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Patho Final > Disorders of skin integrity and function, chap 46 > Flashcards

Disorders of skin integrity and function, chap 46 Flashcards

1
Q

Tinea Corpus

A

Tinea (fungal infection)

Corpus: Ringworm
> children mostly prone

Transmission:
>kittens, puppies, other children

Appearance:
> Circular/oval lesions on trunk, back 
> red, papule with sharp border
     --> central clearing
> Pruritis, mild burning, erythritis
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2
Q

Tinea Capitus

A

Most common in children**
> usually scalp of shaft of hair

Appearance:
Primarily lesions
–> grey, round, hairless patches

Inflammatory Type:
>delayed hypersensitivity
>pustular, scaly, round
> can evolve to bacterial infection

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3
Q

Tinea Pedis

A

Athlete’s Foot- btwn toes, soles/sides of feet

Risk:

  1. Men
  2. Barefoot in public swimming pools, sauna, ect.
  3. Recurrence with exercise/sweating

Appearance:

  1. mild inflamed lesions
  2. Possible exudate
  3. Painful, pruritis
  4. Foul odor
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4
Q

Candidiasis

A 
> Yeast-like fungus: Candida albicans
> Normally in GI tract, mouth, vagina
> thrives in warm, moist areas of skin
> Oral infection can be
  -- d/t long-term antibiotic use
  -- initial signs of HIV

Appearance:
> red rash, well defined border
> pruritis, burning
> can form pustules, infection

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5
Q

Impetigo

A

BACTERIAL
> common in infant and young children
> usually d/t staphylococci or strep

Appearance:

  1. small vesicles on face (usually)
  2. ruptures honey colored serous that hardens and crusts
  3. Pruritis
  4. Multiplies with scratching
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6
Q

Cellulitis

A

BACTERIAL
> Deeper infection of dermis and SC tissue
> normal skin flora or exogenous bacteria

Transmission: bacteria

    • handling fish
  • -swimming
    • animal bites

Manifestations:

    • red, edematous, warmth, shiny, skin tight
    • possible fever, pain
    • can result in septicemia if not treated properly
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7
Q

Necrotizing Fascitits

A

> Rare bacterial infection
usually strep but can be others
Involves deep skin and facial plane of SC tissue

Risks:
> immunocompromised
> cancer
> DM
> recent mjr infections

Manifestations:
> red, swollen, painful area that wxpands quickly
> s and s of inflam / infection
> progress to sepsis

Tx:
> needs to be immediate
> antibiotics- high doses
> surgical debridement

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8
Q

Verrucae

A

Warts: VIRUS
> Benign human papillomavirus (HPV)
> multiple kinds/shapes/ sizes
> non-genital warts are common

Transmission:

  1. direct contact via break in skin
  2. sexual contact for genital warts

Appearance:
> small, grey-white to tan flat papules with rough surface

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9
Q

Herpes Simplex (cold sores)

A

VIRUS
> Associated with oropharyx infections (Type 1)

Triggers: stress, menses, infection, UV burns

Transmission: while active

  1. direct contact with infected saliva
  2. skin contact via athletics/ dentistry/ healthcare
  3. sexual contact (usually in type 2)

Appearance of HS type :

  1. burning, tingling pustules that crust and heal
  2. common of face, mouth, nasal septum
  3. More often and severe if immunocompromised
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10
Q

Herpes Zoster

A

VIRUS
Shingles
1. result of reactivation of latent varicella-zoster virus infection dormant in dorsal root ganglia since primary childhood infection

  1. travels up dermatome
  2. transmission when active

Risk:

  1. h/o chicken pox varicella-zoster infection
  2. age
  3. HIV, immunocompromised
  4. Malignancies
  5. corticosteriod/shemo/radiation therapy

Manifestations:

  1. burning pain, pruritis
  2. sensitive skin
  3. vesicles form, erupt, crust, fall off
  4. 2-6 weeks

Complications:

  1. Neuralgia 1-3 months after skin clears (common)
  2. Blindness if contact with eyes (permanent, rare)
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11
Q

Acne Vulgaris

A 
PUSTULAR DISORDER
> Lesions on face, neck, back and chest d/t increased testosterone after puberty
--85% of teens
-- self esteem issues
-- familial connection
  1. Non-inflammatory
    > Sebaceous glands plug up
    – blackheads: melanin moves up into gland
    – whiteheads: pale, fatty acid irritation
  2. Infalmmatory
    > Pustules, nodules, cysts
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12
Q

Rosacea

A

PUSTULAR DISORDER
> Chronic inflam skin disorder of UKE
> usually affects middle-aged adults: women

Manifestations:
> repeated “blushing” episodes, eventually remains
– Usually nose, cheeks
> Inflam facial pustules, nodules, edema
> dry itchy skin
> Telangiectasis (dilation of capillaries, spidery)
> skin thickens and is sensitive to heat/sun

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13
Q

Psoriasis

A

PAPULOSQUAMOUS DERMATOSIS
Chronic skin inflammation: autoimmune
> 3rd decade onset

Risk:
> heredity
> age

Manifestations:

  1. well-defined round plaques with silver scales
    - - flat or raised
  2. Elbows, knees, scalp, lumbosacral, intragluteal cleft
  3. Hyperkeratosis: epidermal layer of skin thickens over time. Permanent damage to capillaries lead to bleeding paints under scales
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14
Q

