Term
| Contact Dermatitis: General Characteristics |
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Definition
-caused by chemical irritant
-can be allergic cell mediated rxn
-from direct contact with irritant |
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Term
| Contact Dermatitis: Pathophysiology |
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Definition
-Intercellular edema of epidermis
-vesicles/bullae (acute)
-papules, scaling and lichenification (from scratching) in chronic cases. |
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Term
| Contact Dermatitis: Clinical Features |
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Definition
-Itching
-Burning
-Acute: Lesions well demarcated, Erythema, plaques, vesicles, erosions, crusts
-Chronic: Satellite papules and excoriation (scratches that turn into abrasions and lead to bleeding) |
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Term
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Definition
-Patch test: similar rxns that support Dx
-Gram stain/culture if infection suspected |
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Term
|
Definition
-Avoid/remove agent
-Wet dressing
-Burrow's solution: aluminum acetate in water
-Topical corticosteroids
-Severe: systemic steroids
-Chronic lesions: Tx w/topical steroids
-Supportive measures: cleaning w/soap, oatmeal preps, antihistamines |
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Term
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Definition
-Hx and physical exam
-Physical exam includes: general, including skin, hair, nails and mucocutanesous surfaces
-Diagnostics: Diascopy(glass slide to observe color change), KOH prep, scrapings, smear, woods lights, aceto-whitening, biopsy |
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Term
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Definition
| rubbing a lesion causing urticarial flare |
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Term
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Definition
| pinpoint bleeding after scale is removed: seen in Psoriasis |
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Term
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Definition
| pushing blister causing further separation of dermis |
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Term
| Photopatch test, patch testing |
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Definition
| general test used to ID substance causing inflammation of skin, ( allergic rxns) (used to Dx Atopic Dermatits) |
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Term
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Definition
| minor trauma leads to more lesions, (minor rubbing can lead to a lesion) |
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Term
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Definition
| Solid, palpable lesion, less than 10mm in diameter |
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Term
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Definition
| solid, palpable lesion, greater than 10mm in diameter |
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Term
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Definition
| flat, non-palpable lesion, les than 10mm in diameter |
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Term
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Definition
| plateu-like rasied lesion, greater than 10mm in diameter, maybe a group of confluent papules |
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Term
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Definition
| circumscribed, elevated lesion containing serous fluid, less than 5mm in diameter (ex: chicken pox) |
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Term
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Definition
| circumscribed (encircled), elevated lesion, greater than 5mm in diameter, filled with serous fluid. |
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Term
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Definition
| transient, elevated lesion caused by local edema (ex: TB test) |
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Term
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Definition
| small, hemorrhagic spots that cannot be blanched (whitened) by diascopy or pressure. (diascopy: test for blanchability performed by applying pressure w/finger/glass slide and observing color change. |
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Term
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Definition
| Hard, rough surface formed by dried sebum, exudate, blood or necrotic skin |
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Term
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Definition
| Heaped-up pines of horny epithelium with very DRY appearance |
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Term
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Definition
dilated, superficial blood vessels
(ex: rosacea around face) |
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Term
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Definition
| thickened skin w/distinct borders |
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Term
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Definition
| swollen, softened by an increase in water content, appearance skins gets after in water too long (pruny appearance) |
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Term
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Definition
| irregular, rough, convoluted surfaces : covered with warts/warty region |
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Term
| Maculopapular and Plaque Disorders |
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Definition
Eczematous disorders: Eczema and dermatitis used interchangeably.
-Eczema commonly mean endogenous disorders (inside), whereas dermatitis is exogenous disorders (outside) |
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Term
| Atopic Dermatitis: General Characteristics |
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Definition
-Chronic relapsing skins disorder usually beings at CHILDHOOD
-Type 1 IgE mediated hypersensitivity rxn
-Many pts have asthma and rhinitis
=known as a TRIAD: ask manifestations if have asthama, rhinitis: may help Dx Atopic Dermititis. |
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Term
| Atopic Dermatitis: Pathophysiology |
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Definition
-etiology unknown
-epidermis compromised |
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Term
| Atopic Dermatitis: Clinical features |
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Definition
-papules, plaques: with or w/o scales, possibly associated w: edema, erosions, crusts.
-Pruritis, dry, scaly skin
-Scratching leads to lichenification, fissures and worsening rash
-2ndary infection: S. aureus
-most commonly found on flexural surfaces = neck, eyelids, forehead, face, dorsum of hands, feet, elbows.
