Intro to dermatology Flashcards
1
Q
What is the definition of dermatosis
A
any disease of the skin
2
Q
What is the definition of dermatitis
A
inflammation of the skin
3
Q
What is the definition of intertriginous
A
2 skin areas may touch or rub together (axilla of the arm, skin folds of the breast, between fingers)
4
Q
What is the definition of oleaginous
A
oily or greasy
5
Q
what does O/W mean
A
oil in water
6
Q
what does W/O mean
A
water in oil
7
Q
What is the largest organ system in the human body
A
the skin
8
Q
what is the purpose of skin on our body
A
- provide protective barrier
2. maintain water balance
9
Q
what are the two types of protective barriers of the skin
A
- physically
2. immunologically
10
Q
what does the epidermis consist of
A
stratified squamous epithelium; keratinocytes; basement membrane
11
Q
what is the function of the epidermis
A
protection; synthesize keratin; maintain water balance
12
Q
what is the outermost layer of the epidermis
A
stratum corneum
13
Q
what does the stratum corneum consist of
A
Corneocytes - “dead” cells, non-nucleated, flattened keratinocytes
14
Q
What is the function of the stratum corneum
A
provides a barrier - skins 1st line of defense
15
Q
what does the stratum granulosum consist of
A
lipids
16
Q
what is the function of stratum granulosum
A
waterproof barrier
17
Q
what does the stratum spinosum consist of
A
Langerhans cells
18
Q
what is the function of stratum spinosum
A
antigen specific immune response
19
Q
what does the stratum basale consist of
A
melanocytes
20
Q
what is the function of stratum basale
A
produce melanin (UV protection), cell mitosis
21
Q
What does the dermis consist of
A
collagen, elastin, sweat glands, hair follicles, sebaceous glands, arrector pili muscles, nerves, blood vessels, fibroblasts, macrophages, mast cells
22
Q
what is the function of the dermis
A
provides structure, pliability, and tensile strength; thermoregulation; produce immune response
23
Q
what does subcutaneous tissue consist of
A
adipose tissue, nerves, blood vessels
24
Q
what is the function of subcutaneous tissue
A
insulation, absorbs shock, provides energy supply
25
Are pediatric patients skin thick or thin
thin
26
How would you describe an elderly patients skin
thin, dry, more friable
27
What are the 7 critical skin functions
1. Protection
2. Regulates body temperature
3. Maintains hydration
4. Sensory
5. Vitamin D absorption and production
6. Wound repair
7. immune response
28
what are the 3 things dermatoses arise from
1. inability or over-ability to repair
2. hypoactive or hyperactive immune response
3. effects of repair and/or the immune response
29
What some key questions to ask when gathering information about skin
1. What are the symptoms
2. what makes it better/worse?
3. what remedies have you tried?
30
what are the 4 different types of flat lesions
1. erythema
2. erythroderma
3. macule
4. patch
31
What is an erythema flat lesion
pink to red coloring of the skin; blanches (see handprint)
32
what is a erythroderma flat lesion
erythema that covers 90% of the body (see handprint)
33
what is a macule flat lesion
change in color from surrounding skin (< 0.5 cm)
34
what is a patch flat lesion
similar to macule but > 0.5 cm; may have slight scaling
35
What are the 7 different types of raised lesions
1. comedo
2. cyst
3. nodule
4. papule
5. plaque
6. tumor
7. wheal
36
what is a comedo
blocked hair follicle; may be open or closed
37
what is a cyst
fluid or semi solid filled sac lined with epithelium
38
what is a nodule
solid, round, palpable lesion > 0.5 cm
39
what is a papule
small, solid lesion < 0.5 cm
40
what is a plaque
large, solid, flat topped lesion with large surface area (> 0.5 cm)
41
what is a tumor
any mass ( may be included under nodule)
42
what is a wheal
papule or plaque with associated swelling and possible redness and/or pallor
43
what are the 4 types of depressed lesions
1. atrophy
2. burrow
3. erosion
4. ulcer
44
what is atrophy
shrinking of the skin; may occur in epidermis or dermis
45
what is a burrow lesion
wavy tunnel in epidermis from parasites
46
what is an erosion lesion
moist circumscribed lesion; loss of epithelium
47
what is an ulcer
destruction of epidermis and top portion of dermis
48
what are the 6 different surface changes you may see on the skin
1. crusts
2. excoriations
3. fissure
4. keratoderma
5. lichenification
6. scale (desquamation)
49
what are crusts
hardened deposits formed when serum, blood or purulent exudates dry on the skin
50
what are excoriations
erosions typically caused by scratching
51
what are fissures
linear break in skin from increased tension or decreased elasticity (cracks)
52
what is keratoderma
excessive hyperkeratosis resulting in yellow scales
53
what is lichenification
thickening of the skin with increased markings (typically caused by rubbing)
54
what is scale (desquamation)
flat plate or flake coming from the stratum corneum
55
