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Systemics > Skin Pathologies > Flashcards

Skin Pathologies Flashcards

1
Q

Skin Lesion Terms:

bulla

A

large distinct elevation with fluid (large friction or burn blister)

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2
Q

Skin Lesion Terms:

crust

A

dried residue of exudates (residue of impetigo)

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3
Q

Skin Lesion Terms;

cyst

A

enclosed cavity that contains a semisolid or liquid.

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4
Q

Skin Lesion Terms:

fissure

A

linear crack in the skin (Athlete’s foot)

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5
Q

Skin Lesion Terms:

lichenification

A

is a diffuse area of thickening and scaling skin with an increase in skin lines abd markings

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6
Q

Skin Lesion Terms:

macule

A

flat, discoloured spot on skin with sharp borders (mole)

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7
Q

Skin Lesion Terms:

scale

A

thin or thick flake of skin varying in colour, usually secondary to desquamated, dead epithelium (dandruff)

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8
Q

Skin Lesion Terms:

papule

A

solid elevations without fluid with sharp borders (mole)

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9
Q

Skin Lesion Terms:

plaque

A

large, flat, elevated, solid surface (psoriasis)

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10
Q

Skin Lesion Terms:

Pruritis

A

Pruritis is severe itching.

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11
Q

Skin Lesion Terms:

pustule

A

vesicle or bulla filled with purulent fluid (acne, carbuncles)

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12
Q

Skin Lesion Terms::

telangiectasia

A

telangiectasia is an area of dilated superficial blood vessels.

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13
Q

Skin Lesion Terms:

tumour

A

tumour is a large nodule. It may be neoplastic, or new, abnormal tissue formation which grows at the expense of other tissues and serves no useful function.

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14
Q

Skin Lesion Terms:

ulcer

A

opening in the skin caused by sloughing of necrotic tissue, extending past the epidermis (pressure ulcer, stasis ulcer)

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15
Q

Skin Lesion Terms:

vesicle

A

small distinct elevation with fluid (blister caused by herpes simplex)

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16
Q

Skin Lesion Terms:

wheal

A

localized area of edema, often irregular and of variable size and colour (hive, insect bite)

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17
Q

Skin Lesion Assessment

A

A = Asymmetric shape

B = Irregular border

C = Multiple Colours

D = Diameter more than 7mm

E = Change in elevation

F = Feeling of itching or tingling

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18
Q

Viral Infections

A
  1. Herpes Simplex
  2. Varicella (Chicken pox)
  3. Herpes Zoster (Shingles)
  4. Verruca (Warts)
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19
Q

Viral Infections:

  1. Herpes Simplex
A

A cold sore, highly contagious viral infection.

Herpes simplex 1 (non-genital)
Herpes simplex 2 (genital)

Virus able to survive up to 3 days on moist gauze and toilet seats, but cannot survive in extremely chlorinated water

Transmitted by direct skin contact during vesicular stage

Enters body through mucous membranes, cuts and scrapes

Virus lies dormant and recurring episodes are usually less severe than initial

Massage is locally contraindicated

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20
Q

Viral Infections:

  1. Varicella (Chicken pox)
A

contagious infection that produces vesicles and papules over the trunk, face and limbs
spread by airborne droplets

Children require no treatment

Adults the condition is more systemic and severe. Pregnant women and those
persons who are immunosuppressed require immediate medical referral

Vaccines are available

Massage is completely contraindicated until the symptoms disappear.

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21
Q

Viral Infections:

  1. Herpes Zoster (Shingles)
A

Virus lies dormant in a nerve root ganglion until reactivation of the varicella virus when the person is fatigued, under stress, immunosuppressed, elderly, or experiencing trauma or surgery

Lesions occur along dermatome, healing within 3 weeks

Mostly strikes those over 50 years of age if not vaccinated

Massage is locally contraindicated

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22
Q

Viral Infections:

  1. Verruca (Warts)
A

contagious papules or nodules of the epidermis

caused by human papillomavirus

  1. common warts: found on hands and trauma sites
  2. plantar and palmar warts: found on soles of feet and palms of hands
  3. flat warts: found on face & hands
  4. filiform: finger-like projections often occurring on the face

Massage is locally contraindicated

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23
Q

Acute Bacterial Infections

A
  1. Impetigo
  2. Cellulitis
24
Q

Acute Bacterial Infections:

  1. Impetigo
A

Superficial skin condition, usually caused by a staphylococcal infection

Highly contagious and commonly transmitted by direct contact

Red sore (can blister and crust) on affected areas such as around mouth, legs, hands, genitalia and scalp

Easily spread from a localized lesion to other skin surfaces of the body in a few days

Massage locally CI’d

Gloves should be worn by the therapist if massage is to be performed on the area not affected (only possible if the client has a localized outbreak)

25
Q

Acute Bacterial Infections:

  1. Cellulitis
A

Deep inflammatory condition affecting the superficial to subcutaneous skin layers

Caused by staphylococcal or streptococcal infection

Usually affects the face or the limbs, especially the legs, where there is lymphedema or a break in the skin integrity such as an ulcer or wound

Painful, with diffuse swelling and redness observed over the infected part.