-Dermatographism: write on skin! |
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Term
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Definition
| -not routinely done, cultures for suspected 2nd infection maybe help guide treatment |
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Term
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Definition
-antihistamines (reduce itching)
-topical corticosteroids *
-Hydration/topical emollients =key to management
-NO soaps
-UVB phototherapy
-Severe: cyclosporine |
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Term
| Nummular Dermatitis: General Characteristics |
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Definition
-pruritic inflammation disorder
-effects young adults/elderly
-exacerbated in cold weather
(fair skinned people) |
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Term
| Nummular Dermatitis: Pathophys |
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Definition
-form of adult onset atopic derm.
-with xerosis (dry skin)
-permeation of environmental allergbens, induce this type of response |
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Term
| Nummular Dermatitis: Clinical features |
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Definition
-small, grouped vesicles coalesce to form COIN SHAPED plaques w/erythematous base
-crusting and excoriations |
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Term
| Nummular Dermatitis: Labs |
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Definition
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Term
|
Definition
-moisturizers/topical steroids
-tar baths
-UVB phototherapy: basically a not-strong tanning booth: people respond well |
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Term
| Seborrheic Dermatitis: General Characteristics |
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Definition
-common during infancy, puberty, middle/young adults
-occurs where sebaceous glands are most active: body folds, face, scalp, genitalia |
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Term
| Seborrheic Dermatitis: Pathophys |
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Definition
| -associated with normal levels Malassezia: fungi, abnormal immune response |
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Term
| Seborrheic Dermatitis: Clinical features |
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Definition
-scattered yellowish/gray, scaly macules and papules w/greasy look
-sticky crusts, fissures found behind ears (esp in infants)
-on scalp: manifests as "cradle cap" and dandruff in adults |
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Term
| Seborrheic Dermatitis: Labs |
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Definition
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Term
| Seborrheic Dermatitis: Tx |
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Definition
-UV radiation
-cradle cap: tx w/olive oil, compresses and baby shampoo
-ketokonazole shampoo/cream
-hydrocortisone
-Dandruff: Tx w/shampoo w/selnium/zinc/ketokonazole shampoo for ACUTE
-bad cases: tar shampoo, topical steroids
-Other areas: ketoconazole shampoo/topical steroids, blephatitis tx with gentle scrubs of baby shampoo around eyes and sulfa/steroid prep |
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Term
| Peri-oral Dermatitis: General characteristics |
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Definition
-occurs in young women
-papulopustules on erythematous bases
-become confluent w/plaques and scales
-satellite lesions are common (forms near primary lesion)
-lower left lip
-culture to r/u staph infection |
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Term
| Peri-oral Dermatitis: Pathophys |
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Definition
-etiology unknown
-neurological inflamm = STRESS is proposed mechanism |
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Term
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Definition
-AVOID topical steroids (aggravate lesion)
-topical: metronidazole or erythromycin
-oral minocycline, doxycycline, tetracycline
-untreated lesions fluctuate over time = similar to rosacea |
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Term
| Stasis Dermatitis: General characteristics |
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Definition
-Chronic venous insufficiency = can also cause edema, hyperpigmentation, fibrosis, ulceration
-before skin changes: varicose veins, superficial phlebitis, venous thrombosis occur.
-women affected 3X more than men
-pregnancy exacerbates venous infufficiency and stasis dermatitis.
-occurs more often in people who stand for long time |
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Term
| Stasis Dermatitis: Pathophys |
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Definition
-disturbed fucntion of one-way valves of veins= causing backflow
-can result from age, DVT (deep vein thrombosis), CABG, etc. |
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Term
| Stasis Dermatitis: Clinical features |
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Definition
-c/o heaviness/aching in legs: aggravated when standing, relieved when walks
-manifests w/inflammatory papules, scales, crusts.
-stippled pigmentation occurs
-excortiations common
-ulcerations 30% pts
-bilateral distribution of dermatitis
-worry about cellulitis w/this Dx |
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Term
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Definition
-Doppler studies/sonography/venography: show venous insufficiency
-Bx of lesions: dilated vessels, tortous veins, edema, fibrin decomposition= blood stays + gets absorbed, brown-pink color. |
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Term
|
Definition
-compression stockings
-sclerosis of veins: inject glucose and strip vein
-recurrence is common
-vascular bypass/angioplasty for SEVERE cases
-ulcers demand chronic Tx (wound clinics, etc) |
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Term
| Diaper rash/dermatitis: General Characteristics |
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Definition
-inflammation in diaper region
-3 categories: rashes directly/indirectly caused by wearing diapers (irritant contact derm)
-rashes that appear elsewhere but can be exaggereated in groin area
-rashes that appear in diaper area irrespective of diaper use |
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Term
| Diaper rash/dermatitis: Pathophys |
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Definition
-unknown
-triad makes it a problem:
1. activating factors (wet skins)
2. Caretaker intervention (frequent diaper change
3. Etiologic factors (fecal enzymes, friction) |
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Term
| Diaper rash/dermatitis: Clinical features |
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Definition
-3 wks to 2 yrs old (highest is 9mo.-12mon.
