Term
|
Definition
| the interface between an organism and its environment |
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|
Term
| What are the roles of skin? |
|
Definition
Fluid balance
Temperature regulation
Barrier against invading microbes and toxins
Fat storage and insulation
Tactile sensation |
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|
Term
| What are you looking for when assessing the skin? |
|
Definition
Color, integrity, and characteristics
Gestational age, nutritional status, functioning of organ systems, and the presence of cutaneous or systemic disease |
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Term
| Which aspect of assessment identifies most skin variations? |
|
Definition
|
|
Term
| What does palpation determine? |
|
Definition
| thickness, turgor and consistency |
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Term
| What are the basic functions of the skin? |
|
Definition
Physical and immunologic protection
Heat regulation
Sense perception
Self cleaning |
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Term
| What are the 3 basic layers? |
|
Definition
Epidermis
Dermis
Subcutaneous layer |
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|
Term
| What is the outermost layer of the skin? |
|
Definition
|
|
Term
| What are the layers of the epidermis? |
|
Definition
TOP
Corneum
Lucidum
Granulosum
Spinosum
Basale |
|
|
Term
| What is the fxn of the epidermis? |
|
Definition
Barrier
Preventing penetrations and absorption of potential toxins and micro-organisms
Retaining water, heat, and other substances |
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Term
| What is the source for the renewal of the epidermis? |
|
Definition
Basal cell layer
located near the junction of the epidermis and dermis and is source of renewal for the epidermis. Is constantly dividing and growing new Keratinocytes. Basal cell present in hair follicles and sweat glands |
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Term
| What types of cells make up the epidermis? |
|
Definition
| Keratinized Stratified squamous epithelium |
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Term
|
Definition
|
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Term
|
Definition
| Produce melanin. Transferred to other cells with long cell processes (8%) |
|
|
Term
| What are langerhan cells? |
|
Definition
| Form bone marrow/provide immunity |
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Term
|
Definition
|
|
Term
| What is the stratum corneum? |
|
Definition
| Outermost layer of cells forming the epidermal barrier (0.05-0.1mm thick) |
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Term
| When is maturation of the s. corneum accelerated? |
|
Definition
| Preterm infants (10-14 days) |
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|
Term
| What happens at less than 27 weeks? |
|
Definition
| Water loss is double that of an adult at 28 days |
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|
Term
| When does adult maturation occur? |
|
Definition
| 30-32 weeks post conceptual age |
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Term
|
Definition
| Lies directly under the epidermis |
|
|
Term
| What does the dermis consist of? |
|
Definition
Fibrous and elastic tissues (more fragile in preterm skin)
Sweat glands (not fully functioning until 2-3 years of life)
Sebaceous glands and hair shafts
Contains blood vessels and nerves |
|
|
Term
| What does the subcutaneous layer of fat serve as? |
|
Definition
Insulation
Protection for internal organs
Calorie storage |
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Term
|
Definition
| An acute injury progresses to healing within two weeks. |
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|
Term
| How does an acute wound become a chronic one? |
|
Definition
However, when the patient has underlying medical issues, acute wounds can fail to heal in a timely fashion and become a chronic wound.
