Chapter 28 - Skin Disorders Flashcards Preview

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Flashcards in Chapter 28 - Skin Disorders Deck (181):
1

Epidermis

acts as a barrier against invading microorganisms, foreign particles from dirt and debris, chemicals, & UV rays

2

migration of keratinocytes

stratum corneum - stratum granulosum - stratum spinosum - stratum basale

3

melanocytes

synthesize and transfer to keratinocytes the pigment melanin, which blocks solar radiation

4

langerhans cells

aid immune system by collecting & presenting to lymphocytes foreign substances

5

Dermis

composed of connective tissue, provides mechanical support to epidermis and contains blood vessels,nerves, sweat glands, hair follicles, and sebaceous glands

6

Adnexal structures

hair, sebaceous glands, eccrine glands

7

sebaceous glands secrete

sebum

8

sweat glands

cools the surface of the body and internal organs (eccrine glands and apocrine glands)

9

nails

the nail matrix (white semilunar structure) synthesizes the keratinaceous nail plate

10

cafe au lait spots

areas of increased melanin; appear pale brown

11

pale/red skin

may be hereditary

12

cellulitis

infectious inflammation of deep skin structures

(erythema and increased warmth)

13

primary lesions

macules, papules, nodules, tumors, cysts, wheals, vesicles, bull, pustules

14

secondary lesions

excoriations (result from primary lesions that have been manipulated)

15

hyperkeratosis

epidermal skin layer increases in thickness where constant pressure/friction is applied externally

16

hyperkeratosis etiology

skin is less pliable and mechanical stress on hyperkeratotic skin can result in tears or cracks in the epidermis that are painful and could result in infection

17

hyperkeratosis prevention

properly fitted shoes and cushioning

18

hyperkeratosis s/sx

callus may be ovular, elongated, brownish, and or slightly elevated

19

hyperkeratosis management

exposure to rubbing/shearing forces should be minimized; use moisturizers, possibly carefully shave down calluses

20

blisters

shearing forces produce a raised area that contains a collection of fluid below/within epidermis

21

blisters etiology

sports associated with horizontal shearing

22

blisters prevention

talcum powder/petroleum jelly, socks/well fitted shoes, second skin or mole skin

23

blisters s/sx

sharp, burning sensation where "hot spot" is formed; may contain clear liquid or blood (blood blisters result when deeper skin is disrupted)

24

blisters management

leave blister intact for first 24 hours, then disperse fluid (do not cut off skin), clean and place a doughnut pad around dressed blister

25

soft corns and hard corns

types of hyperkeatosis

26

hard corns etiology

most serious - caused by pressure of shoes, hammertoes are usually associated with hard corns that form on top of deformed toes

27

soft corns etiology

result of the combo of wearing narrow shoes and excessive foot perspiration - usually b/w 4 and 5 toes

28

corns prevention

wear properly fitted shoes

29

soft corn s/sx

appears a circular piece of thickened, white, macerated skin

30

hard corn s/sx

on top of hammer toes, bony prominence is pushed against top of shoe

31

macerated

softened by wetting

32

corn management

properly fitted shoes and socks, small feet pad, keep toes separated

33

hyperhidrosis

excessive perspiration

34

hyperhidrosis etiology

emotional excitement often worsens sweating; palms sweat is syrup like; increases possibility of skin irritation and makes adherence of bandages difficult; calluses and blisters more likely to occur

35

hyperhidrosis management

using an astringent (alcohol) or an absorbent powder; aluminum chloride

36

chafing etiology

occurs in athletes who obese or have large limbs,

fiction/maceration (softening) of the skin in a climate of heat and moisture

37

chafing prevention

keep skin dry, clean, and friction free; groin - wear loose, soft cotton underwear

38

chafing s/sx

oozing wounds that develop into crusting and cracking lesions

39

chafing management

chafed area should be cleaned daily with soap and water, a medicated solution, and applying hydrocortisone cream

40

xerotic (dry) skin etiology

athletes exposed to the weather and who bathe often; decrease in humidity along with cold winds causes the skin to lose water

41

xerotic skin s/sx

skin appears dry with variable redness and scaling may be itching or cracking of skin

42

xerotic skin management

prevent water loss and replace lost water (shower once per day, use moisturizing soaps, use lotions)

43

Ingrown Toenails

nail grows into the lateral nail fold and enters the skin

44

ingrown toenails etiology

results from lateral pressure of poorly fitting shoes, improper trimming, or trauma

