Skin part 2 Flashcards
1
Q
what is made of hard keratin?
A
Hair and nails
2
Q
where is the coloring for hair created and by what cell?
A
from melanocytes at he base of the follicle
3
Q
what causes hair to stand up or “goose bump”?
A
Arrector pili muscle
4
Q
what is the main factor with hair growth?
A
nutritional status
5
Q
excessive growth of hair on a woman is called?
A
Hirsutism
6
Q
patches of hair that the cause is to thought to be autoimmune
A
Areata allopecia
7
Q
totally hair loss from head to toe and thought to be autoimmune
A
universalis allopecia
8
Q
hairball in the stomach from the action of pulling out one’s hair and eating it, causing GI distress
A
Tricotillimania or bezoar
9
Q
fungal infection of the head
A
tinea capitis
10
Q
a pt is genetically predisposed response to androgens, with androgen-sensitive and androgen-insensitive follicles. what sex are they and what do they have?
A
Male and Male-pattern alopecia
11
Q
a pt has elevated levels of the serum adrenal androgen dehydroepiandrosterone sulfate with
no loss of hair along the frontal hairline, what sex are they and what do they have?
A
Female and Female-pattern alopecia
12
Q
Autoimmune T-cell–mediated inflammatory disease against hair follicles that results in baldness
A
Alopecia areata
13
Q
Androgen-sensitive areas. Abnormal growth and distribution of hair on the face, body, and pubic area in a male pattern that occurs in women
A
Hirsutism
14
Q
Produce oily/waxy matter, Meibomian glands, Lubricant for skin, Kills bacteria, Glands are activated at puberty
A
Sebaceous Glands
15
Q
chalazion is a…?
A
Blocked Meibomian gland
16
Q
a stye is a….?
A
A small infection forms at the base of an eyelash
17
Q
Different types prevent overheating of the body; also secrete cerumen and milk
A
Sweat Glands
18
Q
abundant on palms, soles of the feet, and forehead – more numerous – ducts empty onto surface of skin
A
Eccrine sweat glands
19
Q
found in axillary and anogenital areas – ducts empty into hair follicles, little role in thermoregulation
A
Apocrine sweat glands
20
Q
modified apocrine glands in external ear canal that secrete cerumen
A
Ceruminous glands
21
Q
specialized sweat glands that secrete milk
A
Mammary glands
22
Q
Mostly water, Some metabolic waste, Fatty acids and proteins (apocrine only)
A
Sweat composition
23
Q
Helps dissipate excess heat, Excretes waste products, Acidic nature inhibits bacteria growth
A
Sweat Functions
24
Q
Odor is created from where?
A
Bacteria sources
25
Mechanical damage, Chemical damage, Bacterial damage, Thermal damage, Ultraviolet radiation, Desiccation
Skin functions that protects deeper tissues
26
Aids in heat regulation/ blood reservoir, Aids in excretion of ammonia, urea and uric acid (sweat), Synthesizes vitamin D
Skin functions
27
these arent vitamins, only steroid hormones
Vitamin D
28
Ergocalciferol
D2
29
Cholecaleiferol
D3
30
what plays a major role in calcium and phosphorous absorption?
Vitamin D
31
children in england have a vitamin D deficiency which has a sequela of?
Rickettes
32
what organs are involved in the vitamin D pathway which control the serum phosphate and calcium levels?
Skin, liver, kidney, bones and small intestines
33
Tendency to affect certain areas in certain patterns and Response to treatment is often a clue to what it is?
Skin Disease
34
Most ___________ are slow growing and treatable except for ________________
skin cancers. and malignant melanoma
35
Name the Lesion Patterns and Shapes
```
Linear
Clustered
Geographic (highly irregular - resembling continents/islands)
Serpiginous – snake-like, wavy margin
Annular/Arciform – circular/disc-like
```
36
Two factors affect significance of damage?
