Skin Disorders Flashcards
Dematitis (eczema)
Inflammation of the dermis skin
Variety of types and causes
Not contagious
Some types of dermatitis
Atopic (chronic conditions)
Stasis (vascular component)
Contact (allergic)
Seborrheic
Dermatitis - clinical presentation
Pruritus
Blisters, swelling
Weeping, oozing
Scales or crusts might develop
Dermatitis - treatment
Treat underlying cause
Anti-inflammatory medications
Prophylactic antibiotics might be given
Atoptic Dermatitis
Immunoglobulin E disease (allergy)
Pruritus
Exacerbations and remissions
Leads to skin thickening and changes in quality of skin
Seborrheic deformities
Sebum rich areas
Scaly, red rash develops
Scalp, forehead, nose folds, ears, around eyes
Ex - cradle cap in children
Changes in humidity, emotional stress, trauma
Contact dematitis
Can be from tape, poison ivy
One of most common
Hypersensitive response
Seborrheic keratosis
Kerintocyte benign neoplasm
Mid life is when appears
Tend to look like they are just apsted onto the skin
Malignant melanoma
Malignant melanoma arising from melanocytes
Sun exposure inc risk
Enlarging, irregular pigmented areas that ulcerate
Metastasis to lymph ndoes, widespread organ dissemination - usually what takes someone to doc
60 is median age
Most common cancer in 25-29 yr old F
Non melanocytic skin cancers
Basal cell carcinoma
Squamous cell carcinoma
Non melanocytic skin cancers - basal cell carcinoma
Most common skin cancer
Less than 0.1% of cancer deaths - does not easily metastasize
Lesions tend to be on face first (nose), can be on trunk, penis, vulva, perianal area too
Non melanocytic skin cancers - Squamous cell carcinoma
Head and neck area
Often disfiguring in later stages
Sun exposure, immunosuppressed, HPV infection are risk factors
Higher rate of met but not as large as melanoma
Rosacea
Dermal support structures are affected Flushing of the face Small erythematous papules with pustules Stinging, burning sensation Thckened skin, facial lymphedema
Rosacea triggers
heat/cold temp wind hot drinks caffeine, alcohol, spicy food exercise, emotion topical products
Cellulitis
Infection of the skin and underlying tissues (most sig the dermis)
Some type of skin break down is initial source
Cellulitis - most common bacteria
GAS
Staph aureus
Pseudomonas is often offending pathogen in nail punctures in the foot
Cellulitis - clinical presentation
Similar to dermatitis but more pronounced Need to differentiate S/s fever, malaise, chills Lymphangitis and lymphadenopathy Wound will exhibit signs of infection
Cellulitis - tx
Antibiotic - may require IV antibiotics up to 6 wks
Tx wound and underlying cause
Psoriasis is what
chronic recurrent skin disease 2/100 population Onset - early to middle adulthood Familial Cause is unknown Excessive cell proliferation and inflammation
Psoriasis - characteristics
There is a 3-4day turnover of the epidermis
Excessive accumulation of day cells (plaques)
Most common type is plaques psoriasis
About 5% of those affected will develop psoriatic arthritis
Psoriasis - common sites
Extensor surfaces
Hands, elbows, knees, scalp
Toenails and fingernails
Psoriasis - presentation
Pruritus is common
White scales (scaly plaques)
Exacerbation and remission pattern
Psoriasis treatment
No cure - just control
Tx is geard at suppressing cell proliferation
Often times combination therapy is used
Psoriasis medical topical agents
corticosteroids Anthralin (bark of tree) Toxarotene (vit A derivative) Coal tar Calcipotriene (form vit D3) Saclicylic acid (remvoe scales)
Psoriasis - oral meds
Cyclosporine (depress immune system)
Methotrexate (folic acid antagonist)
Oral retinoids (vit A derivative)
Psoraisis - biologic meds
Can be injected or infused
Similar in action to drugs used for arthiritc conditions
Alefacept and Efalizumab
Psoriasis - PT
Phototherapy UVB PUVA Goeckerman Regime Lasers
Psoriasis - PT - PUVA
Psoralens (oral or topical) sensitizes the skin to UV - and then they come in and we can use UVA
Psoriasis - PT - Goeckerman Regime
Old school - use of coal tar and UVB
coal tar also senstzes skin to the UV treatment
Psoriasis - PT - lasers
very new, still working on protocols and devices
Herpes zoster (shingles)
Viral infection
Latent
Dorsal root ganglia
Reactivation of the virus produces a severe inflammatory reaction along the course of the infected nerve root
Herpes zoster (shingles) - clinical manifestations
Inc age = inc risk
Burning and pruritis prior to skin lesions
Vesicles appear, break open and crust over
Adjacent skin often becomes involved
Unilateral
During acute stage is infectious
Herpes zoster (shingles) - timeline
Acute stage usually lasts 1-3 wks
Wound healing and pain continue a month or two
Herpes zoster (shingles) - complication
Postherapeutic neuralgia - painful, limits ROM and mm function, can last years
Herpes zoster - tx
antiviral meds - acyclovir, famciclovir, valacyclovir
Corticosteroids
Wound care
Pain control - meds, TENS, topical agents
Warts
Skin growths caused by a viral infection Epidermis level Hyperkeratotic lesions Human pipllomavirus (HPV) Contagious and spread through contact All warts have their own blood supply
Treatment - warts
Aimed at removing warts Medications Freezing Surgical removal Laser
Scabies
Skin infection caused by parasites (mites)
Primary lesion is gray-brown in color and is a few mm in length
F mites lay eggs in these burrows
Eggs hatch within 10 days
Scabies - transmission
highly transmissible both by direct contact and indirect contact
Scabies - s/s
Pruritis
Vesicle formation
Most common site - webbed spaces
Scabies - tx
Benzene compound applied
for the cleaning of surfaces - can use bleach too
Pediculosis
Parasitic infection by lice
Pediculosis - types of lice
1 pediculus humanus capitis (head)
2 pediculus humanus corporis
3 pthirus pubis (pubic) - considered an STD
Pediculosis - transmission
readily tranmissible by direct and indriect contact
Pediculosis - describe
Lice are oval, gray 2-4 mm long Wingless 6 legs F lay eggs along hairshafts Eggs hatch and hells remain on hair Blood sucking - they need the blood source and will die without it wihtin 3 days
Pediculosis - primary symptom
Pruritis
Pediculosis - tx
topical compound (benzene)
Soaking with vinegar solution
Fine teeth comb