Ultraviolet Radiation Damage

A

(UVA not absorbed by ozone)

(UVB most absorbed by ozone)

  1. Delayed response, more genotoxic (burn)
  2. d/t free radicals formation
  3. damage to cellular proteins and DNA

Effects of both are temporary and reversible but research links them to causing skin cancer

Sunburn: mild to severe
> red, burning, blistering, peeling, itchiness

SPF: sun protection factor
> chemical - absorb sunlight
> physical - reflect sunlight

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15
Q

Thermal Injury

first degree burn

A 
> outter epidermis
>pink, red, dry, painful
> usually without blister (like sunburn)
> skin can still function
> heals in 3-10 days

> more serous in infants and elderly

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16
Q

second degree burns

A

Dermis and epidermis

Partial thickness:

  1. red, painful, moist, blisters that weep
  2. sensitive to touch, heat, air
  3. intact blisters help maintain body fluids
  4. heals in 1-2 weeks

Full thickness:

  1. Epidermis and into deep dermis
  2. hair follicles and sweat glands remain intact and still function
  3. mottled pink/red or waxy with flat, dry blisters, edema
  4. loss of sensation possible
  5. Scarring
  6. one month to heal
17
Q

Third degree burn

A
  1. involves SC tissue, possible muscle and bone
  2. waxy white/yellow/tan/black/brown
  3. extensive edema
  4. can be no pain, but seldom exists without some 1st degree and 2nd degree burn pain
18
Q

Burn “rule of nines”

A

back 18%
front 18
each whole leg 18

each arm 9
head 9

19
Q

Complications of Burns

A
  1. Hemodynamic:
    > injury to caps and surrounding tissues
    > fluid loss = hypovolemic shock
  2. Respiratory
    > smoke inhailation
    – CO, toxins, ammonia, chlorine, sulfur dioxide
    – damaged mucosa = bronchspasm, edema
    – thermal injury to resp passage = pneumonia, puml embolism, pneumothorax, ect….
  3. Hypermetabolic response
    > Catecholimine and cortisol released in response to stress
    – muscle /fat wasting, glucose stores depleated
    > Heat production is increased d/t heat loss from burn area
  4. Sepsis
    > burn site ideal for microorganism growth
  5. Circumferential Burns
    > encirculating the whole body or body part
    > Healing to “eschar” constricts (leathery) and must be removed- lyzed
    – Esharotomy/fasciotomy
20
Q

Treatment of Burns

A
  1. Active cooling- hypermetabolic state, need to cool
  2. Fluids
  3. Hemodynamic balance
  4. Nutrition
  5. Analgesia
  6. Wound care
  7. Protection
    - -Antimicrobial
    - - Skin grafts
    1) Autografts- from your own body
    2) Homografts- from another person dead or alive
    3) Synthetic grafts
    - - Physiotherapy
    - - Psychological Support
21
Q

Decubitus Ulcers

A
  1. Pressure
    - - over bony predominance
    - - immobility
    - - compromised integument (disease, age)
  2. Shearing Forces
    - - skeleton moves; skin doesnt. Skin can rip or damage
    - - cell injury and thrombosis
  3. Friction
    - - elbow, heels
  4. Moisture
    - - weakens cell walls by changing pH of skin
22
Q

Nevi

A

Moles

> congenital or acquired benign skin tumors
pigment or not
flat or elevated
hairy or non-hairy

> Melanocytic/junctional/compound nevi
Dysplastic nevi
– rough/pebbly surface, irregular shape
– capacity to transform into malignant melanoma usually related to increased size

23
Q

Malignant Melanoma Nevi

A

> Melanocytic tumor typically sun-exposed areas
rapid progression

Risk:
>increased UV exposure; ho blistering sunburns
> family ho of MM; ho dysplastic nevus syndrome
> fair hair and skin, freckles
> immunocompromised

Manifestations:
> slightly raised, irregular border and surface
> independent or from previous nevi
> may have erythema, tenderness, ulceration, bleeding
> oftened mottled; red(inflammation), white(scar tissue formation), blue (malignant growth)

Growth:
> Radical
– horizontal spread in epidermis

> Vertical

    • invades deeper dermis
    • raised dome lesions
    • increased risk of metastasis
Diagnosis:
A- Asymmetry
B- border irregularity
C- color variation
D- diameter > 6mm 
E- Evolution. Is it changing?
24
Q

Basal Cell Carcinoma

A

> Neoplasm of basal layer of epidermis
Most common neoplasm***
rarely metastasizes
slow-growing

Risk:
> fair skin
>ho sun exposure

Manifestations:
> Nodular
– small flesh colored/pink smooth, thranslucent nodule enlarged over time

Superficial
– scaly erythematous patch/plaque

25
Q

Squamous cell carcinoma

A

> malignant tumor on sun-exposed area
confined to epidermis for long periods, then converts to “invasive” stage
– usually older population

Risk:

  1. UV exposure
  2. Arsenic, industrial tar, coal, paraffin
  3. Black Men; rarely affected

Manifestations:

  1. red-scaling, slightly elevated, irregular border
  2. Shallow chronic ulcer, crusts
  3. Can metastasize if not excised early

Patho Final (4 decks)

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