-onset, duration, change or rash
-rashes outside diaper area
-contact with infants w/similar rash
-recent illness, antibiotics, diarrhea
-assess current diapering practices (creams, cleaning methods) |
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Term
| Diaper rash/dermatitis: Labs |
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Definition
-KOH scrapings from fresh lesion
-finding mites, ova, feces on mineral oil prep can confirm dx of scabies instead |
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Term
| Diaper rash/dermatitis: Tx |
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Definition
-change more frequently
-air to area
-superabsorbent diapers |
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Term
| Lichen simplex chronicus: General characteristics |
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Definition
-long term manifestation of atopic dermatitis
-skin of pt with atopic derm is sensitive to minor touch/rub/scratch
-so lichenifications develops from scratching and plaques that are HIGHLY pruritic
=cycle of itch-scratch lesions |
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Term
| Lichen simplex chronicus: clinical features |
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Definition
-solid, firm, thick plques w/little to NO scaling
-light touch precipitates strong desire to scratch
-common areas: scalp, ankles, lower legs, upper thighs, exterior forearms and genitals, nuchal (nape of neck)
-black skin shows = smaller papules (not large plaques) |
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Term
| Lichen simplex chronicus: Labs |
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Definition
-KOH prep = r/o fungal infection (prep destroys cellular debris and fungal cells are easily seen)
-Bx shows hyperplasia and hyperkeratosis |
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Term
| Lichen simplex chronicus: Tx |
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Definition
-topical steroids
-tar preps w/occlusive dressing
-antihistamines |
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Term
| Pityriasis rosea: General characteristics |
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Definition
-"Herald patches" : widespread symmetrical round/oval pink plaque, raised border, fine scales)
-cause is unknown: thought to be Human Herpes virus 7 |
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Term
| Pityriasis rosea: Clinical features |
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Definition
-mild Upper respiratory infection (URI) before the rash
-Herald patches a week after rash
-rash is on trunk/cleavage area: is salmon-color, slightly raised, papular/macular, 1cm
-long axis of lesion in skins folds: making it look like a "christmas tree"
-lasts 3-8 weeks and goes away spontaneously |
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Term
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Definition
-no Tx
-UVB phototherapy helpful if a pt REALLY wants it gone
-lotions, anti-pruritics, antihistamines (BEST) |
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Term
| Molluscum contagiosum: General characteristics |
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Definition
-common viral dx of skin/mucous membranes by poxvirus
-most common in children
-if adults, lesions in groin area and lower abdomen
-immuno-compromised pts: lesions larger/widespread, more on neck/head |
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Term
| Molluscum contagiosum: Pathophys |
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Definition
| -virus replicates in cytoplasm of epothelial cells: cytoplasmic inclusions= lots of infected cells |
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Term
| Molluscum contagiosum: Clinical features |
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Definition
-lesions: discrete, flesh-colored, waxy, dome-shaped, umbilicated papules
-face, trunk, extremities
-3-6mm
-if they are popped: white, curd-like material |
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Term
| Molluscum contagiosum: Labs |
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Definition
| Bx in immuno-compromised pts to rude out fungus |
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Term
| Molluscum contagiosum: Tx |
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Definition
-not usually necessary: disease is self-limited
-therapy: local destruction of lesions by: curettage (numb skin, wipe away lesion, burn it, scrape it), cryotherapy, electrodessication, or acid/exfoliative peel (Tretinoin) |
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Term
| Lichen planus: General characteristics |
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Definition
-acute/chronic inflammatory dermatitis
-adults
-females more common
-may occur in a "graft vs. host" rxn: transplant and host doesn't accept tissue, lymphoma, drug rxns |
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Term
| Lichen planus: Clinical features |
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Definition
| -4Ps: purple, polygonal, pruritic, papule -Lesions: flat topped, shiny, violaceous papules w/white line surface = known as Wickham's striae -writs, lumbar area, eyelids, shins, scalp -glands, penis, mouth -painful -may affect hair (scarring), nails (longitudnal splintering) |
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Term
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Definition
| -Bx and immuno-fluorescence confirm |
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Term
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Definition
-Topical steroids
-Intralesional steroids: injection that can take down surface of lesion but too much: can take skin away.