45

ingrown toenails prevention

properly fitted shoes and sock, cutting toenails straight across

46

ingrown toenails s/sx

skin swells and is painful, may grow purulent

47

ingrown toenail management

soak in hot water, lift nail from soft tissue and insert a piece of cotton

48

abrasion

top layer of skin is worn away, exposing capillaries;

would is easily infected is not cleaned

49

punctures

may introduce tetanus bacillus into bloodstream

50

lacerations

sharp/pointed objects tears the tissues - susceptible to severe infection

51

skin incision

cut is smooth

52

skin avulsions

skin is torn from the body; keep avulsed tissue for possible reattachment

53

skin bruises

ecchymosis results from disruption of superficial blood vessels (RICE)

54

wound management

clean all wounds with soap and water, dress it with antiseptic

most lacerations/puncture wounds should be treated by a physician

55

who decides if sutures are required

a physician

56

staphylococcus

genus of gram-positive bacteria that commonly appear in clumps on the skin and in the upper respiratory tract. common cause of skin infection

57

streptococcus

also a genus of gram-positive bacteria, appears in long chains. some species are among the most dangerous bacteria that affect humans (scarlet fever), often cause skin infections

58

impetigo contagiosa

primarily in children in late summer and early fall (bacterial)

59

impetigo contagiosa etiology

caused by streptococci or S. aureus - spread rapidly by close contact (wrestling)

60

impetigo contagiosa s/sx

mild itching and soreness, followed by eruption of small vesicles and/or pustules that rupture to form honey-colored crusts - often develops in body folds subject to friction

61

impetigo contagiosa management

thoroughly clean crusted area and apply topical antibacterial agent

62

furunculosis: medical term for _______

boils

63

furunculosis etiology

infections of the hair follicle that usually result in pustule formation (staphylococci)

64

furunculosis s/sx

back of neck, face, buttocks most affected

pustules may be enlarged, reddened and hard from internal pressure

most will mature and rupture spontaneously, emitting pus - DO NOT SQUEEZE

pustules on the face can be dangerous, especially if they drain into veins that lead to brain

65

furunculosis management

protect furuncle from further irritation, administer antibiotics, keep athlete from contact with team while boil is draining

66

carbuncles

develop from staphylococci. similar to furuncles

67

carbuncles s/sx

carbuncles are larger and deeper and usually have several openings in the skin

could cause a systemic infection

68

carbuncles generally seen around

back of neck

first a dark red, hard area and in a few days emerges
into a lesion that discharges yellowish-red pus

69

carbuncles management

surgical drainage combined with antibiotics administration

70

folliculitis

inflammatory condition of the hair follicle (beard, scalp, groin, buttocks)

71

folliculitis etiology (occlusive, PFB, infectious)

caused by no infections or infections agents

occlusive: moist/warm environments

psuedofolliculitis barber (PFB) - penetration of skin by curved hair

Infectious: bacteria, yeast, mites

72

folliculitis s/sx

redness around follicle, development of a papule or pustule at the follicle opening,

may cause scarring/permanent baldness in the affected area

73

folliculitis management

apply noise heat intermittently to increase circulation, antibiotics may be applied locally

74

hidradenitis suppurativa

chronic inflammatory condition of the apocrine glands or large sweat glands

75

hidradenitis suppurativa etiology

often occurs in axilla, scrotum, labia major, and nipples

exact cause is unknown

76

hidradenitis suppurative s/sx

begins as small papule

grow to size of small tumor filled purulent material

deep dermal inflammation can occur - causing large abcesses

77

hidradenitis suppurativa management

avoid use of antiperspirants/deodorants, shaving creams

use medicated soaps

apply prescribed antibiotic lotion

78

acne vulgaris

inflammatory disease involving hair follicles and sebaceous glands

79

acne vulgaris etiology

characterized by close comedones (whiteheads), open comedones (blackheads), papule, pustules, and cysts; sex hormones may contribute

80

acne vulgaris s/sx

face, neck, back

deep lesions may scar

athlete may have emotional issues

81

acne vulgaris management

variety of topical and systemic agents (antibiotics), manipulation of hormone levels, washing with mild soaps, use cosmetics that are non-comedogenic

82

paronychia and onychia

purulent infection of the proximal and/or lateral nail folds

83

paronychia and onychia etiology

staphylococci, streptococci and fungal organisms that accompany contamination of open wounds/hangnails;

common in football lineman; loss of cuticle is a risk factor

84

paronychia and onychia s/sx

painful, bright red swelling of nail fold (acute);

accumulation of purulent material

85

paronychia and onychia management

soak affected finger in hot water with epsom salts, topical antibiotics, removal of purulent material may have to be done through a skin incision

