Pg 472 Flashcards
(352 cards)
1
Q
What are the three types of ultraviolet (UV) wavelengths?
A
- Ultraviolet A (UVA)
- Ultraviolet B (UVB)
- Ultraviolet C (UVC)
UVA can cause elastic tissue damage, UVB contributes to skin cancer, and UVC is blocked by the atmosphere.
2
Q
Which skin type is especially at risk for sun damage?
A
Fair-skinned persons and those with light-colored eyes
They have less melanin, providing less natural protection against UV radiation.
3
Q
What should patients be taught to avoid the damaging effects of the sun?
A
- Wear protective clothing
- Use sunglasses
- Wear a large-brimmed hat
- Use a darker colored, long-sleeved shirt of tightly woven fabric
- Carry an umbrella
The greatest risk is from midday sun, particularly between 10:00 a.m. and 2:00 p.m.
4
Q
What percentage of UV rays occur during midday sun?
A
80%
This is the time when the risk of sunburn is highest.
5
Q
What types of sunscreens are there?
A
- Chemical sunscreens
- Physical sunscreens
Chemical sunscreens absorb into the skin, while physical sunscreens reflect UV radiation.
6
Q
What does SPF stand for?
A
Sun Protection Factor
SPF measures the effectiveness of a sunscreen in filtering and absorbing UV radiation.
7
Q
What is the minimum SPF recommended for daily sunscreen use?
A
15
Products labeled as ‘broad spectrum’ must have an SPF of at least 15.
8
Q
How often should sunscreen be reapplied?
A
Every 2 hours
Sunscreen should also be reapplied after swimming.
9
Q
Fill in the blank: Sunscreens with an SPF of 15 or more filter _____ of the UVB rays.
A
92%
This makes sunburn unlikely when applied appropriately.
10
Q
What are some common photosensitizing drugs?
A
- Antidepressants: fluoxetine, paroxetine, venlafaxine
- Antidysrhythmics: amiodarone, quinidine
- Antihistamines: cetirizine, chlorpheniramine
- Antimicrobials: tetracycline, azithromycin, ciprofloxacin
- Antifungals: griseofulvin, ketoconazole
- Antipsychotics: chlorpromazine, haloperidol
- Cholesterol-lowering agents: atorvastatin, simvastatin
- Diuretics: furosemide, thiazides
- Hypoglycemics: glipizide, glyburide
- Nonsteroidal anti-inflammatory drugs: diclofenac, ibuprofen, naproxen
These drugs can increase the skin’s sensitivity to sunlight.
11
Q
What is the ABCDE rule for skin assessment?
A
- Asymmetry
- Border irregularity
- Color change and variation
- Diameter of 6 mm or more
- Evolving
This rule helps assess lesions for potential skin cancer.
12
Q
True or False: Sunscreens are considered waterproof.
A
False
Sunscreens must be reapplied after swimming, as they are not waterproof.
13
Q
What should patients taking photosensitizing drugs do to protect their skin?
A
Use sunscreen products
They should also assess their skin monthly and seek professional assessment for hard-to-see areas.
14
Q
What is a common side effect of certain drugs that can lead to increased sensitivity to sunlight?
A
Photosensitivity
Photosensitivity can manifest as swelling, redness, and papular, plaque-like lesions similar to sunburn.
15
Q
Name a category of drugs that may cause photosensitivity.
A
Antidepressants
Examples include fluoxetine, paroxetine, and venlafaxine.
16
Q
List two examples of antidysrhythmic drugs that may cause photosensitivity.
A
- Amiodarone (Cordarone)
- Quinidine
17
Q
What type of drugs includes cetirizine and diphenhydramine that may cause photosensitivity?
A
Antihistamines
18
Q
Which category of drugs includes tetracycline and azithromycin that may cause photosensitivity?
A
Antimicrobials
19
Q
Fill in the blank: Griseofulvin and ketoconazole are examples of _______ that may cause photosensitivity.
A
[Antifungals]
20
Q
What are two examples of antipsychotic drugs that may cause photosensitivity?
A
- Chlorpromazine
- Haloperidol
21
Q
Name a category of drugs that includes atorvastatin and simvastatin that may cause photosensitivity.
A
Cholesterol-lowering agents
22
Q
What type of drugs includes furosemide and thiazides that may cause photosensitivity?
A
Diuretics
23
Q
List two examples of hypoglycemics that may cause photosensitivity.
A
- Glipizide
- Glyburide
24
Q
Which category of drugs includes diclofenac and ibuprofen that may cause photosensitivity?
A
Nonsteroidal anti-inflammatory drugs
25
True or False: All drugs that cause photosensitivity have the same manifestations.
False
## Footnote
The manifestations can vary and may include different skin reactions.
26
What is essential for patients taking photosensitizing drugs to understand?
Their photosensitizing effect
27
What are the risk factors for skin cancer?
* Having fair skin
* Blond or red hair with blue eye color
* History of outdoor sunbathing
* Living near the equator or at high altitudes
* Family or personal history of skin cancer
* Having an outdoor occupation
* Spending a lot of time in outdoor recreation activities
* Indoor tanning
## Footnote
These factors increase the likelihood of developing skin cancer.
28
How does the Fitzpatrick Classification of Skin Type assist in skin cancer risk assessment?
It helps determine a person's skin complexion and their risk for skin cancer.
## Footnote
The classification categorizes skin types based on their reaction to sunlight.
29
Why are dark-skinned persons less susceptible to skin cancer?
They have increased melanin, which acts like a sunscreen.
## Footnote
Despite this, they still face risks and should wear sunscreen.
30
Where do melanomas commonly occur in dark-skinned individuals?
* Palms
* Soles
* Mucous membranes
* Under the nails
## Footnote
These areas have less melanin, making them more susceptible to melanoma.
31
What are the two most common forms of skin cancer?
Nonmelanoma skin cancers, specifically basal cell and squamous cell cancers.
## Footnote
More than 5.4 million new cases are diagnosed each year.
32
What is the most common causative factor for nonmelanoma skin cancers?
Sun exposure.
## Footnote
Nonmelanoma skin cancers usually develop in sun-exposed areas.
33
What are the characteristics of actinic keratosis (AK)?
* Most common precancerous skin lesion
* Affects older White population
* Appears on sun-exposed skin
* May spontaneously resolve with reduced sun exposure
## Footnote
AK is also known as solar keratosis.
34
What is the typical presentation of basal cell cancers?
They may occur in sun-protected areas and do not follow the same pattern as squamous cell cancers.