Medical attention is required as soon as possible. Massage is safe to perform once the condition has resolved, be aware recurring outbreak

26
Q

Fungal Infections

A
  1. Ringworm & Athlete’s Foot
  2. Candidiasis
27
Q

Fungal Infections:

  1. Ringworm & Athlete’s Foot
A
  • Fungus grow in a warm, moist environment
  • Infected ring-like patches of skin are itchy and flaky, affecting multiple areas of the body
  • Tinea pedis (athlete’s foot) is the most common:

+ Prevention includes wearing cotton socks and changing them frequently, keeping the feet dry, wearing well ventilated shoes and avoiding walking barefoot in public places

  • Tinea corporis (ringworm of the body) affects the chest, back, shoulders, neck, arms or legs

+ Often affects children from pets

+ Multiple lesions are observed that are fairly similar in size. They vary from pustules to scaly patches

  • Tinea capitis (ringworm of the scalp)

+ affects primarily children, boys 5x more often than girls

+ pink, scaly patches on the scalp and some local hair loss

28
Q

Fungal Infections:

  1. Candidiasis
A
  • Common fungal infection caused by a yeast (candida albicans)
  • Normally resides in the GI tract, genital tract, mouth, esophagus and throat
  • Cutaneous candidiasis affects the skin
  • Candidal paronychia:
    painful, red swollen skin around nail bed. If condition chronic, nails thicken and harden
  • Candidal intertrigo:
    red eroded patches, scaly pustular lesions with an undefined border of satellite papules. Often areas of large skin folds are affected
  • Oral candidiasis (thrush)
    affects oropharyngeal cavity. White flakes, described as looking like cottage cheese, appear over red and inflamed buccal membrane, tongue, gingiva, palate and pharynx. Over time, erosions or ulcers may develop

Massage is locally CI’d

29
Q

Infestations:

Scabies

A

Result of mite infestation

Contagious condition which can be transmitted through prolonged direct contact with an infected person but may also be transmitted through contact with clothing, linens or towels

Intense itching is a classic symptom of a scabies infestation

Massage completely CI’d

If contact occurs before medical diagnosis, the therapist should seek treatment. Linens and towels should be washed in hot water and dried on a hot cycle to effectively kill any mites

30
Q

Premalignant and Malignant Neoplasms

A

A malignant neoplasm is a new, abnormal formation of tissue that grows at the expense of the healthy organism

A premalignant neoplasm has not yet become malignant, however has the potential for malignancy

  1. Actinic Keratosis
  2. Basal Cell Carcinoma
  3. Malignant Melanoma
  4. Squamous Cell Carcinoma
31
Q

Premalignant and Malignant Neoplasms:

  1. Actinic Keratosis
A

Plaque, scale or papule occurring as a result of chronic sun exposure.

Are found on the face, scalp and backs of the hands

Common in fair skinned people
Removed by cryosurgery

Massage is not generally contraindicated. However, techniques which rub or torque the skin, such as frictions or fascial spreading, are avoided directly over the lesion

32
Q

Premalignant and Malignant Neoplasms:

  1. Basal Cell Carcinoma
A

Often found in sun exposed areas such as the face

Most commonly in men aged 40-80

Nodular basal cell carcinoma
waxy, translucent papule has a central ulceration and a raised border.

Other forms of basal cell carcinomas are in ulcerus forms; hyperpigmentation or erythema may be present

Massage locally CI’d

33
Q

Premalignant and Malignant Neoplasms:

  1. Malignant Melanoma
A

Proliferation of melanocytes

3% of all cancers, and increase at a fast rate
affect fair skinned persons more frequently than darker skinned people

Different types

Superficial spreading

Lentigo maligna

Nodular

If a melanoma is medically diagnosed, massage is locally contraindicated and maybe generally contraindicated

34
Q

Premalignant and Malignant Neoplasms:

  1. Squamous Cell Carcinoma
A

Tumour of malignant keratinocytes
The most common skin cancer in Black persons; it is often found in non-sun-exposed areas of the body

In white persons, squamous cell carcinoma is often found in sun-exposed areas, or may develop from actinic keratosis

If a carcinoma is medically diagnosed, massage is locally contraindicated and maybe generally contraindicated