86

tetanus infection etiology

tetanus (lockjaw) is an acute infection of the CNS by tetanus bacillus

87

tetanus infection s/sx

stiffness of the jaw and muscles of the neck, muscles of facial expression become painful, muscles of back and extremities become tetanic, fever elevates, can be fatal

88

tetanus infection management

acute infection - treat in an intensive care unit, must get shot,

immunization should start at age 6 and get given every 5-10 years

89

Fungal infections

group of organisms that include yeasts and molds

90

ringworm (tinea)

superficial fungi infection takes place in superficial keratinized tissue found in hair/nails and the stratum corner of the epidermis

91

Dermatophytes

Ringworm Fungi

many different variations

cause of most skin, nail, and hair fungal infections; belong to 3 genera: Microsporum, Trichophyton, Epidermophyton

92

tinea capitis

ringworm of the scalp; common in children

93

tinea capitis s/sx

small pap

94

tinea capitis management

creams typically

95

tinea unguium/ onychomycosis

ringworm of the nail; seen in water athletes or chronic athletes foots

96

tinea unguium/ onychomycosis s/sx

nail becomes thickened, brittle, and separated from its bed (trauma predisposes)

97

tinea unguium/ onychomycosis management

creams typically do not penetrate nail; often systemic antifiungals or surgical removal of nail is required

98

tinea curries/ "Jock Itch"

ringworm of the groin

99

tinea curries/ "Jock Itch" etiology

bilateral and often symmetric red-brown scaling plaque with a snakelike border

100

tinea curries/ "Jock Itch" s/sx

mild to moderate itching, resulting in scratching and the possibility of a secondary bacterial infection

101

tinea curries/ "Jock Itch" management

will respond to OTC meds (ointments most commonly used); secondary bacterial infection is common and oral prescription may be necessary

102

Erythrasma

a bacterial infection, may mimic tinea curries but lacks scaling

103

tinea pedis/athletes foot

tricophyton species are the most common causes

104

tinea pedis/athletes foot etiology

itchy, dry, scaling infection of the sole of the foot; web-space infection between toes often caused by T. mentangrohpytes with the yeast Candida

105

tinea pedis/athletes foot s/sx

extreme itching on sole of foot, between and on top of toes, appears as a dry, scaling patch or inflammatory , scaling red papule that may coalesce to form larger plaques; secondary bacterial infection from itching is possible

106

tinea pedis/athletes foot management

topical antifungals, *good foot hygiene

107

candidiasis (Moniliasis)

yeastlike fungus that can produce skin, mucous membrane, and internal infections

108

candidiasis (Moniliasis) etiology

occurs if the environment is right (hot and humid weather, tight nothing, and poor hygiene)

109

candidiasis (Moniliasis) s/sx

occurs in body folds (axilla, groin); both candidate and non candidate intertrigo present as beefy red patches but candidate can be distinguished by its satellite pustules.

110

candidiasis (Moniliasis) management

maintain a dry area, anti-fungal creams

111

tinea versicolor

common fungal infection of young adults

112

tinea versicolor etilogy

caused by yeast Malassezia furor (a normal part of the skin's flora, occurring in areas where sebaceous glands actively secrete body oils

113

tinea versicolor s/sx

multiple, small, circular macule that are pink, brown, or white. They commonly occur on the abdomen, neck, and chest. the lesions do not tan when exposed to the sun and are asymptomatic

114

tinea versicolor management

selenium sulfide shampoo, or topical econazole nitrate

115

Herpes Simplex Labialis, Gladiatorum, and Herpes Zoster

Type 1 is extra genital

type 2 is genital

116

Herpes Simplex Labialis, Gladiatorum, and Herpes Zoster etiology

highly contagious and usually transmitted directly through a lesion on the skin or mucous
membrane; after the initial outbreak, it remains dormant and further attacks may be triggered by sunlight,
emotional distress, illness, fatigue, infection.