-topical Tretinoin is for severe lesions
-cyclosporine mouthwash
-system therapy : severe cases
-Psoralens + UVA radiation : generalized eruptions |
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Term
| Dyshidrosis: General characteristics |
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Definition
-40 yrs and younger
-half people have optic problems
-eruptions follow: stress, hot/humid weather |
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Term
| Dishydrosis: Clinical features |
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Definition
Early in disease:
-pruritis
-pain in 2nd infection
-small vesicles in clusters (TAPIOCA appearance)
-occasionally bullae form
-later in disease: papules, scaling, lichenification, erosions : from ruptured vesicles
-hands and feet |
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Term
|
Definition
-cultures to r/o secondary infection
-KOH prep r/o dermatophytosis |
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Term
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Definition
-wet dressings w/Burrow's solution
-large bullae drained out, but otherwise don't drain them
-fissures tx w/oatmeal prep
-topical steroids, systemic for severe |
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Term
| Psoriasis: General characteristics |
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Definition
-2% of population have localized form
-genetic predisposition exists (only 1/3)
-chronic, inflammatory, scaling conditioin
-psoriasis in HIV pts is severe and are resistant to Tx
-28x greater than normal: turnover rate of epidermal cells |
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Term
| Psoriasis: Clinical features |
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Definition
-patches are raised, pink to red papules and plaques
-distinct margins, silvery scales
-peeling away scale produces specks of bleeding from capillaries: Auspitz's sign!
-patches found: elbows, knees, scalp
-pruritis
-scratching leads to more lesions: Koebner's phenomenon)
-some pts have nail involvement: pitting of nails, separated from nail bed, oil spots
-Dx mde by hx and appearance |
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Term
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Definition
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Term
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Definition
-Psorasis Vulgaris
-Psorasis erythroderma
-Gutate psoriasis
-Pustular psoriasis |
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Term
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Definition
-most common type of psoriasis
-chronic recurring scaling papules and plaques |
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Term
|
Definition
-bad, very serious
-lesions involve ENTIRE skin surface
-is exfoliative |
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Term
|
Definition
-common
-acute eruption of typical and atypical lesions
-disseminated pattern (all over)
-not on palsm, soles of feet
-often appears after streptococcal pharyngitis |
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Term
| Pustular psoriasis (von Zumbusch's syndrome) |
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Definition
-abrupt, life-threatneing condition
-widespread pustules that coalesce to form lakes of pus
-fever
-malaise
-leukocytosis
-an ongoing sepsis: always sick until treated |
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Term
|
Definition
-mild: topical corticosteriods, topical vit D preps
-coal tar/salicylic acid: controlling scales
-severe: UVB, PUVA, methotrexate: but risk of skin cancer, cataracts, hepatotoxicity
-pustular: acitretin (retinoid), also erythroderma/arthritic psoriasis: but teratogenic
-cyclosporine but recurrence is common |
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Term
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Definition
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Term
| Pemphigus vulgaris: General characteristics |
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Definition
-bullous auto-immune disease
-IgG induce acantholysis: loss of cell:cell adhesion
-middle age adults |
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Term
| Pemphigus vulgaris: Clinical features |
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Definition
-lesions begin in oral muscosa
-skin lesions occur 6-12 months later
-pain/burning NOT ITCHY
-weakness/malaise
-lesions: round vesicle/bullae: clear liquid, easily ruptured
-randomly scattered
-fragility of blisters (Nikolsky's sign)
=therefore crusts/erosions occur
-2nd infection/fluid/electrolyte imbalance = common cause of morbidity/mortality
-variants |
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Term
|
Definition
-Immunoflorescence of serum/blister material highlights IgG
-Bx proves acantholysis |
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Term
|
Definition
-systemic therapy is required
-starts w/prednisone, then immunosuppressive agents
-Dapsone, gold, cyclophosphamide may help in refractory cases
-supportive therapies include fluid, electrolyte replacement, cleansing baths, wet dressings, topical steroids, abx |
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Term
| Bullous pemphigoid: General characteristics |
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Definition
-autoimmune disorder
-6th decade of life
-autoantibodies, complement fixation, (neutrophil, eosinophils cause bullous formation) |
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Term
| Bullous pemphigoid: Clinical features |
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Definition
-maybe a prodrome of urticarial/papular lesions