35
Q

Benign Neoplasms

A

New proliferations of cells that are not life-threatening

*Massage not CI’d, however some require technique modifications

  1. Venous Lake
  2. Cherry Angioma
  3. Dermatofibroma
  4. Epidermal Inclusion Cyst
  5. Hemangioma
  6. Lipoma
  7. Nevus (Mole)
  8. Seborrheic Keratosis
  9. Skin Tags
  10. Solar Lentigo
36
Q

Benign Neoplasms:

  1. Venous Lake
A

Dark blue, soft, compressible area of dilated capillaries on the lips, face and ears of elderly people

Either may be removed by laser or cauterization

37
Q

Benign Neoplasms:

  1. Cherry Angioma
A

Superficial capillary proliferation, usually affecting middle-aged to elderly people

Either may be removed by laser or cauterization

38
Q

Benign Neoplasms:

  1. Dermatofibroma
A

Benign proliferation of fibroblasts

Firm, discrete papules or nodules me not tender

Darker-skinned people they are hyperpigmented

Lighter skinned people they are reddish

Usually found on the legs but may appear elsewhere.

Idiopathic, may also result from trauma or insect bites

39
Q

Benign Neoplasms:

  1. Epidermal Inclusion Cyst
A

Raised nodules filled with odiferous white material, often a central pore is visible

May become inflamed

Avoid frictions or fascial spreading over top

40
Q

Benign Neoplasms:

  1. Hemangioma
A

superficial proliferation of blood vessels, or telangiectasis

  1. Nevus Flammus (port-wine stain):
    red to purple macule or papule on the face or head; it is present at birth and usually resolves by five years of age
  2. Salmon Patches (Stork bite):
    red macules, usually on the back of the neck; they occur in up to 10% of fair skinned infants
    usually disappear by puberty
  3. Capillary hemangiomas (strawberry marks):
    telangiectatic macules that may develop into soft nodules or tumours
    develop in the first few days or months of life and usually resolve by puberty
41
Q

Benign Neoplasms:

  1. Lipoma
A

a benign proliferation of fatty tissue below the dermis and epidermis

mobile, soft, slightly compressible tumours are from one to several centimetres in size

Often occur in 40+ yr olds around the back, shoulders, arms and legs

42
Q

Benign Neoplasms:

  1. Nevus (Mole)
A
  1. Melanocytic nevus - macule of melanocytes, or dark pigmentation cells, that occurs in childhood
  2. Congenital nevus - present at birth; it may extend down into the subcutaneous fat
  3. Nevus of Ota - affects the dermal layer of the face in the distribution of the trigeminal nerve; primarily affecting Asian and Black persons
  4. Junctional nevus - macule of melanocytes in the junction of the epidermis lind the deeper dermis.
  5. Compound nevus is a papule of melanocytes that extends deeper than the junction, into the dermis itself.
  6. Dermal nevus - papulp that occurs only in the dermis and it lacks melanocytes
  7. Dysplastic nevi :
  • irregulary shaped, pigmented macules with raised areas.
  • > 1 cm diameter than most nevi
  • Pigmentation may be brown, tan, red-pink or sometimes black
  • Atypical, isolated lesions have a low risk of developing melanoma
  1. Halo nevus:
    * pigmented nevus with a surrounding lighter coloured halo
  • common and benign in adolescents, in adults they may indicate melanoma or skin cancer

Both usually removed for risk of cancer

43
Q

Benign Neoplasms:

  1. Seborrheic Keratosis
A

Benign proliferation of keratinocytes (cells that produce the tough protein keratin)

Pigmented, scaly plaque with well-defined borders; the raised lesion appears stuck on the skin

Range up to 2 centimetres in size, occasionally larger.

Commonly found on the trunk, arms and face

Most common in those over 50 years of age

44
Q

Benign Neoplasms:

  1. Skin Tags
A

Outgrowth of normal skin

May have darker pigmentation than the surrounding skin

Forms a papule or nodule on a narrow stalk, often in areas of friction such as the axilla

May be numerous skin tags in one area

45
Q

Benign Neoplasms:

Solar Lentigo

A

Commonly called liver or age spots

Benign proliferations of normal melanocytes as a result of chronic sun exposure and damage

Have darker pigmentation that is even throughout

Found in areas of chronic sun exposure, such as the hands, face and shoulders

46
Q

Non-Infectious Inflammatory Disorders:

A
  1. Acne
  2. Dermatitis and Eczema
  3. Contact & Allergic Contact Dermatitis
  4. Atopic Dermatitis
  5. Hand and Foot Eczema
  6. Venous (Stasis) Eczema
  7. Xerotic Eczema
  8. Psoriasis Vulgaris
47
Q

Non-Infectious Inflammatory Disorders:

  1. Acne
A

Disorder of the sebaceous gland

Overproduction of oil may block the hair follicle allowing bacteria to multiply and cause inflammation

Black heads, white heads, pustules and cysts may be present; scarring may occur

Acne vulgaris occurs during puberty

Acne conglobata is chronic and occurs later in life.