what are the 4 different types of fluid filled lesions
1. abscess
2. bulla
3. pustule
4. vesicle
56
what is an abscess
deep, puss filled cavity in the dermis or SQ tissue; appears as pink nodule
57
what is a bulla lesion
similar to vesicle but > 0.5 cm
58
what is a fluid filled pustule lesion
pus filled cavity; may contain bacteria
59
what is a fluid filled vesicle
cavity or elevation < 0.5 cm between the epidermal layers or dermis/epidermis
60
what are the 3 purpura/vascular lesions
1. infarct
2. purpura
3. telangiectasia
61
what is an infarct
dusky, reddish gray macule or plaque caused by skin necrosis due to occlusion of blood vessels
62
what is purpura
leaking of blood into the skin; non-blanching redness
- small purpura = petechiae
- large purpura = ecchymosis
63
what is telangiectasia
red lines or net like patterns caused by dilation of capillaries
64
what would a group of lesions look like
clustered
65
what would scattered lesions look like
separated; irregular pattern
66
What are some considerations for choosing appropriate agent
1. absorption through stratum corneum
2. potency
3. vehicles
4. age
67
What type of products respond better to oily or wet conditions of the skin
drying base product
68
what type of products respond best to dry skin conditions
moisturizing product base
69
what are the different types of vehicles
1. ointment
2. pastes
3. liquids
4. aerosols
5. powder
70
what is the primary use of oleaginous or hydrocarbon bases
emollients and skin protectants
71
what is the primary use of absorption bases
emollients and skin protectants
72
what is the primary use of water in oil emulsions (ointments and creams)
emollient; avoid intertriginous areas
73
what is the primary use of oil in water emulsions (creams)
may be used for most areas
74
what is the primary use of water soluble bases
- useful when a high surface concentration is needed
| - gels: useful for hairy areas; may contain microspheres of meds
75
what is the primary use for pastes
skin protectants, sun blocks
76
what is the primary use for solutions
good for scalp or hairy areas
77
what is the primary use for suspensions (lotions)
good for large areas
78
what is the primary use for shake lotions
useful for weeping/oozing skin where drying is needed
79
what is the primary use of foams
goof for scalp or hair areas
80
what is the primary use of aerosols
may be preferred for abraded skin
81
what is the primary use of powders
absorb moisture and reduce friction; used in intertriginous areas and on feet
82
what is the use of topical corticosteroids
relief of inflammation and pruritus of corticosteroid responsive dermatoses
83
What disease states are highly responsive to steroids
1. psoriasis
| 2. atopic dermatitis
84
what are the less responsive disease states to steroids
1. psoriasis of the nails
2. insect bites
3. irritant contact dermatitis
85
What is the MOA of topical corticosteroids
exert anti inflammatory, immunosuppressive, antiproliferative and vasoconstrictive effects
86
what is the MOA of anti-inflammatory
binds to glucocorticoid receptors in the cytoplasm of keratinocytes and fibroblasts in the dermis and epidermis to form glucocorticoid receptor complex; this complex travels to the nucleus and binds to DNA at the glucocorticoid response element (GRE); regulates inflammatory process by stimulating or inhibiting gene transcription
87
what is the MOA of immunosuppressive
inhibits immune response in dermis and epidermis
88
what is the MOA of antiproliferative
inhibits IL-1a in fibroblasts to decrease proliferation and inflammation in keratinocytes
89
what is the MOA of vasoconstriction
decreases capillary permeability to decrease anti-inflammatory effects and decrease redness
90
what is absorption of topical corticosteroids enhanced by
- increased skin temperature
- hydration
- application to inflamed or denuded skin
- sensitive intertriginous areas
- skin surfaces with a thin stratum corneum layer
- use of occlusive dressings
91
Who are low potency drugs recommended for
1. children
2. large areas
3. body sites prone to steroid damage
92
How are low potency drugs typically dosed
twice daily for 2-4 weeks
93
how are potent drugs usually dosed
once daily
94
how pulse doing usually dosed for some chronic skin conditions
every other day, once weekly
95
What can most topical corticosteroids lead to
local and systemic side effects
96
what metabolic effects can occur when using a topical steroid
hyperglycemia and Cushing's syndrome
97
what are the most common local side effects
1. burning
2. itching
3. irritation
4. erythema
5. dryness
6. skin thinning/skin atrophy
98
what are the ultra high corticosteroid
1. halobetasol propionate (Ultavate)
2. clobetasol propionate (Temovate)
3. betamethasone dipropionate (Diprolene)
99
what is the medium potency drug
triamcinolone acetonide (Kenalog)
100
what is the very low potency drug
hydrocortisone (as base) 0.5%, 1%, 2%, 2.5%