-Bullae: large, tense, oval, round
-rupture LESS easily than in pemphigus
-bullae collapse and crust, sometimes bleed
-Axillae, thighs, groin, abdomen
-continue to leak and drain themselves
-less painful/severe than pemphigus vulgaris |
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Term
|
Definition
| -Bx and immunoflorescence |
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Term
|
Definition
-high doses of presnisone until remission, then lower dose
-Azathioprine maybe added
-mild cases/localized recurrences = topical steroids |
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Term
| Acne vulgaris: General characteristics |
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Definition
-all age groups
-plugged follicles, retained sebum, bacterial overgrowth, release of FA
-androgens stimulate sebum production |
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Term
|
Definition
-key factor is genetics
-sometimes skips generations |
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Term
| Acne vulgaris: Clinical features |
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Definition
-follicular, papular, pustular lesions
-open comedones (blackheads)-melanin depoits on keratin plug
-closed comedones (whiteheads)
-can be erythematous papules, pustules, nodules, cysts
-sinus tracts occur w/nodular acne |
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Term
|
Definition
-testosterone, FSH, lutenizing homrone, dehydroepiandosterone 5
=levels can be measured
-majority of acne is non-endocrine based |
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Term
|
Definition
-mild: area clean, application of topical preps: retinoids, azelaic acid, salicylic acid
-inflamm lesions: topical benzoyl peroxide, tretoin, erthyromycin, clindamycin
-tetracyclines
-doxymycin=more often in systemic care
-bacterium in acne becoming resistant to abx/meds |
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Term
|
Definition
-Accutane (oral isotrentinoin)
-serious side effects, teratogenic, depression/suicidal thoughts
-premature closure of bones/vison changes, triglyceridemia |
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Term
| Acne rosacea: General characterstics |
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Definition
-chronic
-ages 30-50
-pilosebacous units: increased activity of caps, =flushing, telangiectasias
-episodic outbreaks
-response to heat, alcohol, hot/spicy foods, coffee/tea: bc they are hot |
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Term
| Acne rosacea: Clinical features |
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Definition
-scattered, small papulopustules, sometimes nodules
-comedones DO NOT occur
-red/flushed face
-symmetric distribution on face
-cheeks, chin, forehead, nose
-disfiguring appearance
-suffix -phyma used: rhinophyma (enlarged nose), blepharophyma (eyelid), metophyma (forehead), etc |
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Term
|
Definition
-reduce triggers: alcohol, hot drinks
-topical antifungals, sodium sulfacetamide, abx
-systemic abx: tetra, mino, doxy -cycline
-severe: isotretinoin |
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Term
| Folliculitis: General characteristics |
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Definition
-inflammation of hair follicles
-by s.aureus, also pseudemonas folliculitis = in hot tubs
-non bacterial cause: from working in hot/dirty environment
-perspiration, rubbing tight clothes
-pseudo-folliculitis: ingrown hairs occuring in beard area |
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Term
|
Definition
-inflammmation of hair follicles due to: infection or trauma
-eosinophilic thought to be result of autoimmune process |
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Term
| Folliculitis: Clinical features |
|
Definition
-lesions: erythematous papules and pustules
-not painful, may burn
-sycosis: inflamm of beard is severe! =folliculitis w/eczema and crusting
-abscesses may form |
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Term
|
Definition
-gentle cleansing/mild compresses
-topical: clindamycin, erythromycin, Mupirocin (bacroban) ointement
-oral abx
-hot tub folliculitis resolves w/o Tx (can be treated w/flouroquinolone) |
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Term
| Erythema multiforme (EM): General characteristics |
|
Definition
-induced by drugs following infections or can be idopathic (50% cases)
-50% occur in pt younger 20 yrs
-previous hx is strong risk factor |
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Term
| Erythema Multiforme: Clinical features |
|
Definition
-lesions: begin as macules, then papules, then vesicles/bullae form in center of papules
-localized to hands/feet or generalized
-mucosal lesions (HALLMARK FEATURE)
-fever, weakness, malaise |
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Term
|
Definition
-control herpes outbreak w/acyclovir
-severe: systemic steriods
-avoid target substances |
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Term
| Erythema multiforme: Pathophys |
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Definition
| -herpes-associated : represent result of cell-mediated response rnx to herpes-simplex-virus |
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Term
| Stevens-Johnson /Toxic erythema nodosa (SJS-TEN): General characteristics |
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Definition
-muco-cutaneous blistering
-most often caused: drug rnxs
-SJS: severe form of EM
-TEN: severe form of SJS
-immunologic response
-secondary infection may occur, fluid loss, electrolyte balance
=treated like they are burn pts |
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Term