117

Herpes Simplex Labialis, Gladiatorum, and Herpes Zoster s/sx

local swelling followed by appearance of vesicles; vesicles generally rupture in 1-3 days, spilling out serous material that will form a yellowish crust (lesions heal in 10-14 days)

general malaise with sore throat and lymph gland swelling may occur

herpes simplex gladiators

118

herpes simplex gladiatorum

lesions on the side of the face neck or shoulders (wrestlers)

119

Herpes Simplex Labialis, Gladiatorum, and Herpes Zoster management

therapy usually directed at reducing pain and promoting early healing; antiviral drugs may shorten the course and reduce the recurrence of outbreaks

120

Herpes Simplex Labialis, Gladiatorum, and Herpes Zoster complications

can lead to secondary infection (kerato-conjunctivitis=inflammation of cornea and conjunctiva that could lead to loss of vision)

121

Verruca plana

flat wat

122

verruca plantaris

plantar wart

123

Condyloma acuminatum

venereal wart

124

verruca viras and warts

The human papillomavirus uses the skinUs epidermal layer for reproduction and growth. The verruca wart enters
the skin through a lesion that has been exposed to contaminated fields, floors, clothing, or other warts

125

common wart

verruca vulgaris and plans are prevalent on the hands of children

126

common wart s/sx

appears as a small, round, elevated lesion with rough, dry surfaces; may be painful if pressure applied; warts are subject to secondary bacterial infection (esp. warts on hands and feet)

127

common wart managment

topical salicylic acid or liquid nitrogen and electrocautery

128

plantar warts

found on the sole of the foot; can be spread to hands or other body parts

129

plantar warts s/sx

appear as an area with excessive epidermal thickening and cornification; produce general discomfort and point tenderness; major characteristic is hemorrhagic puncta (look like clusters of small black seeds)

130

plantar warts management

application of a keratolytic, liquid nitrogen or electrodessication, protect with a donut pad

131

molluscum contagiosum

poxvirus infection; more contagious than warts (especially during direct body contact activity) - must be immediately referred to a physician

132

molluscum contagiosi s/sx

small flesh or red-colored smooth-domed papules with a central umbilication

133

molluschi contagiosum management

thorough cleansing and using a destructive procedure (use of a powerful counterirritant, surgical removal of the lesion, or cryosurgery using liquid nitrogen)

134

allergic reactions

an allergy is an immunologically mediated reaction to allergen molecules against which the body's immune system has been previously sensitized

135

Contact dermatitis:

allergic contact dermatitis represents an immunologically mediated reaction to a foreign substance, while irritant contact dermatitis represents a non-immunologic reaction to a chemical irritant

136

contact dermatitis etiology

most common plant causes include poison ivy, poison oak, sumac, ragweed, and primrose; chemicals; adhesive in athletic tape

137

contact dermatitis s/sx

skin reacts with redness, swelling, and the formation of vesicles that ooze fluid and form a crust. A constant itch develops (increased with heat and made worse by rubbing); secondary infection as a result of scratching is common; over time, appearance may change to erythematous, scaling, lichenified papules and plaques

138

contact dermatitis management

identify and avoid irritant (may require extensive testing); topical corticosteroids

139

milaria (prickly heat)

occurs most often during the hot season in athletes who perspire profusely and who wear heavy clothing

140

milaria (prickly heat) etiology

continued exposure to heat and moisture causes retention of perspiration by the sweat glands and subsequent miliaria

141

milaria (prickly heat) s/sx

itching and burning vesicles and pustules (arms, trunk, bending areas of the body)

142

milaria (prickly heat) management

avoidance of overheating, frequent bathing with a non-irritating soap, wearing loose-fitting clothing, and the use of antipruritic lotions

143

chilblains (pernio) etiology

common type of dermatitis caused by excessive exposure to cold

144

chilblains (pernio) s/sx

tissue does not freeze but reacts with edema, reddening, possibly blistering, and a sensation of burning and itching after exposure to cold

145

chilblains (pernio) management

exercise and a gradual warming of the part; massage and application of heat are contra-indicated

146

Burns

may result from excessive exposure to thermal, chemical, electrical, or radiation sources

147

sunburn

represents an inflammatory response to UV radiation-induced skin damage

148

sunburn etiology

thin, white skin tends to absorb more radiation than more pigmented individuals; medications may also cause an adverse response to sun exposure

149

sunburn s/sx

appears 2-8 hours after exposure; prevention by sunscreen is recommended; continued overexposure to sunlight may result in chronic skin thickening, damage, and skin cancer

150

sunburn management

mild burns are treated using cool water in a shower or bath; aloe-based compounds are also beneficial; moderate and severe burns can be relieved by a tub bath with cornstarch

151

Psoriasis etiology

relatively common chronic disease of the skin that causes itching (exact cause is unknown); certain conditions such as infection, smoking, some drugs, climate and may be hormonal factors may cause an outbreak

