Unit 20 Flashcards by Misha Amiri

cellulitis

bact infc of deeper dermis and subcu

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why is cellulitis danger

dt continuity of sub cu layer and inc in space

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what causes cellulitis

bact that enters these layers, mostly
strep puogenes
staph aures

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strep pyogenes

aerobic bact, oppurtunistic, inc in strep throat, exists in urt as normal flora in dec numbers

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staph aures

appears in dec numbers as normal flora on skin. also normal flora in nasal pts in some pts

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how does bact enter in cellulitis

compromised skin

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where does cellulitis bact norally enter

foot (via athletes foot) and ascends up

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what other areas does cellulitis affect

hands, pinna of ear, feet, calves

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where else can bact spread in cellulitis

lympathetic system

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tx for abx

mild: oral abx, sev: IV abx (7-14)d

inc reoccurance

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comp if cellulitis if left untx

lymphangitis
bacteremia via sepsis
gangrene

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psoriasis

chornic integ condition with extensive inflm

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how long does it take for basal cells to move up to the surface normally

1 MO

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how long does it take basal cells to move up to the surface in psorasis

3day

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what does the rapid cell cycle in psoriasis cuase

abn formed cells, cell stacking -> forming scaly patches

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et psorasis

largely idiopathic
genetic (30percent)
autoimmunity

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what triggers autoimmune resp in psoraisis

t cells triggered by skin trauma

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patho of psorasis

skin truama-> activated t cells -> mediators -> accelerated epidermal cycle and abn/unexplained change in growth of keratinocytes and blood vessels

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what does the influx of infm cells cause in psorasis

skin/inflm damage

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why do cells stack in psorasis

inc epidermal cell turnover meaning cells cant die and shed, so they stack

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mnfts psorasis

prsoriatic patches
nail dystrophy and damage with progression
prostatic arthritis

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where do prostatic patches occur in psorasis

elbows, knees,scalp, sacrum

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why does nail pitting and dystrophy occur in psoriasis

change in keratin -> inc amounts -> brittle nails

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what percent of pts experience brittle naisl

30-50 percent

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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

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