## Footnote
Squamous cell cancers usually occur on the head and neck.
35
What is the Fitzpatrick Classification for skin type with the highest risk of burning?
Type I: White, freckles, very fair; always burns, never tans.
## Footnote
This classification helps in predicting skin cancer risk based on skin type.
36
True or False: Nonmelanoma skin cancers develop from melanocytes.
False.
## Footnote
Nonmelanoma skin cancers develop in the basement membrane of the skin.
37
Fill in the blank: The potential for severe local destruction, disfigurement, and disability is associated with _______.
nonmelanoma skin cancers.
## Footnote
While there are few deaths, these cancers can have serious consequences.
38
What is the incidence of skin cancer among Blacks, Asians, and Hispanics compared to other groups?
Lower incidence than Caucasians
## Footnote
Melanoma in dark-skinned persons often goes unrecognized until advanced stages.
39
What increases the risk of melanoma in dark-skinned individuals?
History of dysplastic nevi and lower levels of vitamin D
## Footnote
Less protection against UV radiation.
40
What is Actinic Keratosis (AK) characterized by?
Irregularly shaped, flat, slightly red papule with indistinct borders and hard keratotic scale
## Footnote
AK can be impossible to distinguish from squamous cell cancer.
41
How is Basal Cell Carcinoma (BCC) described?
Locally invasive cancer arising from epidermal basal cells, most common but least deadly skin cancer
## Footnote
Typically occurs in middle-aged to older adults.
42
Where do most BCCs occur?
Head and neck area, followed by trunk and extremities
## Footnote
Sun-exposed areas are most affected.
43
What are the main risk factors for Squamous Cell Carcinoma (SCC)?
Sun exposure, immunosuppression after organ transplant, smoking
## Footnote
SCC can be aggressive and has the potential to metastasize.
44
What is the significance of a biopsy in suspected SCC?
A biopsy should always be done when a lesion is thought to be SCC
## Footnote
It helps confirm the diagnosis.
45
What is the ABCDE rule used for?
To evaluate suspicious skin lesions for melanoma
## Footnote
It assesses Asymmetry, Border, Color, Diameter, and Evolving characteristics.
46
What is the cornerstone of skin assessment for melanoma?
Dermoscopy examination
## Footnote
It helps determine if a lesion should be biopsied.
47
What does the Breslow measurement assess?
Tumor thickness in millimeters
## Footnote
It is the most important prognostic factor for melanoma.
48
What is the prognosis for melanomas less than 1 mm thick?
Small chance of spreading
## Footnote
Thicker melanomas have a greater chance of metastasizing.
49
What is melanoma primarily caused by?
UV radiation from the sun and artificial sources
## Footnote
It damages the DNA in skin cells.
50
What is the initial treatment for melanoma?
Wide surgical excision
## Footnote
Additional therapy may be required if it has spread.
51
What is the 5-year survival rate for advanced melanoma?
Around 27%
## Footnote
This rate significantly worsens with deep tumors or lymph node involvement.
52
What is Actinic Keratosis?
A premalignant skin condition caused by sun damage, characterized by flat or elevated, dry, hyperkeratotic scaly papules, often multiple
## Footnote
Common in older Whites and may recur even with adequate treatment.
53
What are the clinical manifestations of Actinic Keratosis?
• Flat or elevated, dry, hyperkeratotic scaly papule
• Often multiple
• Rough adherent scale on red base
• Often found on sun-exposed areas
## Footnote
Can be rough or wart-like.
54
What treatments are available for Actinic Keratosis?
• Excision
• Cryosurgery
• Laser
• Chemical peel
• Topical fluorouracil
• Imiquimod
• Ingenol mebutate
• Photodynamic therapy
## Footnote
Recurrence is possible even with adequate treatment.
55
What are Atypical or Dysplastic Nevi?
Morphologically between common acquired nevi and melanoma, may be a precursor of melanoma
## Footnote
Often >5 mm with irregular borders and varying colors.
56
What are the characteristics of Atypical or Dysplastic Nevi?
• Often >5 mm
• Irregular border, possibly notched
• Varying colors within a single mole
• Central part often raised
## Footnote
Most common on the back but can occur in unusual sites.
57
What is Basal Cell Carcinoma?
A slow-growing tumor related to sun exposure, characterized by changes in basal cells with no maturation or normal keratinization
## Footnote
Metastasis is rare with a 90% cure rate for primary lesions.
58
What is the prognosis for Basal Cell Carcinoma?
Metastasis is rare, and there is a 90% cure rate with primary lesions
## Footnote
Early detection and treatment are crucial.
59
What is Cutaneous T-Cell Lymphoma?
A localized chronic skin disease possibly related to environmental toxins, with Mycosis fungoides as the most common form
## Footnote
Prevalence is higher in men, and the disease course is unpredictable.
60
What are the main characteristics of Melanoma?
Neoplastic growth of melanocytes anywhere on skin, eyes, or mucous membranes, with a correlation between survival rate and depth of invasion
## Footnote
Poor prognosis unless diagnosed and treated early.
61
What are the classic stages of Melanoma?
• Patch (early)
• Plaque
• Tumor (advanced)
## Footnote
Each stage indicates progression in disease severity.
62
What symptoms are associated with Melanoma?
• Irregular color, surface, and border
• Variegated color (red, white, blue, black, gray, brown)
• Itching
• Lymphadenopathy
## Footnote
Often <1 cm in size, with specific common sites differing by gender.
63
What treatments are available for Melanoma?
• Surgical excision
• Sentinel lymph node evaluation
• Adjuvant therapy (if lesion >1.5 mm)
• Immunotherapy
• Targeted therapy
## Footnote
Key adjuvant therapies include cytokines and inhibitors.
64
Fill in the blank: The most common site for Melanoma in males is the _______.
back
65
True or False: Melanoma can spread through local extension, regional lymphatic vessels, and bloodstream.
True
66
What is Squamous Cell Carcinoma (SCC)?
Cancer of squamous cell of epidermis.
67
Where does Squamous Cell Carcinoma often occur?
On previously damaged skin.
68
What are the clinical manifestations of early Squamous Cell Carcinoma?
Firm nodules with indistinct borders, scaling, ulceration.
69
What are the clinical manifestations of late Squamous Cell Carcinoma?
Covering of lesion with scale or horn from keratinization, ulceration.
70
What is the cure rate of Squamous Cell Carcinoma with early detection and treatment?
High cure rate.
71
What treatments are available for metastatic Squamous Cell Carcinoma?
Immunotherapy for metastatic lesions.