INFECTION |
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Term
|
Definition
| Chronic wounds may lack adequate blood supply and sufficient oxygen for normal wound healing. Constant localized pressure over a weight-bearing surface tends to compress both venous and arterial vessels, decreasing nutrition and oxygenation of the tissues, resulting in tissue breakdown. |
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Term
|
Definition
| A vesicle containing fluid > than 1 cm in diameter |
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Term
|
Definition
| Dried serous exudate, blood, or pus |
|
|
Term
|
Definition
| Raised, palpable lesion with fluid or semisolid filled sac |
|
|
Term
|
Definition
| Large subepidermal hemorrhage that does not blanch |
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|
Term
|
Definition
|
|
Term
|
Definition
| Discolored, flat spot less than 1 cm |
|
|
Term
|
Definition
| Elevated, palpable lesion with indistinct borders |
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|
Term
|
Definition
| Elevated palpable lesion that is SOLID and circumscribed and less than 1 cm |
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|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Elevated, palpable, circumscribed borders, > than 1 cm |
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|
Term
|
Definition
| Larger than petechia, 1-3 cm |
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|
Term
|
Definition
| Elevation filled with cloudy or purulent fluid |
|
|
Term
|
Definition
| Exfoliation caused by excess keratin |
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|
Term
|
Definition
| Elevation, filled with serous fluid that is less than 1 cm in diameter (blister) |
|
|
Term
|
Definition
| Fluid collection that is RED and SOLID |
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|
Term
| When inspecting/palpating the skin, what should be noted? |
|
Definition
Color
Moisture
Temperature
Texture and creasing
Mobility and turgor |
|
|
Term
| What should you note when looking at a skin lesion? |
|
Definition
Measurements in all dimensions
Configuration
Elevation or depression
Palpable characteristics (or absence)
Color
Location(s) on body
Patten of distribution |
|
|
Term
| When inspecting the nails, what should be noted? |
|
Definition
|
|
Term
| When inspecting the hair, what should be noted? |
|
Definition
| Color, distribution, pattern of growth, texture, unusual concentration |
|
|
Term
| What is the lesion associated with lupus? |
|
Definition
|
|
Term
|
Definition
| Serious multisystem disease involves connective tissue and blood vessels. Clinical manifestations include fever, skin lesions, arthritis, renal, cardiac, and pulmonary disease. Lesions may appear in “butterfly” pattern to face. Well-demarcated regions. |
|
|
Term
| What is used to treat lupus? |
|
Definition
| Prednisone is used for treatment of systemic symptoms. Chloroquine sulfate or other antimalarials are sometimes useful in the treatment of skin lesions, but do not reduce the need for prednisone |
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|
Term
|
Definition
| harmless color change in a newborn baby. The condition causes one half of the body to turn dark red, and the other half to turn very pale. |
|
|
Term
| What are cafe-au-lait spots? |
|
Definition
Hyperpigmented lesions that vary in color from light brown to dark brown. Means coffee with milk.
Usually the earliest manifestations of neurofibromatosis.
Does not require medical treatment unless treating the underlying problem. |
|
|
Term
|
Definition
White or lighter patches of skin that may appear anywhere on the body and are caused by a lack of melanin.
Hypomelanic macules. |
|
|
Term
| What are vascular stains? |
|
Definition
| Vascular stains are extremely common lesions that represent superficial dilated blood vessels. They are considered transient lesions, although in some people they are permanent |
|
|
Term
|
Definition
| The pink patches in the middle of the forehead and over the left eye or on the nape of the neck are salmon patches. Also known as nevus simplex or "angel kisses", these are a common capillary malformations that are present at birth. |
|
|
Term
| What is a port wine stain? |
|
Definition
A port-wine stain is a birthmark in which swollen blood vessels create a reddish-purplish discoloration of the skin.
Mostly occurs on the face, darkens with age |
|
|
Term
|
Definition
| When a newborn infant is exposed to low environmental temperatures, an evanescent, lacy, reticulated red and/or blue cutaneous vascular pattern appears over most of the body surface. This vascular change represents an accentuated physiologic vasomotor response that disappears with increasing age, although it is sometimes discernible even in older children. |
|
|
Term
| What is purpura fulminates? |
|
Definition
| a haemorrhagic condition usually associated with sepsis or previous infection, it is the cutaneous manifestation of disseminated intravascular coagulation. Occurs mainly in babies and small children, but there are also rare cases reported among adults. |
|
|
Term
| What is a pressure ulcer? |
|
Definition
| known as a decubitus ulcer, pressure ulcers are open wounds that form whenever prolonged pressure is applied to skin covering bony outcrops of the body. Patients who are bedridden are at risk of developing pressure ulcers. Pressure ulcers are commonly known as bedsores. |
|
|
Term
| What is a stage 1 pressure ulcer? |
|
Definition
| Reddened area of skin. Nonblanchable when pressed. |
|
|
Term
| What is a stage 2 pressure ulcer? |
|
Definition
| Reddness w/ superficial disruption of skin like abrasions or vesiculation |
|
|
Term
| What is a stage 3 pressure ulcer? |
|
Definition
| Full-thickness loss of skin with serosanguineous drainage |
|
|
Term
| What is stage 4 pressure ulcer? |
|
Definition
| Full-thickness loss of skin and invasion of deeper tissue (muscle/bone) |
|
|
Term
| What is an unstagable pressure ulcer? |
|
Definition
| Slough/eschar in the wound bed preventing you from staging it |
|
|
Term
| What does partial thickness mean? |
|
Definition
| wounds extend through the epidermis into the dermis. |
|
|
Term
| What does superficial mean? |
|
Definition
| Superficial wounds involve only the epidermal layer of skin |
|
|
Term
| What does full-thickness mean? |
|
Definition
wounds extend into the subcutaneous tissue and beyond.
