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What is an age associated cause of dryness, and puritus(itching)
The production of sebum by the sebacous glands decrease with age
What type of skin leasion would you find in the older patient?
- Lentigines : Pigmented spots on sun-exposed areas (commonly calle liver - spots)
- Senile Purpura: large purplish bruises that resolve verry slowly.
- Senile angiomas: Bright red papules
- Acrochordons: (skin tags) small soft raised leasions
how can a good functional assesment aid in a skin assesment?
a functional assesment can provide imporntant clues to skin problems. (past and present occuations, exposure to irritants and other irritants, skin care habits, stressors, resent changes)
Distinct flat area with color different from surrounding tissue ( Freckle, Petechiae, Hypopigmentation)
Any raised, solid leision with clearly defined margins; <1 cm in diameter (Mole, Wart)
raised, fluid filled cavity, <1 cm in dimeter (Herpes Simplex, Herpes Zoster)
Raised, well-defined cavity, that contains pus (Acne, Impentigo)
Macule >1 cm (Vitiligo)
Combined papules that form a raised area, >1 cm in diameter (Psoriasis)
Raised, solid leasion >1 cm in diameter; may be hard or soft, and may extend deeper into the surface than papule (Fibroma, xanthoma)
Superficial, irregular swelling caused by fluid accumulation. (allergic response, insect bite)
Frim or soft lesion that extends deep into dermis, may be firm or soft (Lipoma, hemangioma)
Thin-walled, fluid filled chamber, >1 cm in diameter.
Thick, dried exudate remaining after vesicle rupture (impatigo, weeping escmatous dermatitus)
Dry greasy skin flakes (Psoriasis, seborrehic dermatitis,esczema)
Distinct linear crack extending into dermis (Cheilosis, tinea pedis)
Shallow, superficial depression (Impentigo, herpes zoster, or herpes simplex leision after vesicle rupture)
Depression deeper than erosion, may bleed (Preassure ulcer, chancre)
Abrasion caused by scratching (Scratching with insect bites, scabies, dermatitus)
Flat or raised, color darker than surrounding skin (mole)
Fluid-filled cavity in dermis or subcutaneous tissue (sebacious cyst)
What is a Potassium hydroxide (KOH) examination
done to diagnose fugal infection of the skin, hair, or nails by studying a skin specimin.For a culture, the skin scraping or a nail clipping is implanted in medium
What is a Tzanck smear
used to diagnose viral skin infections
What is a scabies scraping
used to detect scabies (mites), eggs or feces excreted buy mites
What is a wood's light examination?
a black light is used to asess for pigmentation changes and superficial skin infections. can also be used to examine the vulva after a sexual assult because it may reveal traces of saliva or semen.
What are the four tupes of byopsy?
- Shave biopsy: a specimine no deeper than dermis is obtained with a scalple
- Punch Biopsy: A circular tool cuts around a leision, which is then lifted up and severed.
- Incisioal biopsy, a wedge of tissue is removed from the incision
- Excisional biopsy for deep specimines, The entire leisipon is remved
- A type of Esczema. has three stages,
- Acute:charecterized by, red oozing, crusty rash and puritus.
- Subacute Stage: redness excoriation, and scaling plaques and pustules. fine scales may give the patients skin a silvery appearaence.
- Chronic Stage: the skin becomes dry, thickened, scaly, and brownish grey.open leisions, scaring.
What can be done to help with comfort for Atopic dermatitis
- Topical corticosteroids: provide the best control of inflamation, -- But can cause skin inflamation, and skin atrophy. loss of pigmentaion and red leisions
- Soaks, Occlusive dressings and emolients help keep skin moist.
- Systemic antihistamine agents are ordered to relieve itching and inflamation
What should the nurse teach the family of a patient with atopic dermatitis?
Dermatitis is not contagious and is not caused by poor hygiene
What is Contact Dermatitis?
an inflammatory condition with a substance that triggers and allergic response
What is Cevorrheic Dermatitis?
- A chronic inflammatory disease of the skin it usually affects the scalp, eyebrows, eyelids, lips, ears, sternal area, axillae, umbilicus, groin, gluteal crease and area under breasts
- cevorrheic dermatitis of the scalp is commonly called dandruff
signs and symptoms of cevorrheic dermatitis
- areas affected may have fine powedery scales, thick crusts or oily patches
- scales may be white, yellowish or reddis
- pruritis is common
medical treatment of cevorrheic dermatitis
- topical ketoconazole (Nizoral)
- sometimes with topical corticosteroid agents
- dandruff is treated with medical shampoos two or three times per week
what is psoriasis
what are the signs and symptoms
what should a patient report
- an inflammatory disorder characterized by abnormal poliferation of skin cells
- signs and symptoms are appearance of bright red lessions that are covered with silvery scales
- the patient should report signs of secondary infections, such as fever, purulent discharge, or increased redness to the physician
what is intertrigo
what type of environment contributes to intertrigo
- inflammation of the skin where two surfaces touch such as axillae, abdominal folds, and area under breasts. the infected area is usually red and weeping with clear margins and may be surrounded by vesicles and pustules. caused by candida albacans, or yeast
- moisture between two touching body surfacces
- intertrigo is very common in patients in long term care facilities
what is acne
- acne is a skin condition that affects hair follicles and sebaceous glands
- charagterized by comedones (white heads and black heads), pustules and cysts
what medications are used to treat acne
mild cases, topical microbial agnets or retinoid agents, azelic acid (Azelex), benzoyl peroxide, if these don't adequately control the acne, the oral antibiotics like tetracycline, azithromycin, or erythromycin. estrogens will also be use to counteract the androgenic hormones.
what is herpes simplex
- causes an infection that begins with itching and burning then forms vesicles that rupture and form crusts most often affectin nose, lips, ears, cheeks and genitalia
- oral HSV lesions are commonly called cold sores or fever blisters
- HSV of the face usually caused by HSV-1 and genital infections are usually cansed by HSV-2, however they are interchangable
what patient teaching should be done with HSV(herpes simplex virus)
- the condition is contagious and tends to reoccur
- sexual contact should be documented so those persons can be advised of the need for medical evaluation
what is herpes zoster
- commonly called shingles also causes chicken pox
- in some people who have had chicken pox, the virus remains latent in nerve tissue until the infection is activated in the form of shingles
- S/S; pain, itching and hightened sensitivity along the nerve pathway followed by vesicles in the area
- the lesions typically last two weeks and are contagious to those who haven't had previous exposure
what is necrotizing fasciitis
- an infection of the deep fascial structures under the skin
- aerobic and anaerobic organisms may be present including streptococcus, staphylococcus, and peptostreptococcus and bacteroids and clostridium
- the organisms secrete enzyms that destroy the tissue including the blood vessels that supply the area
- this infection should be suspected when the patient has a small external wound with evidence of a larger underlying infection
what conditions are treated with plastic surgery
aesthetic surgical procedures are performed to improved appearance whereas reconstructive procedures are done to correct abnormalities
patient teaching that needs to be given before plastic surgery is performed
teaching for self-care.