Depth of burn
| Size of burned area
37
```
Only epidermis is damaged
Skin is red and swollen
Pain subsides in 2–3 days
No scarring
Complete healing complete in about one week
```
First Degree Burns
38
Epidermis and upper dermis are damaged
Skin is red with blisters
Blistering continues to extend after initial burn
Blisters heal in 10–14 days if no complications
Deeper second degree burns heal in 1–3½ months
Scarring common with second degree burns
Second Degree Burns AKA Partial Thickness
39
Destroys entire skin layer
Burn is gray-white or black
Ranges in color from black, brown, tan, red or white
Victim feels no pain (pain receptors are destroyed)
Sudoriforous and sebaceous glands, hair follicles, and blood vessels also destroyed
Third-Degree Burns AKA Full Thickness
40
The most severe of all burns
| Penetrate the bone and cause bone damag
4th degree burns
41
Elevated, rounded, and firm
Claw-like margins that extend beyond the original site of injury
Excessive collagen formation during dermal connective tissue repair
Common in darkly pigmented skin types and burn scars
Keloids
42
What causes pressure ulcers
Pressure ulcers result from any unrelieved pressure on the skin, causing underlying tissue damage (ischemic necrosis). Pressure, Shearing forces, Friction, and Moisture
43
Pressure ulcers risk factors are?
Older adults in hospitals and nursing homes, Neurologic disorders that result in loss of mobility and/or sensation (spinal cord injuries, dementia, or cerebrovascular disease), Immobilization Incontinence, and Debilitation
44
Clinical Manifestations of pressure ulcers risk factors are?
Lying in bed without changing position or relieving pressure over an extended period, Lying for hours on hard imaging and operating tables, Chronic diseases accompanied by anemia, edema, renal failure, malnutrition, sepsis, and urinary or fecal incontinence, and Coarse bed sheets used for turning by dragging, which produces a shearing force
45
Describe the first stage of a pressure ulcer.
Nonblanchable erythema of intact skin
46
Describe the second stage of a pressure ulcer.
Partial-thickness skin loss involving epidermis or dermis (shallow ulcer)
47
Describe the third stage of a pressure ulcer.
Full-thickness skin loss involving damage or loss of subcutaneous tissue (Deep Ulcer)
48
Describe the fourth stage of a pressure ulcer.
Full-thickness skin loss with damage to muscle, bone, or supporting structures
49
Describe the ustageable stage of a pressure ulcer.
Unstageable if wound bed covered with eschar
50
List the Inflammatory Disorders of the skin
```
Dermatitis = Eczema
Allergic Contact dermatitis
Atopic Dermatitis
Irritant Contact Dermatitis
Stasis Dermatitis
Seborrheic Dermatitis
```
51
Caused by a hypersensitivity type IV reaction
Allergen comes into contact with skin, binds to carrier protein to form sensitizing antigen; Langerhans cells process antigen, carry it to T cells, which become sensitized to antigen
Manifestations: Erythema, swelling, pruritus, vesicular lesions
Allergic contact dermatitis
52
Type I hypersensitivity—activation of mast cells, eosinophils, T lymphocytes, other inflammatory cells
Causes red, weeping crusts and chronic inflammation, lichenification
Atopic dermatitis
53
Nonimmunologic inflammation of the skin
Chemical irritation from acids or prolonged exposure to irritating substances
Symptoms similar to allergic contact dermatitis
Treatment—remove stimulus
Irritant contact dermatitis
54
Occurs in the legs as a result of venous stasis, edema, and vascular trauma
Sequence of events: erythema, pruritus, scaling, petechiae, ulcerations
Stasis dermatitis
55
Inflammation of the skin involving the scalp, eyebrows, eyelids, nasolabial folds, and ear canals
Scaly, white, or yellowish plaques
Seborrheic dermatitis
56
Chronic, relapsing, proliferative skin disorder
T-cell immune-mediated skin disease
Scaly, thick, silvery, elevated lesions, usually on scalp, elbows, or knees caused by a high rate of mitosis in the basal layer
Shows evidence of dermal and epidermal thickening
Epidermal turnover goes from 26-30 days to 3-4 days
Cells do not have time to mature or keratinize
Psoriasis
57
Various Kinds of Psoriasis are?