Penetrating is a descriptor sometimes added to indicate that the wound
includes internal organs. |
|
|
Term
| What is Acanthosis Nigricans? |
|
Definition
| Diffuse velvety thickening & hyperpigmentation of the skin. Most often the axilla, other body folds |
|
|
Term
| What is a. nigricans associated with? |
|
Definition
| factors of heredity, obesity, endocrine disorders (metabolic syndrome), drug administration (Nicotinic acid), and malignancy (adenocarcinoma, lymphoma) |
|
|
Term
| What is the treatment of a. nigricans? |
|
Definition
| None. May resolve with resolution of causative agents or weight loss. |
|
|
Term
| What is allergic contact dermatitis? |
|
Definition
| Skin becomes red, sore, or inflamed after direct contact (type IV hypersensitivity) with a substance. T cells and release of lymphokines cause cytotoxicity. It is not contagious or life threatening. |
|
|
Term
| What treats allergic contact dermatitis? |
|
Definition
Anti-itch cream
Wet-compresses
Oral predisone
Corticosteroid cream |
|
|
Term
| What is atopic dermatitis? |
|
Definition
| Acute, subacute, usually chronic pruritic inflammation of the epidermis and dermis occurring in association of personal or family history of hay fever, asthma, rhinitis, or Atopic dermatitis Type I hypersensitivity rxn as a result of mast cells and basophils that have been released. |
|
|
Term
| What treats atopic dermatitis? |
|
Definition
| . Treatment with antihistamines to decrease scratching and secondary infection. Topical corticosteroids are the mainstay of treatment. Occasional systemic steroids may be needed |
|
|
Term
| What is basal cell carcinoma? |
|
Definition
| Most common type of skin cancer. Rarely metastasizes but may invade deeply (especially in the “danger zones” near eyes, nasolabial folds, ear canal, and in posterior auricular sulcus. Caused by sun exposure and or other radiation exposure |
|
|
Term
| What kind of lesion is associated with b.c. carcinoma? |
|
Definition
| papule or nodule. May appear “pearly” with a rolled edge. Fine telangiectasia may be seen. Variable colors |
|
|
Term
| How do you treat b.c. carcinoma? |
|
Definition
| Treatment involves excision with primary closure, skin flaps, or grafts. Lesions in the danger zone should be removed via Mohs surgery. Radiation may be used in cases where severe disfigurement may occur with surgery |
|
|
Term
| What is the second most common skin cancer? |
|
Definition
|
|
Term
| What is malignant melanoma? |
|
Definition
| Lethal form of skin cancer that develops from melanocytes |
|
|
Term
|
Definition
Neoplasm of the endothelium and epithelial layer of the skin caused by Kaposi sarcoma herpes virus 8
Commonly associated with human immunodeficiency virus (HIV) infection |
|
|
Term
|
Definition
Superficial mycotic infection occurring on moist cutaneous sites and mucosal surfaces. Patients may have altered immunity from moisture at site of infection, diabetes, antibiotic therapy, or alteration in systemic immunity.