72
What is the common location for Squamous Cell Carcinoma?
Sun-exposed areas such as face and hands.
73
What is an Atypical or Dysplastic Nevus?
Larger than usual nevi with irregular borders and various shades of color.
74
What is the increased risk of developing melanoma with Dysplastic Nevi?
The more DN a person has, the higher the risk; 10 or more DN increases risk by 12 times.
75
What is the role of immunotherapy in melanoma treatment?
Enhances immune response against melanoma cells.
76
What are some anti-PD-1 agents used in melanoma treatment?
* Nivolumab (Opdivo) * Pembrolizumab (Keytruda)
77
What are BRAF and MEK inhibitors used for?
Targeted therapy for melanoma.
78
What is the function of the BRAF gene in melanoma?
Signals melanoma cells to proliferate.
79
What chemotherapy drugs are used for advanced melanoma?
* Dacarbazine * Temozolomide
80
True or False: Chemotherapy is highly effective for melanoma.
False.
81
What is the role of radiation therapy in melanoma treatment?
Treating lymph node and brain metastases.
82
What is the size of a Dysplastic Nevus?
Greater than 5 mm across.
83
What are the ABCDE characteristics in reference to moles?
Characteristics that may indicate melanoma.
84
What is the Breslow measurement used for?
To report tumor thickness.
85
What cytokines are mentioned for immunotherapy?
* a-interferon * Interleukin-2
86
What is the effect of PD-1 inhibitors?
Boost the immune response against melanoma cells.
87
Fill in the blank: Dysplastic nevi may have the same _______ characteristics as melanoma.
ABCDE
88
What are the main types of bacteria that cause primary and secondary skin infections?
Staphylococcus aureus and group A B-hemolytic streptococci
## Footnote
These bacteria can lead to conditions like impetigo, erysipelas, and cellulitis.
89
What skin conditions can Staphylococcus aureus cause?
Impetigo, folliculitis, cellulitis, and furuncles
## Footnote
These conditions are common results of infections caused by this bacterium.
90
What viral infections are commonly associated with the skin?
Herpes simplex, herpes zoster, and warts
## Footnote
These are among the most common viral infections affecting the skin.
91
What are the two common types of contact dermatitis?
Irritant contact dermatitis and allergic contact dermatitis
## Footnote
These types differ in their causes and responses.
92
What is the primary cause of irritant contact dermatitis?
Direct chemical injury to the skin
## Footnote
This type occurs due to exposure to irritants.
93
What is the primary treatment for allergic dermatitis?
Avoid known irritants
## Footnote
Identifying and eliminating exposure to allergens is crucial.
94
Fill in the blank: The lesions in Stevens-Johnson syndrome (SJS) start as
a red, macular rash with purpuric centers.
## Footnote
The rash typically evolves and can lead to blisters and skin detachment.
95
What are the systemic symptoms that can precede skin findings in SJS/TEN?
Fever, cough, headache, anorexia, myalgia, and nausea
## Footnote
These symptoms may appear 1 to 3 days before skin lesions develop.
96
What are the three classifications of the severity of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN)?
SJS, SJS-TEN overlap, and TEN
## Footnote
These classifications depend on the percentage of total body surface area affected.
97
True or False: Most fungal infections of the skin are harmful in healthy adults.
False
## Footnote
While they may cause embarrassment and distress, they are generally harmless.
98
What does a microscopic examination showing hyphae in a skin scraping indicate?
A fungal infection
## Footnote
Hyphae are thread-like structures characteristic of fungal infections.
99
What is a common preventive measure against insect bites?
Using repellents and maintaining meticulous hygiene
## Footnote
These practices can reduce the incidence of infestations and bites.
100
What role do allergies play in reactions to insect bites?
An allergy to the venom can play a key role in the reaction
## Footnote
This can lead to varying degrees of hypersensitivity.
101
What is the most important action in caring for a patient with SJS/TEN?
Identifying and stopping the offending drug(s)
## Footnote
This is crucial to halt the progression of the disease.
102
Fill in the blank: Fungal infections can infect the skin, hair, and _______.
nails
## Footnote
This highlights the broad impact of fungal infections.
103
What is the common treatment for skin drug reactions like SJS and TEN?
Supportive care, including airway management and fluid replacement
## Footnote
These interventions are vital for patient recovery.
104
What can prompt, routine skin inspection help prevent?
Tick bites and related diseases such as Lyme disease
## Footnote
Regular inspections are particularly important in areas at risk for tick exposure.
105
What is a carbuncle?
Multiple, interconnecting furuncles with many pustules in a reddened area, most common at the nape of the neck.
106
What are the clinical manifestations of cellulitis?
Hot, tender, red, edematous area with diffuse borders; may include chills, malaise, and fever.
107
What is the usual causative agent of cellulitis?
Staphylococcus aureus and streptococci.
108
What is erysipelas?
A superficial cellulitis mainly involving the dermis, presenting as a red, hot, sharply demarcated plaque.
109
What is the potential complication of erysipelas?
Bacteremia.
110
What bacteria commonly cause folliculitis?
Usually staphylococci.
111
Fill in the blank: Folliculitis has an increased incidence in patients with _______.
diabetes.
112
What are the common treatment methods for a furuncle?
Incision and drainage, warm moist compresses, systemic antibiotics.
113
What are the symptoms of furunculosis?
Lesions similar to furuncles, malaise, regional adenopathy, fever.
114
What is impetigo?
A contagious infection with vesiculopustular lesions that develop thick, honey-colored crust surrounded by redness.
115
What is the most common location for impetigo?
Face as a primary infection.
116
What are the topical treatments for impetigo?
Incision and drainage, warm moist compresses, antimicrobial cream, and antiseptic measures.
117
What systemic antibiotics are often used for widespread infections of impetigo?
Systemic antibiotics like cephalexin, doxycycline, dicloxacillin, or clindamycin.
118
Furuncles are often associated with
severe acne or seborrheic dermatitis.
119
What is a common characteristic of a furuncle?
Tender, red, painful area around hair follicle with draining pus.
120
What is the main goal of treatment for folliculitis?
To relieve symptoms and prevent further infection.
121
What is the typical healing outcome for folliculitis?
Usually heals without scarring.
122
What are the common areas affected by folliculitis?
Scalp, beard, and extremities in men.
123
What is the most common benign skin problem?
Acne
## Footnote
Other common benign skin problems include psoriasis and seborrheic keratoses.
124
What is psoriasis?
