Skin Infections/Burns

Question 1

Impetigo

Answer 1

-Bacterial
-Causes: minor skin injuries, bites, dermatitis, staph (MRSA)
-Sx: red macule, erupt/moist excaudate, honey colored crust, spreads through direct contact
-Tx: topical and oral antibiotics
-Education: prevent spread and secondary infections

Question 2

Cellulitis

Answer 2

-Bacterial
-Causes: compromised skin barrier, staph, strep, flu
-Sx: swollen warm red area, fever, malaise, swollen lymph nodes, extends to SQ tissue
-Tx: oral antibiotics, parenteral antibiotics, antipyretics, immobilization
-Education: outpatient FU, complete antibiotic therapy

Question 3

Warts

Answer 3

-Viral
-Common in 1-7; peaks 9-10
-Incubation: 2-6 months
-Causes: Direct contact, mucous membrane contact, papillomavirus
-Dx: visual assessment
-Sx: elevated, rough, firm, skin colored papules, no pain/itching
-Tx: electrotherapy, cryotherapy, laser, no one Tx is effective
-Education: prevent spread and secondary infections, no picking

Question 4

Cold sore

Answer 4

-Viral
-Causes: herpes simplex 1
-Dx: visual assessment
-Sx: lips/nose, itches, burns, crusts
-Tx: oral antivirals, takes 2 weeks
-Education: prevent spread and secondary infections

Question 5

Tinea capitis

Answer 5

-Fungal
-“ringworm”
-Dx: visual assessment
-Sx: balding, weakened hair, can result in kerion
-Tx: Griseofulvin (8-12wks) and take with high fat, Fluconazole if > 12 y/o, Ketoconazole shampoo
-Education: log duration of meds, hair regrowth in 12 months, emotional support

Question 6

Tinea corporis

Answer 6

-Fungal
-“ringworm”
-Causes: direct contact w/ human, animal, item
-Dx: visual assessment
-Sx: scaly on the inside, raised red circular border
-Tx: topical cream (clotrimazole, ketoconazole)
-Education: contagious

Question 7

Oral candidiasis

Answer 7

-Fungal
-“thrush”
-Causes: candida albicans, newborns, use of steroid or antibiotics
-Dx: visual assessment
-Sx: white patches, non-removable milk, refusal to nurse/eat- discomfort
-Tx: oral nystatin
-Education: swab mouth, swish before swallow, sterilize paci/bottles, treat mom too

Question 8

Mosquitoes

Answer 8

-Can result to west Nile virus
-Sx: varies, firm, itchy, papule, can be present for days
-Tx: topical antihistamine, topical steroids
-Education: prevention, Deet if > 2m/o

Question 9

Bites/Stings

Answer 9

-Can result in anaphylactic reaction
-Sx: varies, small, itchy wheel, insertion site has stinger, warm, painful, edema, N/V
-Tx: remove stinger ASAP, clean, cool compress

Question 10

Ticks

Answer 10

-Can result in lymes disease
-Sx: head embeds, firm, pruritic nodule, edema
-Tx: remove w/ tweezers, clean, observe for LD for 30 days
-Education: about LD (bulls eye rash, fatigue, muscle weakness, joint pain), check for ticks

Question 11

Scabies

Answer 11

-Infestation
-Mite burrows under skin and lays eggs
-Sx: itches at night, pimple like rash forms a line
-Tx: scabicide for 12 hrs every week, calamine lotion for itching
-Education: contagious, treat whole family, wash clothes in hot water and seal in plastic bag for 72 hours

Question 12

Lice

Answer 12

-Infestation
-Nits hatch 7-10 days
-Adult lice can live 1 month
-Causes: direct contact w/ human
-Sx: white specks on hair shaft, itching
-Tx: 1& permetherine shampoo
-Education: contagious, treat whole family, wash clothes in hot water, dry on hot, boil combs, brushes, bad non-laundered for 14 days

Question 13

Atopic Dermatitis

Answer 13

-“eczema”
-Sx: pruritus, dry lesions in chunks, cheeks, trunk, hands, flexural areas
-Tx: hydrate skin, tepid bath, avoid scents/wools, antihistamine, topical steroids (intermittent)
-Education: prevent secondary infections, avoid excessive bathing

Question 14

Contact Dermatitis

Answer 14

-Causes: allergies, irritants (soap, animal dandruff, poisonous plant, metal)
-Sx: red bumps that can be moist and weeping, warm, tender, raw skin
-Tx: remove irritant, limit exposure
-Education: wash clothes, rash is not contagious, do not burn poison ivy, pets

Question 15

Diaper Dermatitis

Answer 15

-Contact dermatitis
-Most common
-Sx: erythema, small vesicles that ooze, scale, itches, raw skin
-Tx: remove soiled diaper, clean area w/ water, air dry, zinc barrier cream

Question 16

Seborrheic Dermatitis

Answer 16

-Contact dermatitis
-“cradle cap”
-Sx: patchy scaling, dry flakes on ears or eyelids, redness
-Tx: gently scrub scales and crust, apply mineral or vegetable oil, antiseborrheic shampoo

Question 17

Acne

Answer 17

-common in adolescents
-Sx: lesions, papules, pustules, nodules, cysts
-Tx: limit cosmetic products, dietary changes, gently cleanse, antibacterial agents or OC pills
-Education: self-image, self-esteem, prevent secondary infections

Question 18

Hemangiomas

Answer 18

-“vascular tumor”
-Risk factors: female, LBW, fair skin
-Sx: small red bumps, can grow to spongy mass, common on face, scalp, chest, neck, back
-Tx: monitor growth, corticosteroids, propranolol, surgery
-Education: bleeding risk

Question 19

Vitiligo

Answer 19

-Loses pigmentation
-Sx: white patches, hair loses pigmentation
-Tx: phototherapy, corticosteroids, calcineurin inhibitor may return color
-Education: self-esteem, protect from sun

Question 20

Superficial Burn

Answer 20

-Partial epidermis only
-Red, dry, blanches w/ pressure, little swelling
-Healing: 5-7 days
-Ex: sunburns

Question 21

Superficial Partial Thickness Burn

Answer 21

-Most of epidermis and into dermis
-Red, blistered, moist, swelling
-Healing: 7-10 days w/o scarring
-Ex: Scald burns

Question 22

Deep partial thickness Burn

Answer 22

-Total epidermis, partial dermis
-Red to white, blistered, moist, swelling
-Healing: >14 days and might have hypertrophic scarring
-Ex: direct flame

Question 23

Full thickness Burn

Answer 23

-Complete epidermis and dermis
-Charred, leathery, does not blanch, swollen, pain is variable
-Healing: >2 weeks w/ hypertrophic scarring