Caused by C. Albicans |
|
|
Term
| What sites are affected by candidiasis? |
|
Definition
| mucosa, vulvovaginitis, diaper candidiasis, intertriginous, follicular, and chronic cutaneous candidiasis |
|
|
Term
| How is candidiasis treated? |
|
Definition
| topical or systemic treatment with antifungal creams/tablets. Prevention includes procedures to avoid constant skin contact with moisture |
|
|
Term
| What is Erythema Multiforme? |
|
Definition
| Reaction pattern of blood vessels in the dermis with secondary epidermal changes with characteristic erythematous iris-shaped papules and vesicobullous lesions. Typically involves with palms, soles, and mucous membranes. May be pruritic or painful |
|
|
Term
| How is Erythema Multiforme treated? |
|
Definition
| If severely ill, doses of prednisone (50-80 mg/day). Control of Herpes Simplex outbreaks using oral Acyclovir may prevent development of recurrent erythema multiforme |
|
|
Term
| What is Granuloma Annulare? |
|
Definition
| Self-limited chronic inflammation of the dermis that exhibits papules in an annular arrangement |
|
|
Term
| How is Granuloma Annulare treated? |
|
Definition
| intralesional triamcinolone acetonide 3.0 mg/ml or topical corticosteroids with occlusion may be useful. May recur. |
|
|
Term
|
Definition
| Cutaneous infection caused by HSV 1 and 2 virus types. Type 1 usually occurs above the waist/Type 2 below the waist. Lesions to mucous membranes are first umbilicated and then evolve into punched-out lesions. Secondary infections with Staph aureus are common. |
|
|
Term
| How is herpes simplex treated? |
|
Definition
| Treatment with acyclovir 200 mg 5x daily for 5-10 days. Treat staph infections with sensitive antibiotics. |
|
|
Term
|
Definition
Acute localized infection caused by varicella-zoster virus (VZV) and is characterized by unilateral pain and vesicular or bullous eruption limited to a dermatome innervated by a corresponding sensor ganglion.
SHINGLES |
|
|
Term
|
Definition
| high dose Acyclovir (800 mg 5x daily for 10 days) hastens healing of acute lesion. The risk of postherpetic neuralgia in patients over 60 years old is >50%. Dissemination may occur, and motor paralysis may occur if the virus involves the cranial nerves. |
|
|
Term
|
Definition
| An acute purulent infection which is at first vesicular and later crusted-a very superficial infection of the skin affecting mostly young children and young adults. |
|
|
Term
|
Definition
| Treatment with Bactroban ointment. Systemic antibiotic therapy may be necessary with sensitive antibiotics if extensive lesions are present. |
|
|
Term
|
Definition
Self-healing, rapidly developing epithelial neoplasm that mimics squamous cell carcinoma. May grow to 2.5 cm diameter in six weeks.
Caused by HPV |
|
|
Term
| How is keratocanthoma treated? |
|
Definition
| Spontaneous regression in 2-6 months, sometimes 1 year. No specific treatment. May result in disfiguring scar. May need to biopsy-as lesion can mimic squamous cell carcinoma. |
|
|
Term
| What is nodular type malignant melanoma? |
|
Definition
| One type of primary melanoma that arises quite rapidly (4 mos to 2 years) from normal skin or a melanotic nevus. 15-30% of melanoma in the US. Family history, light skin color, excessive sun exposure, history of melanocytic nevus important. |
|
|
Term
| Where does malignant melanoma occur most frequently in both sexes |
|
Definition
| Appear on upper back in males, lower legs in females, and other sites |
|
|
Term
| How is malignant melanoma treated? |
|
Definition
Excisional or punch biopsy acceptable
. Nodal biopsy only needed if >1.7 mm thickness or suspicion of node involvement. Skin grafts may be needed for large areas |
|
|
Term
| What is molluscum contagiosom? |
|
Definition
| Discrete, umbilicated, pearly-white papules caused by a poxvirus and occur in both children and adults that develop over 2-3 months. Not symptomatic |
|
|
Term
| How is molluscum contagiosum treated? |
|
Definition
| Usually spontaneous remission. May use curettage, liquid nitrogen, or light electrocautery |
|
|
Term
|
Definition
| Dermatophyte infection of the nail plate. The term onychomycosis includes infections caused by both fungus and yeasts.May occur due to reduction in blood flow with age or peripheral nerve injury. Mechanical pressure by footwear can also cause injury and increase susceptibility of nail keratin to dermatophytic infections. |
