Skin Flashcards

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ml3923
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76382
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Skin Flashcards
Updated:
2011-03-31 02:52:41
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Skin
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Dr. Tuck Exam 3
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  1. Allergic Contact Dermatitis
    • Common form of cell-mediated or delayed hypersensitivity
    • Various things can form the sensitizing antigen: microorganisms, chemicals, foreign proteins, latex, drugs, metals, poison ivy
  2. Manifestations of Allergic Contact Dermatitis
    • Erythema
    • Swelling
    • Itching with vesicular lesions in the area of allergen contact
  3. Treatment of allergic Contact Dermatitis
    topical or systemic steroids
  4. Irritant Contact Dermatitis
    • Nonimmunologically mediated inflammation of the skin that can cause systemic involvement
    • Exposure to soaps, detergents, agents used in industries cause the lesions (which resemble allergic contact dermatitis)
    • Remove source of irritation
  5. Statis Dermatitis
    • Usually occurs on the legs as a result of venous stasis and edema associated with varicosities, phlebitis, and vascular trauma
    • Develop erythema and pruritis
    • Then scaling, petechiae, and hyper pigmentation
    • Progressive lesions become ulcerated, especially around ankles and tibia
  6. Treatment of Stasis Dermatitis
    • Elevate legs
    • No tight clothing
    • Do not stand for long periods of time
    • Acute cases are treated with antibiotics
    • Chronic lesions treated with wet dressings of Burow solution or silver nitrate
  7. Seborrheic Dermatitis
    • Common, chronic inflammation of the skin: scalp, eyebrows, eyelids, ear canals, nasolabial folds, axillae, chest, back
    • Have periods of exacerbation and remission
    • Lesions are scaly, white or yellow plaques with mild pruritus
  8. Treatment of Seborrheic Dermatitis
    • Use shampoo with sulfur, salicylic acid, or tar
    • Topicals include antifungals or low-dose steroids
  9. Pityriasis rosea
    • Self-limiting, inflammatory disorder that occurs more often in young adults, usually during the winter
    • Cause is thought to be a herpes-like virus
  10. Manifestations of Pityriasis Rosea
    • Starts as a single lesion called the herald patch
    • This patch is circular, demarcated, salmon-pink, 3-4 cm in diameter, and usually found on the trunk
    • Early lesions are macular and papular
    • Secondary lesions develop within 14-21 days and extend over the trunk and upper part of the extremities
    • Rarely on the face
  11. Diagnosis/Treatment of Pityriasis Rosea
    • Can be confused with syphilis, psoriasis, seborrheic dermatitis
    • Usually self-limiting and resolves in a few months with symptomatic treatment for pruritus; sunlight for resolution
  12. Lichen Planus
    • Benign autoimmune inflammatory disorder of the skin and mucous membranes
    • Some develop after exposure to drugs or film-processing chemical
  13. Manifestations of Lichen Planus
    • Begins with nonscaling, violet-colored pruritic papules, 2-4 mm in size, usually on wrists, ankles, lower legs, genitalia
    • Papules are flat-topped
    • New lesions are pale pink and evolve into a dark violet color
    • Persistent lesions become hypertrophic Itching is the most distressing symptom
    • May last months to years: average duration is 6-18 months
    • Postinflammatory hyperpigmentation is common
  14. Treatment of Lichen Planus
    Antihistamines for itching and topical/systemic corticosteroids for inflammation
  15. Pemphigus
    • Name means to blister or bubble
    • Rare autoimmune blistering disease of the skin and oral mucous membranes caused by circulating autoantibodies
    • Clinical course can be rapidly fatal to benign
  16. Diagnosis/Treatment of Pemphigus
    • From manifestation and histologic exam of the skin
    • Treatment is systemic corticosteroids in high doses
    • Patient may be treated in a burn center
  17. Erythema multiforme
    • Characterized by inflammation of the skin and mucous membranes, often associated with toxic reactions to a drug
    • Lesions vary in presentation and may involve the skin or mucous membranes or both
    • Characteristic “bull’s eye” or “target” lesions occur on the skin surface with a central erythematous region surrounded by concentric rings
  18. Erysipelas
    • Acute superficial infection of the upper dermis
    • Usually caused by group A beta hemolytic strep
    • Face, ears, lower legs
  19. Manifestations of Erysipelas
    • Chills, fever, malaise precede onset of lesions
    • Initial lesions are firm, red spots that enlarge and coalesce
    • Coalesce to form clearly circumscribed advancing, bright red, hot lesion with raised border
    • Itching, burning, tenderness are present
    • Use cold compresses and systemic ABT
  20. Sebborheic Keratosis
    • Benign proliferation of basal cells that produce elevated lesions that may be smooth or warty
    • Usually seen in older people
    • Multiple lesions on the chest, back and face
    • Tan to waxy yellow, flesh colored, or dark brown-black
    • Often greasy appearing
  21. Actinic keratosis
    • Premalignant lesion found on skin exposed to sun
    • Prevalence is highest in those with unprotected, light colored skin
    • Rare in blacks
    • Rough, poorly defined papules; may be felt more than seen
    • Some areas may have telangiectasias
    • Freeze with liquid nitrogen
  22. Basal Cell Carcinoma
    • Most common human cancer
    • Tumors grow upward and laterally or downward to the dermal/epidermal junction
    • Usually have depressed centers and rolled borders
    • Usually do not metastasize, but grow by direct extension to adjacent structures
  23. Basal Cell Carcinoma is mostly seen on ____ and ____. Growth is ____.
    • Face
    • Neck
    • Slow
  24. Squamous Cell Carcinoma
    • Tumor of the epidermis
    • Two types: in situ and invasive
    • Significantly more malignant if left untreated
    • Areas affected are the head and neck
    • Pre-malignant lesions are sun-damaged skin or actinic keratosis
  25. Bowen Disease
    Dysplastic epidermal lesion found on unexposed areas of the body such as the penis and demonstrated by flat, reddish, scaly patches; they rarely invade surrounding tissue and almost never metastasize
  26. Malignant Melanoma
    • Early recognition is key
    • ABCDE rule: asymmetry, border irregularity, color variation, diameter larger than 6 mm, evolving or rapid enlargement
    • Causes: genetic predisposition, solar radiation, steroid hormone activity
    • Treatment is guided by size and depth of lesion
    • Surgery, radiation, chemotherapy, biologic response modifiers
  27. Paronychia
    • Acute or chronic infection of the cuticle Acute paronychia is the rapid onset of painful inflammation of the cuticle, usually after minor trauma
    • An abscess may develop requiring I & D for relief of pain
    • Most common causative organisms are staph and strep
  28. Onychomycosis
    • Is a fungal or dermatophyte infection of the nail plate
    • Nail plate turns yellow or white and becomes elevated with the accumulation of hyperkeratotic debris
    • Treatment is difficult as topical or systemic antifungals do not penetrate the nail bed very well

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