Integumentary Flashcards
(46 cards)
Lichenification
Skin becomes hardened and leathery that’s caused by chronic inflammation and scratching
Excoriation
Scratch or abrasion of the skin, commonly seen in conditions with pruritis
Fissure
Linear cleavage, sharp walls, or crack through the epidermis, smaller than a laceration caused by irritants, dryness, or fungal infections
Purpura
flat, non-blanchable, confluent, purple-colored irregularly shaped lesions on skin ranging 2-20 mm in size
A 52-year-old woman states, “these purple splotches appeared on my arms and legs following a round of chemotherapy.”
Wheal
clustered, smooth, slightly raised circumscribed, pruritic skin-colored lesions of various sizes up to 2 cm surrounded by an area of erythema
An 18-year-old states, “this itchy rash appeared all over my body a few hours after starting my antibiotic”
Linear
streaks such as noted in photodermatitis, with vesicular lesions forming, typically a number of hours after exposure to plant oil (urushiol) contained in poison ivy, poison oak, poison sumac
Crusting
Formation of an outer layer or coating on the skin that occurs when bodily exudates (e.g., pus or blood) dry up, e.g., impetigo
Macule
Single, flat, non-palpable area of discoloration, irregularly shaped, and 0.5 cm at the widest diameter (< 1 cm wide), same texture as rest of skin
A 50-year-old man says I have had that spot on my cheek for years. Freckles, sunspots.
Papule
Single, uniformly colored, slightly raised, solid irregularly shaped with defined borders
A 45-year-old woman states, that thing on my shoulder hasn’t’ changed in years. Solid pimple, acrochordon (skin tag), molluscum contagiosum
Scattered
generalized over body without a specific pattern or distribution, as seen in viral exanthem such as rubella
Confluent / Coalescent
multiple lesions blending together, such as the plaques seen in severe psoriasis vulgaris
Annular
“bull’s eye” lesion often seen with central clearing
- Lyme’s disease
- Steven-Johnsons
- epidermal necrolysis / TEN
Potency
Low potency on face
Medium potency on Arms/Legs/Trunk
High potency on hands and feet
*lichen sclerosis is the only area that we can put high potency topical steroids is clobetazol
Psoriasis vulgaris
tx
Medium potency topical corticosteroid
Scabies (scabies mites)
tx
Permethrin Lotion
Verruca Vulgaris (warts)
Tx
Imiquimod Cream
Skin Cancer, Actinic Keratosis, Warts, HPV
Tinea Pedis
tx
Topical Ketoconazole
Rosacea
Tx
Topical Metronidazole
Phytodermatitis
- poison ivy, poison oak, poison sumac
Systemic Treatment
Systemic corticosteroid is preferred when greater or equal to 20% is affected prescribe:
- prednisone PO for 5-7 days
- reduce dose of prednisone 50% for another 5-7 days
Phytodermatitis
- poison ivy, poison oak, poison sumac
Topical Treatment
Mid or High potency topical corticosteroids on body
- triamcinolone (0.1% Kenalog, Aristocort) or
- clobestasol (0.5% Temovate)
Low-potency corticosteroids on face
- desinode (Desowen)
Phytodermatitis
- poison ivy, poison oak, poison sumac
Adjunctive Treatment
- cool compress
- calamine lotion
- colloidal oatmeal bath
- OTC analgesics
- Oral antihistamines (pruritus)
Impetigo (honey crusted exudate)
Nonbullous (no blisters)
Causes
Tx
Causes
- Staphylococcus aureus
- Streptococcus pyogenes
Tx: MUPIROCIN OINTMENT
Improvement: 3-5 days
Pregnancy B: do not use if breastfeeding
Cellulitis
What is it?
Causes?
Tx
Infection of dermis and subcutaneous fat with s/s/ of heat, redness, discomfort
Cause
- Streptococcus pyogenes (most common)
- Staphylococcus aureus
- MRSA
- MSSA
Tx: systemic antimicrobial therapy
Erysipelas (superficial form of cellulitis )
How does it present?
More red with sharply demarcated borders compared to cellulitis