|
|
Term
| How is onchychomycosis treated? |
|
Definition
| Oral antifungals such as Terbinafine 250 mg 1x daily for 6-12 weeks or Sporanox 200mg 2x daily for 1 week and then 3 weeks off, then retreat x1 week. Need to watch liver functions. |
|
|
Term
|
Definition
| Infestation of the scalp by the head louse. It feeds on the scalp and neck, and deposits eggs on the hair. Minimal symptoms |
|
|
Term
| What is the treatment for head lice? |
|
Definition
| Treatment with Permethrin 1% cream. Apply to scalp after washing hair. Leave on scalp x 10 minutes, rinse. Remove nits with fine tooth comb. Repeat after 7 days if living lice still present. Wash/dry-clean clothes/bedding as appropriate. |
|
|
Term
| What is pityriasis rosea? |
|
Definition
| Exanthematous, maculopapular, red, scaling eruption that occurs mainly on the trunk. Causes pruritis for some-may be severe. |
|
|
Term
|
Definition
| Regression is usually spontaneous. May use UVB treatments, antihistamines for pruritis. |
|
|
Term
|
Definition
| Psoriasis affects 1.5-2% of the population of western countries. Hereditary skin disorder causing chronic scaling papules and plaques in a characteristic distribution. Pruritis is common. Papules and plaques with silvery-white scale. Pustules may be present. |
|
|
Term
| How do you treat psoriasis? |
|
Definition
| Discourage scratching as this accelerates the proliferative process. Treat with topical agents. Use the lowest potency formulation for the shortest length of time. Phototherapy and systemic corticosteroids may be needed for widespread lesions. |
|
|
Term
|
Definition
| Skin infestation by a mite. Usually spread by skin-to-skin contact and causes intractable pruritis with frequent secondary bacterial infection. Misdiagnosed scabies is what the term “seven year itch” is based on. |
|
|
Term
| How do you treat scabies? |
|
Definition
| Permethrin 5% cream applied to entire body and then rinsed after 8-12 hours. Eurax may be used in pregnancy. Treat entire family, and wash all clothes and linens. |
|
|
Term
| What is squamous cell carcinoma? |
|
Definition
| Malignant tumor of epithelial keratinocytes. Arises as a result of exogenous carcinogens (sunlight exposure, exposure to ionizing radiation, & other causes). Persons who work outdoors and have fair skin at higher risk. |
|
|
Term
| How is s.c. carcinoma treated? |
|
Definition
| Treatment involves wide excision. SCC has an overall remission rate after therapy of 90%. Lesions from ionizing radiation or in an old burn scar are more likely to metastasize. Low rate of metastasis overall. Patients outdoors often need to use sunscreen with high SPF and protective clothing. Avoid tanning beds. |
|
|
Term
|
Definition
| Dermatophytic infection of the scalp. Acute infection characterized by follicular inflammation with painful, boggy nodules which drain pus and result in scarring alopecia. Scaling alopecia is seen in chronic infection. Lymphadenopathy may be seen |
|
|
Term
| How do you tinea capitis? |
|
Definition
| Treatment with Griseofulvin orally for 1-2 months usually needed. Watch liver functions if on drug for several months. Infection may recur. |
|
|
Term
|
Definition
| Scaling papular lesions occur in an annular arrangement with peripheral enlargement and central clearing on the trunk, limbs, or face. Commonly known as “ringworm”. |
|
|
Term
| How do you treat tinea corporis> |
|
Definition
| Treatment with topical antifungal creams 2x daily for 7- 10 days. If extensive lesions, may need Griseofulvin |
|
|
Term
|
Definition
Highly contagious primary infection characterized by successive crops of pruritic vesicles which evolve to pustules, crusts, and at times scars. Mild constitutional symptoms. Known as “Chickenpox”.
Caused by Varicella Zoster virus |
|
|
Term
| How is varciella treated? |
|
Definition
| Varicella vaccine given routinely now-required for school admission. Treatment is usually symptomatic. Adults may require treatment with Acyclovir 800 mg 4x daily for 5 days within 24 hours of illness. May give VZIG to immunocompromised patients if exposed to VZV. |
|
|
Term
| What is verruca vulgaris? |
|
Definition
A discrete benign epithelial hyperplasia manifested by papules and plaques caused by viral infection.