A chronic autoimmune disease affecting around 7.5 million Americans
## Footnote
It is fairly common and affects men and women at equal rates, with the highest occurrence in Whites.
125
At what age does psoriasis usually develop?
15 to 35 years old.
126
What percentage of people with psoriasis have at least one relative with the disease?
One-third.
127
What are some health conditions associated with psoriasis?
* Metabolic syndrome
* Heart disease
* Type 2 diabetes
* Psoriatic arthritis
128
What is the most common form of psoriasis?
Plaque psoriasis.
129
How are lesions of plaque psoriasis characterized?
Red, scaling papules that merge to form plaques with adherent silver scales.
130
What areas of the body are commonly affected by psoriasis plaques?
* Knees
* Elbows
* Scalp
* Hands
* Feet
* Lower back
131
What is the primary goal of psoriasis treatment?
Varies from improved quality of life to complete disease resolution.
132
How can psoriasis affect a person's emotional health?
It erodes self-image, leading to self-consciousness, social withdrawal, and depression.
133
What is isotretinoin used for?
To treat acne.
134
What are the serious precautions associated with isotretinoin?
* Can cause serious damage to fetus
* Contraindicated in pregnant women or those wanting to become pregnant
* Cannot donate blood during and for 1 month after treatment
135
What are some side effects of phototherapy?
* Nausea
* Itching
* Redness
136
What is the role of methoxsalen in phototherapy?
It is combined with UVA light (PUVA) for treatment.
137
How often are phototherapy treatments generally given?
2 to 3 times a week.
138
True or False: Psoriasis is more physically disabling than emotionally disabling for most patients.
False.
139
Fill in the blank: Psoriasis is associated with _______.
[metabolic syndrome, heart disease, type 2 diabetes, psoriatic arthritis].
140
What are the two types of Herpes Simplex Virus (HSV)?
HSV-1 and HSV-2
141
How long before symptoms occur after contact with HSV?
Symptoms occurring 2 days to 2 weeks after contact
142
What factors can worsen Herpes Simplex Virus infections?
* Sunlight
* Trauma
* Menses
* Stress
* Systemic infection
143
How is recurrent HSV infection characterized?
Recurrence in similar spot with grouped vesicles on reddened base
144
What is Herpes Zoster commonly known as?
Shingles
145
What is the primary cause of Herpes Zoster?
Activation of the varicella-zoster virus
146
How does the incidence of Herpes Zoster change with age?
Incidence increases with age
147
What are the common clinical manifestations of Herpes Zoster?
* Grouped vesicles and pustules
* Burning, pain, and neuralgia preceding outbreak
* Usually unilateral
148
What is the recommended treatment for Herpes Zoster?
* Antiviral agents (e.g., acyclovir, famciclovir, valacyclovir)
* Analgesia
* Vaccine (Zostavax) for prevention
149
What causes plantar warts?
Human papillomavirus (HPV)
150
What are common treatments for plantar warts?
* Topical immunotherapy (imiquimod)
* Cryosurgery
* Salicylic acid
* Duct tape
151
What characterizes a verruca vulgaris?
Caused by HPV, may disappear spontaneously in 1-2 years
152
What is the common treatment for actinic keratoses?
Phototherapy
153
Fill in the blank: The immunosuppressive effects of PUVA increase the risk for _______.
[SCC, BCC, and melanoma]
154
What is photodynamic therapy used to treat?
AK and some skin cancers
155
What is the mechanism of action for photodynamic therapy?
The drug reacts with oxygen upon light application, killing target cells
156
What should patients receiving PUVA wear to protect against UV light?
Prescription goggles that block 100% of UV light
157
True or False: Plantar warts are usually painless.
False
158
What is a common characteristic of warts?
Cone shaped with black dots (thrombosed vessels) when wart removed
159
What should be taught to a patient preparing for phototherapy for actinic keratoses?
Importance of sun protection and monitoring lesions for changes
160
What are the common clinical manifestations of bedbug bites?
Wheal surrounded by vivid flare, firm hives transforming into persistent lesions, often grouped in threes appearing on uncovered parts of the body
## Footnote
Bedbugs are typically present in furniture and walls during the day and bite at night.
161
Which species are referred to as Hymenoptera?
Bees and wasps
## Footnote
These insects can cause intense, burning, local pain, swelling, and itching.
162
What are the types of lice mentioned in the text?
* Pediculus humanus var. capitis (head lice)
* Pediculus humanus var. corporis (body lice)
* Phthirus pubis (pubic lice)
## Footnote
These parasites suck blood and lay eggs on skin and hair.
163
What causes scabies?
Sarcoptes scabiei
## Footnote
The mite penetrates the stratum corneum and deposits eggs, leading to an allergic reaction.
164
How is scabies transmitted?
By direct physical contact and sometimes by shared personal items
## Footnote
It is rarely seen in dark-skinned people.
165
What is the causative agent of Lyme disease?
Borrelia burgdorferi
## Footnote
This spirochete is transmitted by ticks in certain endemic areas.
166
What are the common symptoms of Lyme disease?
* Spreading, ring-like rash
* Flu-like symptoms
* Possible cardiac, arthritic, and neurologic manifestations
## Footnote
The rash is common in groin, buttocks, axillae, trunk, and upper arms and legs.
167
What is the primary treatment for Lyme disease?
Oral antibiotics, such as doxycycline
## Footnote
IV antibiotics may be necessary for arthritic, neurologic, and cardiac symptoms.
168
What are the main adverse effects of radiation therapy?
* Permanent hair loss (alopecia)
* Telangiectasia
* Atrophy
* Changes in pigmentation
* Ulceration
* Hearing loss
* Eye damage
* Mucositis
## Footnote
Adverse effects depend on the location and dose of radiation delivered.
169
What is total body skin radiation used to treat?
Cutaneous T-cell lymphoma
## Footnote
This treatment follows a lengthy course and causes premature skin aging.
170
Fill in the blank: The __________ is used for palliative pain control in melanoma.
radiation therapy
171
True or False: Radiation therapy requires multiple visits to a radiology department.
True
172
What is a potential complication of radiation therapy around the eyes?
Lens damage
## Footnote
Shielding is needed to prevent this damage.
173
What is Candidiasis commonly caused by?
Candida albicans
## Footnote
Candidiasis is also known as moniliasis and affects various body areas.
174
What are the clinical manifestations of Candidiasis in the mouth?
White, cheesy plaque resembling milk curds
## Footnote
50% of adults are symptom-free carriers.
175
What are common symptoms of vaginal Candidiasis?