Plaque psoriasis – most common, patches or plaques
Inverse psoriasis – skin folds
Guttate psoriasis – (drops) small, distinct lesions
Pustular psoriasis
Erythrodermic psoriasis - inflammatory
58
Benign, self-limiting inflammatory disorder
Usually occurs during winter months
Herald patch: Circular, demarcated, salmon-pink, 3- to 4-cm lesion
Pityriasis rosea
59
Benign, inflammatory disorder of the skin and mucous membranes
Unknown origin, but T cells, adhesion molecules, inflammatory cytokines, and antigen presenting cells are involved
Nonscaling violet-colored, 2- to 4-mm lesions
Wrists, ankles, lower legs, genitalia
Lichen planus
60
Inflammatory disease of the pilosebaceous follicle
Acne vulgaris
61
Inflammation of the skin that develops in adulthood
Lesions: Erythematotelangiectatic, papulopustular and phymatous
Also: Associated with chronic, inappropriate vasodilation resulting in flushing and sensitivity to the sun
Acne rosacea
62
Excessive hormonally influenced sebum production
Abnormal keratinization of portions of the follicular epithelium
Response to anerobic bacterium P. acnes
Follicular rupture and inflammation
Acne Vulgaris
63
Inflammatory, autoimmune disease with cutaneous manifestations
Thought to be an altered immune response to an unknown antigen or response to UV wavelengths with the development of self-reactive T and B cells, decreased number of regulatory T cells, and increased proinflammatory cytokines
Autoantibodies and immune complexes cause tissue damage
Lupus erythematosus
64
Restricted to the skin
Photosensitivity
Butterfly pattern over the nose and cheeks
Subtype of systemic lupus erythematosus (SLE)
Leads to SLE in approximately 5% of cases
Discoid lupus erythematosus
65
Diseases that have different causes and clinical courses but share the common characteristic of vesicle, or blister, formation
Vesiculobullous Disorders
66
List the two Vesiculobullous Disorders?
Pemphigus & Erythema multiforme
67
Rare, chronic, blister-forming disease of the skin and oral mucous membranes
Blisters form in deep or superficial epidermis
Autoimmune disease caused by circulating IgG autoantibodies: The antibodies are against the cell surface adhesion molecule, desmoglein in the suprabasal layer of the epidermis
Pemphigus
68
Three types of Pemphigus
Pemphigus vulgaris (severe)
Pemphigus foliaceus
Pemphigus erythematosus
69
how do you diagnosis Pemphigus?
Tissue biopsies demonstrate autoantibody presence
70
More benign disease than pemphigus vulgaris
Bound IgG and blistering of the subepidermal skin layer
Subepidermal blistering and eosinophils distinguish pemphigoid from pemphigus
Bullous pemphigoid
71
Acute recurring disorder of skin and mucous membranes
Associated with allergic or toxic reactions to drugs or microorganisms
Caused by immune complexes formed and deposited around dermal blood vessels, basement membranes, and keratinocytes
“Bull’s-eye” or target lesion: Erythematous regions surrounded by rings of alternating edema and inflammation
Erythema multiforme
72
Bullous lesions form erosions and crusts when they rupture
Affects the mouth, air passages, esophagus, urethra, and conjunctivae
Severe forms:
Stevens-Johnson syndrome (bullous form)
Toxic epidermal necrolysis
Erythema multiforme
73
What are inflammatory skin disorders?
stasis and seborrheic
74
Whats the events of stasis?
erythema, pruritus, scaling, petechiae, ulcerations
75
anerobic bacterium P. acnes causes what?
Acne vulgaris
76
Whats the diffenece btwn acne vulgaris and acne rosacea?
Vulgaris has comedones while rosacea is seen in adults with no comedones.
77
What are autoimmune diseases caused by circulating IgG?
pemphigus
78
What disease is associated with bound IgG and blisters?
Bullous pemphigus
79
what is desmoglein associated with?