152

Psoriasis s/sx

lesions begin as reddish papule that collectively form plaques with distinctive borders; lesions may progress to a yellowish-white, scaly appearance; most likely to occur on elbows, knees, scalp, genitalia, and trunk (particularly around umbilicus)

153

Psoriasis management

topical glucocorticoids with a kerolytic agent

154

scabies etiology

caused by mite Sarcopotes Scabiei which produces extreme nocturnal itching; the mite burrows a tunnel into the skin to deposit its eggs

155

scabies s/sx

burrows appear as dark lines between the fingers, toes, body flexures, nipples, and genitalia

156

scabies management

topical application of permethrin (Elimite); all bedding and clothing should be washed with hot water; secondary infection due to itching is common

157

Lice (Pediculosis) etiology

head lice (Pedicures humans capitis), pubic lice (Phthirus pubis), or body lice (Pedicures humans corporis - lays eggs in seams of clothing)

158

Lice (Pediculosis) s/sx

the louse's bite causes an itching dermatitis (itching provokes pustules and excoriations)

159

Lice (Pediculosis) management

NIX (synthetic pyrethroid permethrin) shampoo/cream; wash all clothes and bedding in hot water

160

Fleas etiology

fleas are small, wingless insects that suck blood; individually, bites cause only minor discomfort

161

fleas s/sx

a large number of biting fleas will be very uncomfortable; most fleas bite in patterns of three and concentrate their bits on the ankle and lower leg

162

fleas management

prevent itching with an antipruritic lotion (calamine or a topical corticosteroid). scratching could result in secondary infection

163

Ticks etiology

parasitic insects that are carriers of a variety of micro-organisms that can cause Rocky Mountain spotted fever or Lyme disease (can become easily attached to athletes because they live in grass and bushes)

164

Ticks s/sx

RMSF & Lyme disease are characterized by headache, fever, malaise, myalgia, and rash

165

RMSF

petechiae and purapura (small dark spots that retain their color when pressure is applied) localized to the distal arms, legs, hands, and feet

166

Lyme disease

erythema chronicum migrans (annular red ring) is the typical rash of Lyme disease

167

Ticks management

apply mineral oil or fingernail polish to the tick body, at which time it will remove its head (and can thus be removed by grasping or pulling the tick by its head)

168

Mosquitos etiology

unless a carrier of a disease, it produces a bite that causes milk discomfort, usually attached to lights, dark clothing, and warm, moist skin

169

mosquitoes s/sx

the bite produces a small reddish papule; multiple bites may lead to a great deal of itching

170

mosquitoes mangement

topical medication to relieve itching (calamine lotion or topical corticosteroids); repellants

171

stings etiology

hypersensitive athletes may respond with an allergic reaction that may be fatal (must be closely monitored in case of anaphylactic reaction); stings to the head, face, and neck are particularly dangerous

172

stings s/sx

increased heart rate, fast breathing, chest tightness, dizziness, sweating, and even LOC

173

stings management

in uncomplicated situations, the stinger must be removed with tweezers, apply detergent soap

174

spider bite etiology

bite marks are usually too small to be seen; spiders don't bite more than once

175

black widow bite

shiny black spider with red to orange colored markings (hour glass shape, on belly)

176

brown recluse bite

violin-shaped body with long legs

177

spider bite s/sx

pain, small puncture wounds, redness, itching, and swelling that last a few days; the wound will have a center blister surrounded by a red ring and then a white ring. the blister breaks leaving a scab

severe muscle pain and cramps in back, shoulders, and abdomen, weakness, vomiting, fever, or rash

178

spider bite management

rash eventually goes away over a 2-10 week period; anti-inflammatory medications may be necessary to stop itching or make the rash go away

179

Pityriasis rosea etiology

acute inflammatory skin rash of unknown origin that occurs most often in people ages 10-35. Most common in spring and fall; not a sign of internal disease, nor is it caused by a fungus, bacteria, or allergy;

180

Pityriasis rosea s/sx

a single pinkish-red patch called a 'herald patch' that appears on the chest or bak and enlarges over several days. within 2-3 weeks, a secondary macular eruption occurs on the trunk over the ribs and on the upper extremity; lesions are red and scaly with a clearing in the center -- appear in a symmetrical distribution over the trunk and deformities

181

Pityriasis rosea management

rash eventually goes away over a 2-10 week period; anti-inflammatory medications may be necessary to stop itching or make a rash go away