Vaginitis with red, edematous, painful vaginal wall and white patches
## Footnote
Symptoms include itching and pain on urination and intercourse.
176
Where does Candidiasis typically appear?
Warm, moist areas such as groin, oral mucosa, and submammary folds
177
What is Tinea Corporis commonly known as?
Ringworm
178
What is the typical appearance of Tinea Corporis?
Annular (ring-like) scaly appearance with well-defined margins
179
What is Tinea Cruris commonly referred to as?
Jock itch
180
What is Tinea Pedis commonly known as?
Athlete's foot
181
What are the clinical manifestations of Tinea Pedis?
Interdigital scaling and maceration, scaly plantar surfaces, sometimes with redness and blistering
## Footnote
May be itchy and painful.
182
What is Tinea Unguium also known as?
Onychomycosis
183
What are the symptoms of Tinea Unguium?
Scaliness under distal nail plate, brittle, thickened, broken, or crumbling nails with yellowish discoloration
184
What is the incidence of Tinea Unguium related to?
Increases with age
185
What is the main treatment for Tinea Unguium?
Oral antifungal (terbinafine, Lamil, traconazole)
## Footnote
Topical antifungal cream has minimal effectiveness if unable to tolerate systemic treatment.
186
What is the role of laser technology in skin treatment?
Efficient treatment for many types of skin problems
187
What can lasers do in surgical use?
Cut, coagulate, and vaporize tissue
188
What is the most common type of laser used in skin treatment?
CO2 laser
189
What does the argon laser primarily treat?
Vascular and other pigmented lesions
190
What are some common OTC topical antibiotics?
* Bacitracin-neomycin-polymyxin (Neosporin)
* Bacitracin
* Polymyxin B
191
What is mupirocin used for?
Superficial Staphylococcus infections such as impetigo
192
What are commonly used oral antibiotics for systemic infections?
* Penicillin
* Erythromycin
* Doxycycline
* Clindamycin
* Linezolid
* Vancomycin (drug of choice for severe infections)
193
What are the effects of topical corticosteroids?
Local anti-inflammatory and antipruritic effects
194
What should be considered before applying a corticosteroid preparation?
Try to diagnose a skin problem first
195
What does the potency of a corticosteroid preparation depend on?
The concentration of the active drug
196
What type of hypersensitivity is associated with Allergic Contact Dermatitis?
Type IV delayed hypersensitivity response
## Footnote
This type of hypersensitivity involves an immune response that occurs after sensitization to an antigen.
197
What are the common clinical manifestations of Allergic Contact Dermatitis?
* Red papules and plaques
* Itching
* Occasional vesicles
* Appearance of lesions 2-7 days after contact with allergen
## Footnote
The lesions often take the shape of the causative agent.
198
What is the main treatment approach for Atopic Dermatitis?
* Topical or oral corticosteroids
* Antihistamines
* Skin lubrication
* Elimination of contact allergen
* Avoidance of irritating affected area
* Systemic corticosteroids if sensitivity severe
## Footnote
Treatment may vary based on the severity and stage of the condition.
199
What are the stages of Atopic Dermatitis?
* Acute stage: Redness, oozing vesicles, extreme itching
* Subacute stage: Scaly, light red to red-brown plaques with itching
* Chronic stage: Thickened skin, lichenification, dry skin, itching
## Footnote
Stress reduction can help reduce flares.
200
What is a common cause of Drug Reactions?
Any drug that acts as an antigen and causes hypersensitivity reaction
## Footnote
Certain drugs like penicillin are more likely to cause reactions.
201
What are the characteristics of Urticaria (Hives)?
* Redness and edema in upper dermis
* Raised or irregularly shaped wheals
* Can occur anywhere on the body
* A single lesion usually resolves in 24 hours
## Footnote
Often triggered by an allergic event.
202
What can be a potential side effect of long-term corticosteroid use?
* Adrenal suppression
* Skin atrophy
* Capillary fragility
* Rosacea
* Acne
* Bruising
## Footnote
Atrophy may not occur until the corticosteroid has been in use for 2 to 3 weeks.
203
What is the most potent delivery system for a topical corticosteroid?
Ointment
## Footnote
Ointments allow for better absorption and effect compared to creams.
204
What is the role of intralesional corticosteroids?
Injected directly into or just beneath the lesion
## Footnote
Provides a reservoir of medication with effects lasting several weeks to months.
205
What are some common antihistamines used for treating allergic skin reactions?
* Diphenhydramine
* Loratadine (Claritin)
* Fexofenadine (Allegra)
* Cetirizine (Zyrtec)
## Footnote
Antihistamines can vary in their sedative effects and efficacy in controlling itching.
206
True or False: Systemic corticosteroids are primarily used for long-term therapy in skin problems.
False
## Footnote
Systemic corticosteroids are generally reserved for short-term therapy for acute problems or severe diseases.
207
Fill in the blank: Antihistamines with sedative effects, such as ________, may be better for itching.
diphenhydramine
## Footnote
Sedative effects can enhance symptom relief but may impair activities like driving.
208
What is Acne Vulgaris?
An inflammatory disorder more common in teenagers that may begin and persist, with flares occurring with hormonal changes and before menses.
209
What type of sensation may patients experience with immunomodulators?
Transient burning or feeling of heat at the application site.
210
What is the purpose of skin scraping in dermatology?
To obtain a sample of surface cells for microscopic inspection and diagnosis.
211
What are common tests performed on skin scrapings?
* Mineral oil examination for scabies
* 10% to 20% KOH for fungus.
212
True or False: Electrodessication typically involves deeper tissue destruction than electrocoagulation.
False.
213
What is topical fluorouracil used to treat?
Precancerous lesions, especially actinic keratosis (AK), and some skin cancers.
214
What are common side effects of using topical fluorouracil?
* Redness
* Burning
* Itching.
215
Fill in the blank: Curettage involves the removal and scooping away of tissue using an instrument called a _______.
curette.
216
What is the appearance of a lipoma?
A benign tumor that is encapsulated.
217
What is punch biopsy used for?
To obtain a tissue sample for histologic study or to remove small lesions.
218
What may occur within 1 to 3 weeks of topical fluorouracil application?
Painful, eroded areas over the damaged skin.
219
What is the role of electrodessication and electrocoagulation in dermatology?
Coagulation of bleeding vessels and destruction of small vascular lesions.
220
What is lentigo associated with?
Increased number of melanocytes in the basal layer due to aging.
221
What should be done to reduce redness and itching after applying topical fluorouracil?
Apply a low-potency topical corticosteroid 20 minutes after dosing.