Caused by human wart viruses of the papova group, HPV |
|
|
Term
| How do you treat verruca vulgarism? |
|
Definition
| salicylic acid, liquid nitrogen, curettage with local anesthesia, or laser surgery |
|
|
Term
|
Definition
| blemishes on the skin associated with aging and exposure to ultraviolet radiation from the sun. ...in elderly there is an increased loss of elastin and a decrease in subcutaneous fat in the elderly |
|
|
Term
|
Definition
| Silvadene acts on the cell membrane and wall by eliminating any existing bacteria. Additionally, it helps by inhibiting infectivity and other forms of bacterial and fungal growth bacterial growth so they can't spread to other areas of the skin or infiltrate the blood |
|
|
Term
| What are the antibiotic ointments? |
|
Definition
bacitracin
triple antibiotic ointment is
(polymixin B,neomycin, bacitracin)
gentamicin
Mupirocin
Bactroban |
|
|
Term
| Which antibiotic is active towards gram-neg bacteria? |
|
Definition
|
|
Term
| Which antibiotic ointment is towards gram-pos bacteria? |
|
Definition
|
|
Term
|
Definition
.Gentamicin works by stopping the growth of certain bacteria. It belongs to a class of drugs known as aminoglycoside antibiotics.
Gentamicin is used to treat minor skin infections (such as impetigo, folliculitis) or minor infections related to some skin conditions (such as eczema, psoriasis, minor burns/cuts/wounds
This antibiotic only treats bacterial infections. It will not work for virus or fungus infections. |
|
|
Term
| What is used to treat yeast infections? |
|
Definition
| Ciclopirox, econazole, ketoconazole, and oxiconazole (ZOLE) |
|
|
Term
| What is used to treat acne? |
|
Definition
Adapalene
Azelaic Acid
Benzoyl peroxide
Clindamycin
Dapsone
Erythromycin
Oral antibiotics
Isotretinoin (Accutane) |
|
|
Term
|
Definition
| , isotretinoin is a derivative of vitamin A taken in pill form for 15-20 weeks. Doctors normally prescribe it for people with "severe nodular acne" that does not respond to other treatments. Nodules are inflammatory lesions with a diameter of 5mm or more. A single course of 15-20 weeks has been shown to result in complete clearing and long-term remission of acne in many people. Reduces the amount of oil produced by the oil glands. |
|
|
Term
| What is the risk when taking accutane? |
|
Definition
| THERE IS AN EXTREMELY HIGH RISK THAT A DEFORMED INFANT CAN RESULT IF PREGNANCY OCCURS WHILE TAKING ACCUTANE IN ANY AMOUNT AND EVEN FOR SHORT PERIODS OF TIME. |
|
|
Term
| What is used to treat psoriasis? |
|
Definition
Corticosteroids
Vitamin D analogues
Tazorac (tazarotene) and other retinoids |
|
|
Term
| What is a kerotolytic agent? |
|
Definition
Keratolytics represent a class of therapeutic compounds characterized by the capability of decreasing cell-to-cell cohesion in the stratum corneum and, therefore, promoting the physiologic shedding process.
SALICYLIC ACID |
|
|
Term
| What are the treatments for fungal infections? |
|
Definition
Ciclopirox
Econazole
Ketoconazole
Oxlconazole
Clotrimazole
Miconazole
ZOLE |
|
|
Term
| What are topical meds used for inflammation? |
|
Definition
| diclofenac, ibuprofen, ketoprofen, piroxicam |
|
|
Term
| What is hydrocortisone cream? |
|
Definition
| This medication is used to treat a variety of skin conditions (e.g., insect bites, poison oak/ivy, eczema, dermatitis, allergies, rash, itching of the outer female genitals, anal itching). Hydrocortisone reduces the swelling, itching, and redness that can occur in these types of conditions. This medication is a mild corticosteroid. |
|
|
Term
| When should hydrocortisone cream not be used? |
|
Definition
Do not use if there is an infection or sore in the area to be treated. Skin infections can become worse when this medication is used.
Children may be more sensitive to the effects of too much corticosteroid medication. |
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