Acne rosacea exhibits erythema, usually on the face, and occurs in middle-aged adults

Avoid massaging local lesions if likely to rupture and spread bacteria

48
Q

Non-Infectious Inflammatory Disorders:

  1. Dermatitis and Eczema
A

Dermatitis: general term used to describe a wide variety of non-contagious, inflammatory skin disorders

Itchy, red, scaly and inflamed skin

Acute and severe: edema, vesicles and bullae

Subacute: scaling plaques

Chronic: lichenification, scales and changes in pigmentation

Massage avoided locally only if open and oozing lesions

Avoid the use any oils/lotions or fragrances that could aggravate (ask the client)

49
Q

Non-Infectious Inflammatory Disorders:

  1. Contact & Allergic Contact Dermatitis
A

From direct contact with an irritating substance

Primary irritant contact dermatitis: toxic agent causing injury through skin contact

Allergic contact dermatitis: delayed hypersensitivity reaction because of an allergy to the substance or agent

Massage is CI’d over areas affected by contact and allergic dermatitis, specifically, open lesions, blisters or if it is uncomfortable for the client

Substances irritating for that client are avoided

50
Q

Non-Infectious Inflammatory Disorders:

  1. Atopic Dermatitis
A

Chronic form of dermatitis in those people with familial predisposition to dermatitis, allergic rhinitis and asthma

Likely due to a combination of immunological response, epidermal dysfunction and genetic susceptibility

Lesions are very itchy

Cutaneous hypersensitivity, chronic redness, scaling, skin eruptions, plaques and papules are present

Massage locally CI’d if open lesions or uncomfortable to client

51
Q

Non-Infectious Inflammatory Disorders:

  1. Hand and Foot Eczema
A

Chronic, often pruritic, inflammatory skin disorder ranging from an acute to chronic presentation

Redness, vesicles, papules and plaques are present

People affected are those with their hands frequently immersed in water

Usually, the palms of the hands including the sides of the fingers or the soles of the feet are symmetrically affected

Massage locally CI’d if open lesions or uncomfortable to client

52
Q

Non-Infectious Inflammatory Disorders:

  1. Venous (Stasis) Eczema
A

Women are more often affected and persons 50+ years of age

Affects the lower limbs of people with chronic venous stasis

  1. Early stage:

hyperpigmentation, sensations of itchiness, aching or burning
Red, scaly and itchy patches become vesicular and crusty due to scratching
Calf edema

  1. Chronic:

thickened brownish-red plaques over dystrophic skin
generally asymptomatic, but acute flare-ups occur

  • Lymphatic Massage proximal to affected area if no ulcerations or infections
53
Q

Non-Infectious Inflammatory Disorders:

  1. Xerotic Eczema
A

An inflammatory disorder of severely dry skin, with plaques, scales, redness and fissures into the skin

Legs, hands and arms are often affected

Common disorder of dry skin may be caused by a decrease in surface skin lipids

Nummular eczema: coin-shaped, extremely itchy xerotic lesions

Massage locally CI’d if open lesions or uncomfortable to client

54
Q

Non-Infectious Inflammatory Disorders:

  1. Psoriasis Vulgaris
A

An inherited, chronic, hyper proliferating, scaling, inflammatory condition affecting the skin and occasionally the mucous membranes

Lesions are well demarcated red papules and plaques with silver-white scales

May involve only a few coin-sized lesions or extensive, thick lesions covering much of the body

Exacerbation and remission cycle

Massage locally CI’d if open lesions or uncomfortable to client

55
Q

Pigmentation Disorders:

A
  1. Vitiligo
  2. Post-inflammatory Hyperpigmentation
56
Q

Pigmentation Disorders:

  1. Vitiligo
A

An acquired skin depigmentation condition affecting 1% of population, usually slow and progressive

Well-defined depigmented macules of varying size
usually on the face and on the skin surrounding joints, such as the hands and knees

Massage needs no modification

57
Q

Pigmentation Disorders:

  1. Post-inflammatory Hyperpigmentation
A

Overproduction of melanin granules as a result of the inflammatory process

More common and severe in darker skinned people

Causes: trauma (cuts, burns), acne, eczema and a response to certain medications. Phytophotodermatitis (exposure to sunlight after exposure of the skin to certain plant juices or essential oils)

Dark macules occur either in the epidermis (a brownish colour) or the dermis (a bluish or greyish colour)

Systemics (26 decks)

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