222
What is the risk of minor electrosurgery on patients with pacemakers?
Electrical energy can affect both pacemakers and internal defibrillators.
223
What types of lesions can be removed using curettage?
* Warts
* Actinic keratosis
* Seborrheic keratosis
* Small basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs).
224
What is the typical appearance of acrochordons?
Common skin tags that appear on the trunk.
225
What does the term 'nevi' refer to?
A group of melanocytic lesions commonly known as moles.
226
What is Acne Vulgaris?
An inflammatory disorder of sebaceous glands
## Footnote
More common in teenagers and may persist into adulthood.
227
What are the two types of lesions associated with Acne Vulgaris?
* Noninflammatory lesions (open comedones, closed comedones)
* Inflammatory lesions (papules, pustules)
## Footnote
Flare can occur with corticosteroids, androgen-dominant birth control pills, and before menses.
228
Where is Acne Vulgaris most commonly found on the body?
* Face
* Neck
* Upper back
229
What is the primary treatment for Acne Vulgaris?
* Topical benzoyl peroxide
* Retinoids
* Antimicrobials (clindamycin, minocycline, erythromycin)
* Systemic antibiotics
## Footnote
Isotretinoin may provide lasting remission for severe nodulocystic acne.
230
What are Acrochordons?
Commonly known as skin tags, small, skin-colored, soft, pedunculated papules
## Footnote
Common after midlife and often appear on neck, axillae, and upper trunk.
231
What causes Lentigo?
Increased number of normal melanocytes in the basal layer of epidermis from sun exposure
## Footnote
Also known as 'liver spots' or 'age spots'.
232
What is a Lipoma?
A benign tumor of adipose tissue, often encapsulated
## Footnote
Most common in the 40- to 60-year-old age group.
233
What is Psoriasis?
An autoimmune chronic dermatitis that involves very rapid turnover of epidermal cells
234
What are the common features of Psoriasis?
* Sharply demarcated silvery scaling plaques
* Reddish skin often on scalp, elbows, knees, palms, soles, and fingernails
* Symptoms vary in intensity
## Footnote
Usually develops before age 40 and has family predisposition.
235
What is the goal of treating Psoriasis?
To reduce inflammation and suppress rapid turnover of epidermal cells
## Footnote
No cure, but control is possible.
236
List some topical treatments for Psoriasis.
* Corticosteroids
* Tazarotene
* Calcipotriene
* Anthralin
* Tacrolimus
* Halobetasol propionate
## Footnote
Intralesional injection of corticosteroids may be used for chronic plaques.
237
What systemic treatments are used for Psoriasis?
* Natural or artificial UVB
* PUVA (UVA with topical or systemic photosensitizer)
* Traditional and oral therapies (methotrexate, retinoid, apremilast, cyclosporine)
* Biologic therapies
## Footnote
Examples of biologic therapies include adalimumab, brodalumab, certolizumab pegol, among others.
238
What is rosacea?
A common disorder of the central face with an unclear cause
## Footnote
Rosacea has four major subtypes.
239
What are the four major subtypes of rosacea?
* Erythematotelangiectatic (ETR)
* Papulopustular (PPR)
* Phymatous (PHY)
* Ocular rosacea (OR)
## Footnote
Each subtype has distinct clinical manifestations.
240
What are the clinical manifestations of Erythematotelangiectatic rosacea?
* Telangiectasia
* Redness
* Flushing
## Footnote
Telangiectasia refers to thread-like red lines or patterns on the skin.
241
What are the clinical manifestations of Papulopustular rosacea?
* Redness
* Flushing
* Papules
* Pustules
## Footnote
These symptoms can cause significant discomfort.
242
What are the clinical manifestations of Phymatous rosacea?
* Thickening of the skin
* Hypertrophy of the nose
## Footnote
This subtype may lead to noticeable changes in facial appearance.
243
What are the clinical manifestations of Ocular rosacea?
* Tearing
* Stinging
* Itching
* Dryness of the lids
## Footnote
Ocular rosacea can significantly impact eye comfort.
244
What common factors can exacerbate rosacea?
* Foods
* Alcohol use
* Smoking
## Footnote
Lifestyle factors often play a role in the severity of rosacea symptoms.
245
What are some treatments for rosacea?
* Ablative laser surgery
* Minocycline
* Trimethoprim/sulfamethoxazole
* Topical treatments (e.g., sulfacetamide)
## Footnote
Treatment options vary depending on the severity and subtype.
246
What are seborrheic keratoses?
Benign skin growths that usually occur after age 40, with an unknown etiology
## Footnote
They tend to increase in number with age.
247
What is a characteristic appearance of seborrheic keratoses?
Well-defined shape, appearance of being 'stuck on'
## Footnote
They can also increase in pigmentation over time.
248
When is biopsy indicated for seborrheic keratoses?
If unable to distinguish from melanoma
## Footnote
Biopsy helps rule out more serious conditions.
249
What is cryosurgery?
The use of subfreezing temperatures to destroy epidermal lesions
## Footnote
It is commonly used to treat warts, skin tags, and other lesions.
250
What agent is most often used in cryosurgery?
Topical liquid nitrogen
## Footnote
It causes cell rupture during thaw, leading to cell death.
251
What are some skin problems treated by laser?
* Acne scars
* Hair removal
* Hemangiomas
* Leg veins
* Pigment discoloration
* Pigmented nevi
* Port wine stain
* Psoriasis
* Resurfacing of skin
* Rosacea
* Skin lesions
* Tattoo removal
* Vascular lesions
* Warts
* Wrinkles
## Footnote
Laser treatments offer a range of cosmetic and therapeutic benefits.
252
What is the procedure for a punch biopsy?
Marking the biopsy area, anesthetizing it, rotating the punch, and removing a small cylinder of skin
## Footnote
Hemostasis is achieved with pressure or absorbable gelatin.
253
What is Mohs surgery?
Microscopically controlled removal of skin cancer in thin horizontal layers
## Footnote
This technique helps ensure complete removal of cancerous tissue.
254
What is the purpose of examining specimens in cancer treatment?
To see if any cancer cells remain after the first excision.
255
What are the benefits of Mohs surgery?
* Preserves normal tissue
* Produces a smaller wound
* Can completely remove cancer.
256
True or False: Mohs surgery is typically performed under general anesthesia.
False
257
What is the importance of a careful history in nursing management of skin problems?
It helps detect findings that could lead to identifying the cause of skin problems.
258
What should patients be taught regarding the duration of skin treatment?