---
80
where is desmoglein found?
---
81
what are the types of pemphigus?
Pemphigus vulgaris (severe)
Pemphigus foliaceus
Pemphigus erythematosus
82
what is associated with extensive confluent erosions and crust
with a few large flaccid bullae?
83
what distinguish pemphigoid from pemphigus?
Subepidermal blistering and eosinophils
84
what Vesiculobullous Disorders is associated with TEN and steven-johnson syndrome?
erythema multiforme
85
whats the serve form of erythema multiforme with bullus?
steven-johnson syndrome
86
what is the infection of the hair folicles?
folliculitis caused by s. aureus
87
what is a furuncle?
boils/inflammation of hair follicle caused by s.aureus
88
how do you know a pt has a gram + infection?
skin is hot and tender to touch
89
scald skin syndrome from staph aureus is what type of infection?
gram + superfical in skin
90
what is a carbuncle?
collection of infected hair follicles, may develop in abscesses.
91
how do you know cellulitis is getting worse?
its ascending
92
what is impetigo?
alpha hemolytic stept or staph
a superfical lesion on skin
kids
93
what is Erysipelas?
group a strept
| acute superficial infection of the upper dermis
94
what is a superficial form of cellulitis?
erysipelas
95
what is cellulitis?
infection of dermis and sub Q
caused by strept B and staph
could be localized or ascending
96
where does varicella virus live for a prolonged period?
nerve root
97
when herpes zoster shows symptoms where does it appear?
one sided nerve dermatome
98
what are characteristics of Condylomata acuminata?
genital warts
Highly contagious, sexually transmitted
Cauliflower-like lesions occur in moist areas, along the glans of the penis, vulva, and anus
Oncogenic HPV a primary cause of cervical
99
what is it called when Fungi cause superficial skin lesions?
dermatophyte
100
what is mycoses?
fungal disorders
101
mycoses caused by dermatophytes are termed
tinea
102
name the 5 tinea
```
Tinea capitis (scalp)
Tinea pedis (athlete’s foot)
Tinea corporis (ringworm)
Tinea cruris (groin, jock itch)
Tinea unguium (nails) or onychomycosis
```
103
how are fungal infections diagnosed?
KOH prep
104
what causes Tinea versicolor?
the organism Pityrosporum ovale
105
where is Candida albicans normally found?
on skin, in GI tract, and in vagina
106
what is unique about oral thrush?
it could be scrapped off
107
what looks like thrush thats precancerous and cant be scrapped off?
oral luekoplaquea
108
what are predisposing conditions for candidiasis?
systemic administration of antibiotics, pregnancy, diabetes mellitus, Cushing disease, debilitated states, age younger than 6 months, immunosuppression, and neoplastic diseases
109
Pediculus humanus capitis
Lice that infest the head
110
Pediculus humanus corporis
Lice that infest the body
111
Phthirus pubis
Pubic lice (crabs)
112
Sarcoptes scabiei
Itch mites
113
which parasite is sexually transmitted and borrows into the skin?
scabies - itch mites
114
what are nits?
lice eggs
115
what are characteristics or vascular disorder?
---
116
what is the MOA of uticaria?
Histamine release causes endothelial cells of the skin to contract
which Causes leakage of fluid from the vessels
117
what immune response is uticaria?
type 1
118
how does uticaria appear?
geographic type patterns that are raised
119
what vascular disorder is characterized by taut skin, massive deposits of collage, inflammation, autoimmune w association of several antibodies and hypopigmentation?
scleroderma
120
what are symptoms of scleroderma?
Facial skin becomes very tight
Fingers become tapered and flexed; nails and fingertips can be lost from atrophy
Mouth may not open completely
50% of patients die within 5 years
121
what are types of insect bites?
Ticks, Mosquitoes, Flies and Spider
122
Lyme disease, Rocky Mountain spotted fever
Ticks
123
Malaria, yellow fever, dengue fever, filariasis, St. Louis encephalitis
Mosquitoes
124
Painful bites
| Urticaria, mild bleeding
Flies
125
why is a spider bite the worst?
localized allergic reaction
126
What disease is Autoimmune, rare, chronic, blister-forming disease of skin and oral mucous membranes and caused by IgG autoantibodies?
