- type 1 = extragenital
- type 2 = genital
47
Q
Herpes Zoster
A
- shingles
- only on one side of the body
- trunk & head
48
Q
Verruca Virus and Warts
A
- verruca plana (flat wart)
- verruca plantaris (plantar wart)
- condyloma acuminatum (venereal wart)
- different types of human papilloma virus
- uses epidermal layer of skin to reproduce and grow
- wart enters through lesion in skin
49
Q
Common Wart
A
- small, round, elevated lesion with rough dry surfaces
- painful with pressure
- topical salicylic acid or liquid nitrogen to fix
50
Q
Plantar Warts
A
- spread through papilloma virus
- sole of foot, or adjacent to areas of abnormal weight-bearing
- point tenderness
- hemorrhagic puncta (black seeds)
- protect & prevent
- shave callus
- can be removed by freezing
51
Q
Molluscum Contagiosum
A
- poxvirus infection
- contagious with direct body contact
- **very contagious
- small, flesh or red colored, smooth-domed papule
- physician referral
- removed surgically or counterirritant, or cryosurgery
52
Q
Allergic, Thermal and Chemical Skin Reactions
A
- allergens may be food, drugs, clothing, dusts, pollens, plants, animals, heat, cold, dyes or light
- reddening and swelling of tissue, hives, burning
- ATCs must recognize gross signs of allergic responses, be prepared to remove allergens, treat topically or systemically
53
Q
Contact Dermatitis (allergic and irritant)
A
- poison ivy, poison oak, sumac, ragweed, primrose
- topical medications
- chemicals found in fragrances, soaps and detergents
- pre-wrap, tuf skin, tape, ice or heat
- *poison ivy can get into lungs and go systemic
54
Q
Contact Dermatitis Signs/Symptoms
A
- onset may range from 1 day to 1 week
- redness, swelling, formation of vesicles that ooze fluid and form crust, constant itching
- may change from redness and blistering to scaling, lichenified papillose and plaques
55
Q
Contact Dermatitis Management
A
- avoid allergen
- compresses or soaks, topical corticosteroids
56
Q
Miliaria (Prickly Heat)
A
- continued exposure to heat and moisture causing retention of perspiration
- itching and burning vesicles and pustules
- occurs most often on arms, trunks, and bending areas of the body
- avoidance of overheating, frequent bathing with non-irritating soap, wear loose fitting clothing and use of anti-itch lotions
57
Q
Sunburns
A
- inflammatory response to injury cause by uv ray
S/S: erythema, shock, malfunctioning of organs w/in skin, - appears 2-8 hrs following exposure, symptoms most severe 12 hrs after
- dissipate w/in 72-96 hrs
58
Q
Sunburn Management
A
- sunscreen
- treat a burn according to the degree of inflammation
- cool water, aloe based solutions
- moisturizers for dryness and peeling
- OTCs can help with pain/discomfort
- severe burns require physician assistance
59
Q
Scabies
A
- caused by mites that tunnel and lay eggs which causes extreme nocturnal itching
60
Q
Scabies S/S
A
- dark lines, between fingers and toes, body flexures, nipples and genitalia
- excoiations, pustules and papillose caused by itching tends to hind true cause
- skin develops hypersensitivity to the mite
61
Q
Scabies Management
A
- permethrin 5% is treatment of choice
- washing of bedding and clothing is necessary
- topical corticosteroids to treat itching
62
Q
Lice
A
- head, pubic region, body
- bitch cause itching dermatitis and subsequent scratching
- rapid cure using any number of agents, mayo.
- to prevent re-infestation all clothing and bedding should be washed in hot soapy water or discarded
63
Q
Fleas
A
- small, wingless insects
- discomfort from bites
- concentrated on ankles and lower legs
- prevent with topical agents
- avoid scratching
64
Q
Ticks
A
- parasitic insect
- can transmit rocky mountain spotted fever and lyme disease
- headaches fever, malaise, myalgia and rash
- remove tick, referral, systemic treatment
65
Q
Mosquitoes
A
- produce bites that can be irritating, itchy, painful
- can transmit blood-borne illnesses
- topical medication, repellents
66
Q
Stinging Insects
A
- bees, wasps etc.
- hypersensitive individuals
- increase HR, breathing
- Anaphylatic reaction
- swelling of mouth and throat, difficulty breathing, vomiting, etc.
67
Q
How to avoid insect stings
A
- smelly lotions/shampoos
- brightly colored clothing
- epipen on site for athletes with known allergy
- **Anaphylactic reaction immediate physician referral
68
Q
Spider Bite
A
- typically not dangerous to humans
- rarely bite more than once
- black widow & brown recluse
- pain, swelling, puncture wounds, muscle pain & cramps, headache, anxiety, vomiting, increase BP, difficulty breathing
69
Q
Spider Bite Management
A
- wash wound
- apply anti-biotic
- seek medical attention if infections occurs/ulcer does not heal, nausea, vomiting, fever or rash occur
- if muscle cramping occurs pt. MUST go to nearest emergency room
70
Q
Pityriasis Rosea
A
- acute inflammatory skin rash of unknown origin
- occurs between ages of 10-35
- single pinkish-red patch on the chest or back
71
Q
Pityriasis Rosea S/S & management
A
- within 2/3 days a secondary eruption occurs on chest/upper extremities
- red scaly with clearing in the center
- typically doesn’t require treatment
72
Q
Psoriasis
A
- genetic factors may play role
- lesions begins as reddish papule that progress to plaques
- progress to yellowish
- elbows, knees, trunk, genitalia, belly button
- long term oral meds
- self-management
73
Q
Skin Cancer
A
- exposure to sun
- malignant tumor that grows in skin
- 50% of all cancers
- small shiny bump
74
Q
Basal Cell Carcinoma
A
- found in individuals w/light eye/hair color
- small shiny bump
75
Q
Squamous cell carcinoma
A
- appears as nodules, red, scaly, patches of skin
- lips, ears, face
- fair skinned people
76
Q
Malignant Melanoma
A
- mole
- asymmetry
- border
- color
- diameter
- fair skinned
77
Q
Skin Cancer Management
A
- immediate referral if suspicious of any skin lesion
- surgery 90% of cases
- laser, radiation