|
Definition
-epidermolysis and blistering from keratinocyte apoptosis
-shedding of skin leads to death of cells |
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Term
| SJS/TEN: Clinical features |
|
Definition
-fever, photophobia, sore throat, muscosal inflamm, sore mouth
-Lesions: near trunk, painful/sting
-progression in 4 days: diffuse erythema, necrotic epidermis, sheet-like loss of skin (very easily), Nikolsky's sign
-regrowth: 3 wks
-lower layer of skin is really shiny (dermis)/putting new skin on doesn't help |
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Term
|
Definition
-Pt have anemia/lymphopenia
-Bx |
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Term
|
Definition
-withdrawl of offending agents
-intense necrosis: transfered to burn untit, fluid resuscitation
-tx for fluid/elyte balance: complicated by infection/sepsis
-tx debate: steroids, abx |
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Term
| Hidradenitis suppurativa: General characteristics |
|
Definition
-disease of apocrine gland areas: axilla, anogenital, scalp
-females btw puberty and menopause more than males (anogenital)
-predisposing factors: obesity, hx of acne, apocrine duct obstruction, bacterial infection, genetics |
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Term
| Hidradenitis suppuritiva: Clinical features |
|
Definition
-lesions: blackheads and/or pustules
-sinus tracts possible
-severe form of acne |
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Term
| Hidradenitis suppurativa: Labs |
|
Definition
| -culture for secondary infections |
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Term
| Hidradenitis suppurativa: Tx |
|
Definition
-lesions: tx with intralesional triamcinolone, incision/drainage of abcesses, excision of sinus tracts(draining systems) (take out gland in arm pit)
-abx until lesion resolve
-pednisone added if lesions are 2+ wks
-severe: anogenital esp, see psychological support |
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Term
| Furuncles and carbuncles: General characteristics |
|
Definition
-furuncles: boils/risens, most are deep-seated infections of hair follicles, s. aureus
-furuncle=infection of single follicle
-carbuncle=1+ infected follicle: as conglomerate mass |
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Term
| Furuncles and carbuncles: Clinical features |
|
Definition
-lesions: red,hard, tender in hair-bearing areas of head, neck and body
-progress to become fluctuant and rupture spontaneously, draining pus and necrotic tissue |
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Term
| Furuncles and Carbuncles: Tx |
|
Definition
-warm, moist, compresses
-abx and incision/drainage are added as appropriate once lesion is mature
-cloths for warm compresses handled carefully |
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Term
| Cellulitis: General characteristics |
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Definition
| -acute, spreading inflamm. of dermis/subcutaneous tissue |
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Term
| Cellulitis: clincial features |
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Definition
-swollen, red, hot, tender
-Pt may have lymphadenopathy, fever, chills, malaise |
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Term
|
Definition
-ID causative organism by culture, best to tx with abs that coers: H flu, strep species, and staph
-(normally its a live on skin)
-problem w/vascular system bc causes pooling
-tx w/beta lactams
-severe: wide spectrum abx
-mark areas of involement to note progression
-surgery if needed (rice krispies?) |
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Term
| Impetigo: General characteristics |
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Definition
-highly contagious
-gram positive!
-2 forms: bullous and non bullous
-s.aureus
-s.pyogenes |
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Term
| Impetigo: Clinical features |
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Definition
-non bullous: frequent, 70% children younger than 15 yrs
-non-bullous: red macule/papule, 2-5mm
-fragile vesicle/pustule, ruptures an becomes; honey-yellow crusted, smaller 2cm
-no surrounding redness
-Bullous: vesicle into bulla, w/no redness, clear liquid becomes cloudy |
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Term
|
Definition
-bacterial culture to Id: resistant form of impetigo: MRSA (methicillin-res) and if outbreak occurs
-exudate underneath crust |
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Term
|
Definition
-abx: against s.aureus/s.pyogenes
-beta lactams as empiric choice (bc MRSA =folliculitis/absecess)
-topical abx in pts w/small/few lesions |
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Term
| Erysipelas: General characteristics |
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Definition
-superficial bacterial skin infection
-common name= St. Anthony's
-used to be on face (s.pyogenes) now on legs (strep A)
-source in face cases: nasopharynx
-local factors affect: venous insuff., bites, incisions |
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Term
| Erysipelas: Clincal features |
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Definition
-Hx recent trauma/pharyngitis
-prodromal sx: malaise, chills, fever, (w/in 48hrs)
-pruritis, burning, tenderness
-small erythematous patch, progress to fiery-red, shiny plaque |
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Term
|
Definition
-unneeded in classic cases
-only culture for immunosuppressed
-ddx from cellulitis: streakyness and where its located |
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Term
|
Definition
-elevation/rest: so much edema!