Pemphigus
127
skin injury from exposure to extreme cold results in?
frostbite
128
what causes the burning reaction in frostbite?
alternating cycles of vasoconstriction and vasodilation
129
what causes the alternating vasoconstriction and vasodilation during frostbite?
Prostaglandins, thromboxanes, bradykinin and histamine (similar to burn inflammation)
130
during frost bite ice crystals form where?
extracelluar and intracellular
131
Name two nail disorders
Paronychia
| Onychomycosis
132
What nail infection is associated with the nail plate?
onychomycosis
133
name the 4 types of benign skin tumors? MASK
```
Seborrheic Keratosis
Benign proliferation of basal cells
Actinic Keratosis
Premalignant (in elderly)
Keratoacanthoma
Tumor arising from hair follicles
Nevi (Moles)
```
134
what bengin skin tumor has Benign proliferation of basal cells?
Seborrheic Keratosis (germ layer)
135
how does seborrheic keratosis appear?
multiple brown warty papules on nodules having stuck on appearance
136
whats another name for actinic keratosis?
solar keratosis
137
what is solar keratosis?
macules and papules with coarse adhearing scaling on forehead from sun damage
138
what is a keratocanthoma?
Dome shaped tumor with a central plug
139
what does a keratocanthoma with a central plug resemble?
Squamous cell carcinoma
140
Skin cancer is categorized into cancerous what are they?
malignant and benign
141
What is the difference between benign and malignant skin cancer?
malignant - metastasizes, (melanoma)
| benign - does not spread, encapsulated (carcinoma)
142
name the 4 types of skin cancer
Basal cell carcinoma
Squamous cell carcinoma
Malignant melanoma
Kaposi sarcoma
143
which skin carcinoma can metastasize and to where?
lymph node - squamous cell carcinoma
144
which are some characteristics of Basal cell carcinoma?
affects p53 gene
curly rolled borders
associated with UV exposure
145
whats the most deadly skin cancer, with genetic predisposition? why?
malignant melanoma - Metastasizes rapidly to lymph and blood vessels
146
what are the 4 types of Kaposi sarcoma?
Drug-induced immunosuppresion
Associated with AIDS
Endemic – equatorial Africa
Classic form – elderly (purple lesions)
147
what virus is kaposi sarcoma associated with?
Kaposi-Associated Herpesvirus 8
148
kaposi sarcoma affects what cell?
progenitus cell = Endothelial Cells
149
What is ABCD rule used for?
used to check for malignant melanoma
150
ABCD
```
A = Asymmetry
Two sides of pigmented mole do not match
B = Border irregularity
Borders of mole are not smooth
C = Color
Different colors in pigmented area
D = Diameter
Spot is larger then 6 mm in diameter
```
151
what characteristic would you see with kaposi?
Kaposi Sarcoma – dark purple macules, nodular plaques
152
a Pt has white thick plaque of firm consistency and irregular margins on the inner side of the cheek and the pt was a heavy pipe smoker
oral leukoplakia
153
3 types of vascular skin lesions
Strawberry Hemangioma
Cavernous Hemangioma
Port Wine Stain
154
Port Wine Stain
sharply marginated port wine red macula occur in a distribution of the maxillary in kids
155
Cavernous Hemangioma
large soft semispheric blue tinged swelling of dermis and sub Q
156
Strawberry Hemangioma
a purple dermal nodular lesion near elbow of a newborn may go away
157
how does Integumentary system reflects changes from genetic and environmental factors
skin - becomes thinner, drier, wrinkled, and demonstrates changes in pigmentation
capillary loops - Shortening and decrease in number
melanocytes and Langerhans cells # decreases
Atrophy - sebaceous, eccrine, and apocrine glands
hair - color changes, Fewer hair follicles, and growth of thinner hair