Skin problems may be slow to resolve, and they should follow package directions for OTC drugs.
259
Fill in the blank: Wet compresses are often applied for _______.
[superficial skin problems that involve inflammation, itching, and infection]
260
What are the initial steps in nursing management for skin problems?
* Assess patient's skin for acute and chronic problems
* Assess risk factors
* Document findings and develop a care plan.
261
What should be considered when teaching patients about sun exposure?
Risks associated with sun exposure and methods for decreasing exposure.
262
What is the recommended thickness for compress material when applying a wet compress?
4 to 8 layers thick.
263
What type of water should be used for a wet compress?
Room temperature tap water, filtered, bottled, or sterile water if necessary.
264
True or False: Continuous compresses can have solution added to them.
False
265
How long should intermittent compresses be placed?
10-30 minutes, several times a day.
266
What should be done if the skin appears macerated during treatment with compresses?
Stop the compresses for 2-3 days.
267
What should be used to protect the mattress and linens during the application of compresses?
A water-resistant pad.
268
What should be done with materials used repeatedly for wet compresses throughout the day?
Change and wash them daily.
269
What types of therapies should nurses teach patients about for skin disorders?
* Dressings
* Baths
* Oral or topical medications.
270
What is crucial to evaluate after administering therapies for skin problems?
Treatment effectiveness and any adverse effects.
271
What are common bases for topical medications?
Common bases include:
* Cream
* Gel
* Lotion
* Ointment
* Paste
* Powder
* Baths
## Footnote
Each base has specific properties that influence the effectiveness of the medication.
272
What is the purpose of baths in skin treatment?
Baths help to decrease itching and can be relaxing for the patient.
## Footnote
Agents such as colloidal oatmeal and sodium bicarbonate can be added to bath water.
273
Fill in the blank: To prevent increased irritation and inflammation, the patient should ______ the skin dry with a towel after a bath.
gently pat
274
What should be applied after a bath to maintain skin hydration?
Cream, ointment, emollients, or other prescribed topical agents.
## Footnote
This helps seal moisture in the skin and increases absorption of topical agents.
275
What factors influence hygienic practices?
The patient's skin type, lifestyle, culture, age, and gender.
## Footnote
The normal acidity of the skin and perspiration protect against bacterial overgrowth.
276
True or False: Most soaps are alkaline and can lead to a loss of skin protection.
True
277
What is pruritus?
Pruritus is the sensation of itching.
## Footnote
It can be caused by various physical or chemical stimuli and is carried by nonmyelinated nerve fibers.
278
What should older persons avoid to prevent skin dryness?
Harsh soaps and shampoos, and frequent bathing.
## Footnote
Older skin tends to be drier and requires gentler care.
279
What is lichenification?
Lichenification is thickened skin marked by scratching or rubbing.
## Footnote
It often occurs with conditions like atopic dermatoses.
280
What should be done to treat skin lesions with jewelry inserted?
Care for them with antibacterial soaps that do not contain sulfites.
281
What is the role of wet compresses in treating pruritus?
Wet compresses help to decrease itching by hydrating the skin.
## Footnote
Apply for 30 to 60 minutes, then pat the skin dry and apply a lubricant.
282
What is the main side effect of systemic antihistamines?
Sedation.
## Footnote
This can be beneficial at night when itching is often worse.
283
Fill in the blank: Occlusion with a plastic wrap can increase the absorption of _______ or simple emollients.
topical corticosteroids
284
What can trap perspiration against the outer layer of the epidermis?
Plastic wrap.
## Footnote
This helps to enhance the effectiveness of topical treatments.
285
What should patients avoid to decrease the sensation of itching?
Anything that causes vasodilation, such as heat or rubbing.
286
What is the purpose of applying topical agents in a downward motion?
To spread evenly in the direction of hair growth.
287
What is lichenification?
Thickening of the skin due to chronic rubbing or scratching.
## Footnote
Common sites include the hands, forearms, shins, and nape of the neck.
288
What are some common causes of itching that can lead to lichenification?
Dryness and irritation.
## Footnote
Preventing the cause of itching is key to preventing lichenification.
289
What precautions should be taken to prevent the spread of skin infections?
Wear gloves when handling open wounds, practice hand washing, and dispose of dressings properly.
## Footnote
Most skin problems are not contagious, but precautions are still necessary.
290
What are the most common contagious skin lesions?
* Impetigo
* Streptococcal infections
* Staphylococcal infections (e.g., MRSA)
* Fungal infections
* Scabies
* Pediculosis
## Footnote
Moist skin can increase the risk of these infections.
291
What practices can minimize the risk of secondary infections in open skin lesions?
Meticulous hygiene, hand washing, and regular dressing changes.
## Footnote
Scratching can create portals for pathogens.
292
What signs indicate a possible infection after a skin procedure?
* Redness persisting longer than a week
* Fever greater than 101°F
* Increased pain
* Pronounced swelling
* Purulent drainage
## Footnote
These symptoms should be reported to the healthcare provider immediately.
293
How should an oozing wound be cared for post-procedure?
Cleanse with saline solution twice daily and apply antibiotic ointment with a nonadherent secondary dressing.
## Footnote
Keeping wounds moist and covered promotes rapid healing.
294
What is the typical timeline for suture removal?
4 to 14 days, depending on the site.
## Footnote
Sometimes alternating sutures are removed after the third day.
295
What psychological effects can chronic skin problems have on patients?
Emotional stress, social and employment issues, poor self-image, and problems with sexuality.
## Footnote
The visibility of lesions can contribute to these issues.
296
What types of cosmetics are recommended for patients with skin sensitivities?
* Oil-free
* Hypoallergenic
## Footnote
Rehabilitative cosmetics can help camouflage skin conditions like vitiligo and melasma.
297
What are some common cosmetic procedures?
* Chemical peels
* Toxin injections
* Fillers
* Laser surgery
* Breast enlargement/reduction
* Face-lift
* Liposuction
## Footnote
Transitory side effects may include mild redness, pain, and swelling.
298
What are the most common reasons patients seek cosmetic procedures?
To improve body image and enhance self-confidence.
## Footnote
Economic considerations may also influence these decisions.
299
What is laser surgery used to treat?
Congenital and acquired vascular lesions.
## Footnote
Examples include cherry angiomas and spider leg veins.
300
What are common cosmetic topical procedures?
* Chemical Peels
* Tretinoin (Retin-A, Renova)
* Microdermabrasion
* A-Hydroxy Acids (e.g., Glycolic Acid, Lactic Acid)
## Footnote
These procedures are used to improve the appearance of the skin.