-saline wet dressings
-strep causation: beta-lactam! (also cephalosporin, macrolide
-hospitlization in severe cases for close monitoring |
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Term
| Abscess: General characteristics |
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Definition
-localized infection
-collect of purulent material in cavity formed by necrosis
-sterile abscess: form w/o bacterial pathogen |
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Term
| Abscess: Clinical features |
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Definition
-tender, erythematous, fluctuant area =formation of pus
-located: axillary, butt, perirectal, head, neck
-discharge/drainage can be cx
-usually 1+ organism
-caused: injection (when alcohol is still wet, has not killed fully ) |
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Term
|
Definition
-treated w/hot soaks
-once lesion can be moved, incised and drained (WICK can be placed for healing by aiding in draining)
-abx are hardly ever given w/abscess |
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Term
| Dermatophytosis: Funal infections! |
|
Definition
-superficial fungal infection: hair, nails, skin
-3 most common: Trichophyton, MIcrosproum, Epidermophyton
-use Tinea w/area
-T.rubrum most common now |
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Term
| Dermatophytosis: Clinical features |
|
Definition
-erythematous, annular patch w/borders
-itching, stinging, burning
-maceration/peeling fissure comon btw digits
-nails have thickening discoloration
-kerion=idurated, boggy, inflamm plaque w/spustules : found w/t.capitis, INTENSE rxn |
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Term
|
Definition
| -KOH prep = presence of fungus |
|
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Term
|
Definition
-topical creams/ointments
-nail: oral ketokonazole
-fluconazole (kerions)
-NO steriods
-monitor LFTs in long term PO med use (ppl with hepatic disorders) |
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Term
| Tina versicolor: (Pityriasis versicolor): clinical features |
|
Definition
-hypo/hyper-pigmented macules : do not tan
-asymptomatic -notice in the summer, tan is spotted
-not appear contagious
-seen in people w/tanning beds
-transfer person:person (wrestlers)
-back/bra line |
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Term
|
Definition
| -KOH prep = shows hyphae/spores (spaghetti and meatballs) |
|
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Term
|
Definition
-daily applications: selenium sulfide shampoo
-oral tx w/ketoconazole
-Imidazole creams (expensive) |
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Term
| Scabies: General characteristics |
|
Definition
-infestation w/sarcoptes scabiei and 8 legged mite
-found in pt of any age, not younger than 3 months |
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Term
| Scabies: Clinical features |
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Definition
-hands, genitalia, axillary areas
-web spaces: btw fingers/toes, beltline, edges of socks
-pruritic, vesicles/nodules w/excoriations = crusting
-second infections: A streptococci |
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Term
|
Definition
-mites, eggs, feces in scrapings
-drop mineral oil before scraping
-microscopy confirms
(they can burrow in skin) |
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Term
|
Definition
-1% lindane/5% permetherin lotion/cream
-applied twice to kill twice
-antihistamines |
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Term
| Spider bites: General characteristics |
|
Definition
-most are venomous, but only a few can puncture skin
-usually while pt is sleeping
-pain w/in 3 hours, sx in 4-6 hrs
-necrotic injury: 2 wks
-black widows: neurologic overstim (muscle aches, spasms, rigidity)
-brown recluse: significant today (not blackwidow)
-infarct of skin, blood coagulation w/in vessels
-sinking macule, pale gray, inflamm.
-lesions extend to muscle as large as palm of hand
-clamps down vascular system |
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Term
|
Definition
-local care/analgesics
-neurologic manifestations: diazepam/calcium gluconate
-pts can get more aggitated benzos
-brown recluse: not debridement, antivenin is rare bc not available |
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Term
| Pediculosis: General characteristics |
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Definition
-Lice: three pairs legs, females lay 300 nits
-Pediculus humanas variety capititus: infect scalp, P. human var. corporis: infect body, Phitirus pubis: infect pubic area: CRABS!
