Unit 20 Flashcards
cellulitis
bact infc of deeper dermis and subcu
why is cellulitis danger
dt continuity of sub cu layer and inc in space
what causes cellulitis
bact that enters these layers, mostly
strep puogenes
staph aures
strep pyogenes
aerobic bact, oppurtunistic, inc in strep throat, exists in urt as normal flora in dec numbers
staph aures
appears in dec numbers as normal flora on skin. also normal flora in nasal pts in some pts
how does bact enter in cellulitis
compromised skin
where does cellulitis bact norally enter
foot (via athletes foot) and ascends up
what other areas does cellulitis affect
hands, pinna of ear, feet, calves
where else can bact spread in cellulitis
lympathetic system
tx for abx
mild: oral abx, sev: IV abx (7-14)d
inc reoccurance
comp if cellulitis if left untx
lymphangitis
bacteremia via sepsis
gangrene
psoriasis
chornic integ condition with extensive inflm
how long does it take for basal cells to move up to the surface normally
1 MO
how long does it take basal cells to move up to the surface in psorasis
3day
what does the rapid cell cycle in psoriasis cuase
abn formed cells, cell stacking -> forming scaly patches
et psorasis
largely idiopathic
genetic (30percent)
autoimmunity
what triggers autoimmune resp in psoraisis
t cells triggered by skin trauma
patho of psorasis
skin truama-> activated t cells -> mediators -> accelerated epidermal cycle and abn/unexplained change in growth of keratinocytes and blood vessels
what does the influx of infm cells cause in psorasis
skin/inflm damage
why do cells stack in psorasis
inc epidermal cell turnover meaning cells cant die and shed, so they stack
mnfts psorasis
prsoriatic patches
nail dystrophy and damage with progression
prostatic arthritis
where do prostatic patches occur in psorasis
elbows, knees,scalp, sacrum
why does nail pitting and dystrophy occur in psoriasis
change in keratin -> inc amounts -> brittle nails
what percent of pts experience brittle naisl
30-50 percent
psoriatic arthritis
autoimmune problem in smaller, distal joints like fingers and toes
what percent of pts have psoriatic arthritis
15-20% ots
1st approach tx in psoriasis
topical meds
which topical meds may be used in psorasis
vit d
steroids
renenoids
fx of vit d in topical meds for psorasis
dec of # keratinocytes and t cells, regulates them
fx of retenoids in topical med tx for psorasis
dec inflm and modulate keratinocytes
more sev approach for psorasis
methotrexate cyclosporine phototx topical application of tar biologic agents like tnf
cyclosporine
cytotoxic, immunosupressants
fx of phototx in psorasis
controlled and regulate exposure to UV B light to surpress and decrease cell cycle
fx of biologic agents like TNF
causes apoptosis of extra normal cells
what percent of skin ca’s make up all ca
1/3
3 major types of skin ca
basal cell carcinoma
squamous cell carcinoma
malignant melanoma
what 2 types of ca;s make up 90% of skin cas
basal cell carcinoma
squamous cell carcinoma
et of skin ca
inc sun exposure/uv light exposure causing cumulative exposure
actinic keratosis
pre ca lesion most pts present with
what percent of cure rate occurs with early detection
95%
nevus/nevi
moles/beningn growth
basal cell carcinoma
most common ca with best progress
where does basal cell carcinoma arise
in basal cells of lower epidermis
characteristics of basal cell carcinoma
slow growing, appears on exposed surfaces,.
local invastion+destr, no pain
characteristics of lesions on basal cell carcinoma
dome shaped, nodular lesion, similar in most pts in early stages
does basal cell carcinoma met
no
tx/dx for basal cell carciona
biopsy
what happens in late stage basal cell carcinoma
change in lesions with latge stages (pt spec)
where does squamous cell carcinoma originate
keratinocytes
where does squamous cell carcinoma usually appear
exposed surfaces
characteristics of leisons ins squamous cell carcinoma
fast growing, poorly defined, with variable appearance
can squamous cell carcinoma affect local strs
yes (deep skin
where does squamous cell carcinoma met to
local lymph nodes
malignant melanoma origin
melanocytes
characteristics of malignant melanoma
worst form, inc progression, rapid progression with mets
where does malignant melanoma form
exposed and non exposed surfaces
main features of malignant melanoma
change in lesion over 3-8mo
double/inc in size
change in colour/multi colours
what other mnfts occur in lesions of malignant melanoma
prutis, bleeding, crusting, ulcerations, irregular border, raised border
where does malignant melanoma mets to
bone, brain, lung , liver
tx for skin ca
early detection
excision
what is skin ca prevalence proportional to
age (cumulative exposure)
what is skin ca inversely proportional to
melanin