301
What is the indication for Chemical Peels?
Improves appearance of photodamaged skin, especially fine wrinkling and reduces actinic keratoses
## Footnote
Chemical peels can include various acids like Jessner and TCA.
302
What is the primary effect of Microdermabrasion?
Smooths appearance of photodamaged and wrinkled skin, acne scarring
## Footnote
It also improves appearance of actinic and seborrheic keratoses.
303
What are the side effects of Tretinoin?
* Redness
* Swelling
* Flaking
* Pigmentation changes
* Teratogenic effects
* Increased phototoxicity with photosensitive drugs
## Footnote
Tretinoin is often applied at night due to light inactivation.
304
What patient teaching is recommended for Tretinoin use?
Apply at night, use emollients, sunscreen, and avoid abrasive facial cleansers
## Footnote
This is important to manage severe sensitivity.
305
What is the main purpose of a face-lift (rhytidectomy)?
The lifting and repositioning of the lower two-thirds of the face and neck to improve appearance
## Footnote
Indications include redundant soft tissue, asymmetric redundancy, trauma, and solar elastosis.
306
What are common complications associated with cosmetic surgery?
Complications can occur if the person smokes or does not follow activity restrictions
## Footnote
Proper postoperative care is essential to minimize risks.
307
What is the purpose of liposuction?
To remove subcutaneous fat to improve facial and body contours
## Footnote
It is not a substitute for diet and exercise.
308
What are the contraindications for liposuction?
* Use of anticoagulants
* Uncontrolled hypertension
* Diabetes
* Poor cardiovascular status
## Footnote
Younger patients with good skin elasticity are better candidates.
309
How is liposuction typically performed?
Under local anesthesia, a blunt-tipped cannula is inserted through a small incision to break loose fat and remove it with suction
## Footnote
Multiple sessions may be necessary depending on the area.
310
What is the healing process after liposuction?
Firm pressure is applied to the wounds until drainage stops, and results may take several months to be evident
## Footnote
Postoperative care is crucial for optimal results.
311
True or False: Antibiotics are always used after a face-lift procedure.
False
## Footnote
Antibiotics are used at the healthcare provider's discretion.
312
What is a major consideration before cosmetic surgery?
Informed consent and realistic expectations.
313
True or False: A face-lift effectively reduces deep wrinkles on the forehead and temples.
False.
314
What should be reviewed with patients regarding healing after surgery?
The timeframe for healing.
315
What should patients expect regarding the final results of cosmetic procedures?
Healing may take up to 1 year and results are affected by age, health, and skin type.
316
What is the typical pain management after cosmetic procedures?
Mild analgesics.
317
What should patients be taught to recognize after surgery?
Signs and symptoms of infection.
318
What indicates adequate circulation in the surgical area postoperatively?
Warm, pink skin that blanches on pressure.
319
What are the uses of skin grafts?
To protect underlying structures, reconstruct areas, facilitate rapid closure, and minimize complications.
320
What is the ideal healing method for wounds?
Healing by primary intention.
321
What are the two types of traditional skin grafts?
Free grafts and skin flaps.
322
What is an autograft?
A graft taken from the patient's own body.
323
What is the method of free skin grafting that uses an operating microscope?
Reconstructive microsurgery.
324
What are skin flaps used for?
To cover wounds with a poor vascular bed, provide padding, and cover wounds over cartilage and bone.
325
What is soft tissue expansion used for?
To provide skin for resurfacing defects, removal of disfiguring marks, or as a preliminary step in breast reconstruction.
326
In soft tissue expansion, what is placed under the skin?
A subcutaneous tissue expander.
327
How often can saline solution be used for expansion in soft tissue expansion?
Weekly.
328
What is the primary tissue characteristic of the tissue expander next to a defect?
Color and texture.
329
What are engineered skin substitutes?
Engineered skin substitutes are products like Apligraf, Dermagraft, and Integra that are gaining popularity, each with its own indications and benefits.
330
What are the characteristics of 2-layered engineered skin substitutes?
They have both dermal and epidermal components.
331
From what sources are skin substitutes engineered?
Skin substitutes are engineered from neonatal foreskins and cadavers.
332
What structures do skin substitutes lack?
Skin substitutes do not contain structures such as Langerhans cells, macrophages, and lymphocytes.
333
What are the advantages of using engineered skin substitutes?
Advantages include:
* Ready availability
* No donor site
* Use in outpatient settings
* Minimal scarring
* Less pain
334
What is the age and profile of patient G.L.?
G.L. is a 48-year-old White, fair-skinned man who is a long-distance truck driver.
335
What leisure activities does G.L. enjoy?
G.L. enjoys swimming and bicycling.
336
What is G.L.'s medical history related to skin cancer?
He has a history of basal cell cancer (BCC) on his left ear in the last 4 years.
337
What familial history does G.L. have regarding melanoma?
His father was treated for metastatic melanoma in the past 2 years.
338
What changes did G.L. notice about his lesion?
He first noted the lesion 1 month ago when it started changing size.
339
What are the characteristics of G.L.'s lesion?
The lesion is 4-mm, deep brown, scalloped with vaguely defined borders.
340
How many dysplastic nevi were found on G.L.'s back?
5 dysplastic nevi were found on his back.
341
What did the excisional biopsy confirm about G.L.'s condition?
The excisional biopsy confirmed superficial spreading melanoma.
342
What were the results of the sentinel node biopsy?
The sentinel node biopsy results were negative.
343
What stage is G.L.'s melanoma?
Melanoma stage I.
344
What is one risk factor for melanoma that G.L. has?
G.L. has a history of basal cell cancer.
345
What manifestations of melanoma are present in G.L.?
A changing lesion on the left arm and dysplastic nevi.
346
What is the prognosis for a patient with stage I melanoma?
The prognosis is generally favorable.
347
What treatment options are available for G.L.?
Options include surgical removal of the melanoma.
348
What is the priority of care for G.L.?
To manage his anxiety regarding treatment outcomes.
349
What are the priority clinical problems for G.L. based on the assessment data?
Anxiety and concerns about the melanoma.
350
How can G.L. be helped to deal with his anxiety over treatment outcomes?
Providing reassurance and clear information about the treatment process.
351
What should be included in G.L.'s teaching plan regarding future sun exposure?
Advice on protecting skin from sun damage.
352
Which safe sun practices should be included in a teaching plan for a patient with photosensitivity? (select all that apply)
* Wear protective clothing
* Apply sunscreen liberally and often