-person:person |
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Term
| Pediculosis: Clinical features |
|
Definition
-pruritis severe
-excoriations=secondary infection
-lice are visible /difficult to find, nits can be seen on hair shafts |
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Term
|
Definition
|
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Term
|
Definition
-Prevention
-insecticides (Permethrin, pyrethrins, malathion)
-Lindane, alternative
-comb out nits, ptroleum jelly to sufficate
-reapplication to kill newly hatched lice |
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Term
| Alopecia: General characteristics |
|
Definition
-loss of hair
-male patterned baldness (Androgenic alopecia)
-Minoxidil solutions |
|
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Term
|
Definition
unknown causes
-seen in thyroiditis, pernicious anemia, Addison's disease
-tiny hairs are found, loss can be patchy, involve only the scalp/entire body (alopecia universalis)
-may respond to systemic steroids |
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Term
|
Definition
| -occur w/thallium, vit A, retinoids, antimitotic agents, anticoagulants, oral contraceptives |
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Term
|
Definition
-distal separation of the nail plate from nail bed
-common causes: excessive exposure to water, soaps, detergents, psoriasis, drugs, thyroid disease |
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Term
|
Definition
-infection w/fungi or yeast
-Tx: systemic/topical agents
-recurrence is high |
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Term
|
Definition
-infalmm. of nail fold, erythema, swelling, throbbing pain
-acute: minor trauma to fingertip, pain, tenderness, swelling
-chronic: sx lasting 6+wks, inflamm, pain, swelling, after exposure to water/moist environment |
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Term
|
Definition
-warm water soaks
-oral abx w/gram + bacteria (staph-Augmentin/clindamycin)
-it can progress to abscess, then should be drained |
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Term
|
Definition
-subcutaneous infect of pulp space /closed infection that can rupture
Tx:-abx
-then I & D to preserve venous flow
-incision of nail pad (underneath nail)
-culture drainage if MRSA
-update tetanus |
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Term
| Systemic findings of Felon |
|
Definition
-Beau's lines (transverse furrows)
-atrophy
-clubbing fingers, cyanosis
-spoon nails
-stippling/pitting
-hyperpigmentation |
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Term
| Acanthosis nigricans: General characteristics |
|
Definition
-hyperpigmentation disorder : hereditary or acquired
-associated w/:obesity, endocrine disorders, para-neoplastic syndromes, drug induced |
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Term
| Acanthosis nigricans: clinical features |
|
Definition
-skin darkens, appears dirty
-skin is thick and velvety w/accentuated skin lines
-usually back of neck/underarms |
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Term
| Acanthosis nigricans: Labs/tx |
|
Definition
-maybe underlying disorder/can test this
-no tx |
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Term
|
Definition
-hyperpigmentation disorder of sun-exposed areas
-maybe associated w/pregnancy/oral contraceptives/meds |
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Term
| Melasma: clinical features |
|
Definition
-young adults
-hyperpigmented macular areas: over several weeks
-color usually uniform |
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Term
|
Definition
-Wood's lamp exam: uv light on skin to ID hyperpigmented macule
-tx: 3% hydroquinone soln w/0.025% tretinoin gel, hydroquinone/glycolic cream
-sun block!! |
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Term
|
Definition
-destruction of melanocytes w/thyroid dz, anemia, DM, addison's dz
-30% FHx
-TX: sunscreens, cosmetic cover up, regpigmentation therapy
-counseling |
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Term
| Angioedema/urticaria: General |
|
Definition
-urticaria=disorders most commonly caused by food/drug allergies/head/cold
-hives/wheals
-wheals=size of pencil eraser to size of dinner plate
-itchy and sting/burn |
|
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Term
|
Definition
-maybe self-limiting, minutes-hours
-allergic rx to food/drugs
-IgE attaches to mast cellcauses release of histamine,etc |
|
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Term
|
Definition
-6+ wks
-wax/wane lesions
-maybe by stress
-females 2x more affected than males
-rxn to cold, water, infection, exercise, sun |
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Term
|
Definition
-cause eliminated
-antihistamines
-chronic: H2 blockers added to H1
-maybe addition of steroids
-progress to anaphylaxis? epipen given. |
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Term
|
Definition
-caused by HPV
-HPV replicates in cutaneous/growth is local
-flat/superficial
-plantar warts= deeper, heads of cauliflower
-oral cavity/larynx: life threatening if block airway
-anogenital warts occur external genitalia/perianal area
-cervical warts: risk for dysplasia-progress to cervical cancer |
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Term
|
Definition
-microscope show: hyperplasia/hyperkeratosis, Koilocytotic cells
-presence of HPV confirms
-Immunofluorescence: probes can detect HPV in cervical tissue |
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Term
|
Definition
-regression is typical
-type, location, age predict tx
-salicylic acid plasters: common warts
-cryosurgery/electrodessication effective, but can scar
-Imiquod = genital
-Intralesional interferon
-trichloroacetic acid =genital
-surgical excision, recurrence is common
-vaccine again 4 strains |
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