Encapsulated, semisolid or fluid-filled mass in dermis or sub-q tissues (i.e. sebaceous cyst). A spherical or oval papule or nodule may be a cyst if, when palpated, is resilient (feels like an eyeball)
small <1cm superficail circumscribed elevation. Serous or blood-tinged fluid (i.e. chicken pox, herpes, poison ivy/oak, dermatitis, blisters, second degree burns)
vesicle >1cm. fluid filled bleb, blister (i.e. second degree burn)
vesicle filled w/ puss (cloudy or purulent fluid, WBC) may or may not be infected (i.e. acne, impetigo, folliculitis)
round or flat topped and irregular shape evanescent (shiny) lesions. Form acute accumulation or edema fluid in upper dermis (i.e. mosquito/insect bites, allergic reaction)
solid, circumscribed, elevated, round or ellipsoid, located deep in dermis or sub-q (i.e. dermatofibroma)
Define Secondary skin lesions
changes from alteration in primary lesions (i.e. rubbing, scratching, medication, invoultion)
Secondary skin lesion: scales are flakes of dead, cornified (hard/firm) tissue being shed. Theyare dry and ususlly white. (i.e. psoriasis, ringworm, peeling sunburn). Scales usually indicate inflammatory change and thikening of the epidermis.
Secondary skin lestion: Crust: dried mass of serum, pus, dead skin, debris (broken vesicles or pustules)
Crusts can be found surrmounting any lesion, i.e. eczema
-other infectious dermatitis
What color characteristics will Crusts have?
yellow if from serum, green or yellow-green if from pus, brown or dark red if formed from blood
Crusts are characteristic of what kind of infection?
Irregular shaped excavation (depth) caused by loss of substance w/ gradual disintergration and necrosis of tissue (i.e. decubiti, stage 3 pressure sore).
Ulcers usually result from the impairment of vascullar and nutrient supply to the skin.
Deep linear split through epidermis into dermis, (i.e. chapping, athlete's foot). Fissures usually result when something/somewhere is moist and you add and infection to the area and it never gets dry= hard to heal
permanent dermal changes w/ production of excess collagen following damage to corium (i.e. vaccination, burn, deep scratch, cut, incision). A scar is the replacement of normal tissue by fibrous connective tissue at the site of injury to the dermis.
What are the majority of bacterial infections in the skin caused by?
staphylococcus or streptococcus
What is follicultitis?
a superficial staph infection of the upper hair follicle
What are Furuncles
boils caused by staph that are deep in the hair follicle
What are predisposing factors to Furuncles?
*contact w/ oils, uncleanliness, maceration (skin area left wet)
-common on face, neck, arms, legs, groin
-Tx: warm compress (reduces inflammation and allows it to rupture)
-ruptures: yellow purulent discharge (puss), then to serosanguinous fluid after hours/days
-surgical Tx: incision and drainage (can also use topical AB, but first you need it to rupture)
generalized nonfollicular infection- either staph or strep of deeper connective tissue.
-teach pt. to bathe daily w/ antibacterial soap
-allow to dry in-between Tx
-position to promote circulation
-teach to avoid tight garments
-strict iso for MRSA (perform C&S to see if MRSA)
-do not share contaminated articles
-Tx: warm compress to incr. circulation and decr. swelling
Rx for cellulitis
Usually topical cream is enough to treat cellulitis, but you may need po or iv AB
-providoine-iodine and cream (i.e. silver sulfadiazine)
-anti-inflammatory steroid Rx low to high doses
-if severe po or IV AB necessary
Define Impetigo Contagiosa
(superficail bacterial infection)
-due to staph, strep, or both
-begins as discolored spots then vesicles or bullae taht rupture leaving a superficail moist erosion and that germ laden fluid spreads to surrounding skin.
-exudate dries and forms heavy, honey-colored crust and scabs
-most often on face, hands, perineum
What is the Tx for Impetigo?
-bacterial ointment topically, systemic if severe.
-explain disease and Tx, hand washing esp.
-soak crusts w/ warm water and remove crust carefully in order to get to the lesion, then apply AB ointment
Define FUNGAL infections
Many affect sperficail skin and are fast multiplying.
"tinea" = fungal infection
-tenia pedis: athletes foot:
maceration and fussures between toes, pinhead-size vesicles in the plantar area and pruritis
-tinea manus: hands
-tinea cruris: groin (jock itch)
sx: scaly, circumscribed patches, bald spots, itching