Skin disorders Flashcards
(120 cards)
1
Q
6 parts to skin disorders
A
Fungal Infections Pigmented Lesions Viral Infections Bacterial Infections Skin Cancers Miscellaneous Disorders
2
Q
2 Types of Fungal infections
A
Superficial skin lesions
Systemic Fungal Infections
3
Q
3 ways of fungal transmission
A
Implementation: Tineas
Inhalation: cryptococcal
Taking antibiotics: candidiasis
4
Q
T/F fungal infection are most common in the elderly and immuno-compromised
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True
5
Q
T/F Fungal infection Can proliferate more easily in patients with vascular indwelling catheters, organ transplant recipients and patients receiving chemo
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True
6
Q
4 types of Superficial fungal skin lesions
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Tinea pedis
Tinea captitis
Tinea versicolor
Candidiasis
7
Q
Superficial fungal infections includes what?
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dermatophytes/fungi that infect hair, skin and nails
Candidiasis
Tineas
8
Q
Fungal infections =
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mycoses or dermatophytes
9
Q
What is the treatment for Superficial fungal infections
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Treatment: usually can be treated with topical antifungal preparations
Systemic antifungals needed for extensive areas or for treatment failures
10
Q
2 types of common fungi
A
Yeast= Candida albicans
Superficial dermatophytes= Tineas
11
Q
what is Tinea pedis
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Dry, scaling pruritic lesions
May only affect skin in the web space between the toes
12
Q
Risk factors for tinea pedis
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Coming into contact with infected skin or fungus in the environment
13
Q
prevention of tinea pedis
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Use of shower shoes, cleaning tub/shower after each use may minimize transmission
14
Q
treatment of tinea pedis
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Topical antifungals in most cases. Most are OTC.
Systemic antifungals for resistant cases - oral or IV
15
Q
4 characteristics of tinea capitis
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can affect scalp, eyebrows or eyelashes
scaly erythematous lesions and hair loss
may cause permanent alopecia (baldness)
is the most common pediatric dermatophyte
16
Q
treatment for tinea capitis
A
PO systemic anti-fungals bid for 4-6 weeks
Topicals are NOT effective
17
Q
what is tinea versicolor
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a ringworm that affects the skin of the upper chest, back, or arms
Is caused by a type of yeast that lives naturally on your skin
Rash occurs when the yeast grows out of control
18
Q
risk factors of tinea versicolor
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Hot climate, sweating a lot, oily skin, weakened immune system, NOT contagious
19
Q
characteristics of tinea versicolor
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Acidic bleach from the growing yeast causes skin discoloration.
Can be spots or patches that can be white, pink, red or brown,
20
Q
treatment of tinea versicolor
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Topical antifungals including shampoos such as Selsum Blue
21
Q
what is candidiasis
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Thrush/Yeast infection
22
Q
risk factors for candidiasis
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Immunosuppression (iatrogenic/acquired), antibiotic use
23
Q
Appearance of candidiasis
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may appear as white lesions in the mouth
Beefy red with satellite lesions in intertriginous areas
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Q
treatment for candidiasis
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topical anti-fungal agents
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3 systemic fungal infections that affect lungs
histoplasmosis, blastomycosis, pneumocystis
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systemic fungal infection that affects lungs AND meninges
cryptococcosis
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What is histoplasmosis
Fungal infection that mostly affects lungs
Histoplasma capsulatum = fungus that lives in the soil
Acquired when person breaths in the dust that contains the fungi
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when does histoplasmossis occur
around 10 days after exposure
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what are the symptoms of histoplasmosis
usually self-limiting and stays in the lungs
| Systemic infections = may occur and can be fatal
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what is the treatment for histoplasmosis
usually none unless severe or chronic disease occurs
| Systemic antifungals usually to treat
31
what is blastomycosis
Caused by Blastomyces fungus
Typically affects the lungs
Acquired by breathing in the spores = AIRBORNE
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symptoms for blastomycosis
Symptoms appear 3 weeks to 3 months after exposure
Most do NOT get sick
Flu-like symptoms can develop
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treatment for blastomycosis
systemic antifungals for severe cases for 6 months to 1 year
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what does pneumocystis cause
Causes a form of pneumonia: pneumocystis pneumonia
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risk factors for pneumocyctis
immunocompromised
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what causes pneumocystis
fungus is common in the environment; AIRBORNE
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symtpoms of pneumocystits
mild, flu-like, pleuritic chest pain, fatigue
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treatment for pneumocystis
treatment usually combo of 2 IV antifungals and corticosteroids
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what is Cryptococcus meningitis
Fungus found in soil and bird droppings
Infection in the meninges rare in healthy people
Occurs in a few days to weeks from contact
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symptoms of Cryptococcus meningitis
nausea/vomiting, change in mental status, lethargy, sensitivity to light
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treatment of Cryptococcus meningitis
IV/PO antifungals
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what is Cryptococcus: PULMONARY INFECTION
Acquired from inhalation of the fungus found in soil
Causes a severe pneumonia with respiratory failure
Incubation times vary from 2-11 months after exposure
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symptoms of Cryptococcus: PULMONARY INFECTION
SOB, coughing, fever, mental status changes
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treatment of Cryptococcus: PULMONARY INFECTION
PO/IV antifungals
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2 types of pigmented lesions
melasma
| vitiligo
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what is melasma
Characterized by dark macules on the face
More common in women
Mask of pregnancy
Oral contraceptives
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treatment of melasma
Avoid sun
Bleaching creams with hydroquinone
Tretinoin/Retin-A (vitamin A derivative
48
what is vitiligo
Acquired condition characterized by abnormalities in the production of melanin
Pigment disappears from a patch of skin
Occurs suddenly before or around the age of 21
Affected areas spread
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treatment and cause for vitilgo
no treatments
| casue unknown
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4 Viral skin infections
Verrucae Vulgaris
Human papilloma
virus
Herpes Zoster
Herpes Simplex: HSV1/HSV2
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what is Verrucae Vulgaris
common wart
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transmission of Verrucae Vulgaris
low risk of person to person; higher risk with wet, macerated skin; nail biting, thumb suck can cause spread to nails
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who is affected by Verrucae Vulgaris
children and young adults more commonly
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symtpoms of Verrucae Vulgaris
unusual skin growth identified by person as a wart
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treatment of Verrucae Vulgaris
usually self-limited and resolve on their own
Cryotherapy, duct tape, topical salicylic acid
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what is Human papilloma virus
Considered an STD; many different types of HPV (over 200)
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transmission of HPV
oral
vaginial
anal sex
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treatment of hpv
anti-virals
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Prevention and early diagnosis for HPV
Vaccine
| pap smears
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What is Herpes Zoster: shingles
Varicella zoster virus lies dormant on a dermatome segment after infection with chickenpox
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what reactivates varicella zoster virus
Virus becomes reactivated by immunosuppression, stress, or illness
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what is prodrome in shingles?
Prodrome: burning/tingling along dermatome and then rash develops with vesicles that dry and crust over
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5 characteristics of shingles
Characteristics: vesicles on red base that follow along dermatomal distribution-asymmetric (does not cross midline)
Usually extremely painful
Clears in 2-3 weeks
Usually occurs in people over 50; can occur in anyone who has had chicken pox
Most contagious when vesicles are weeping
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treatment for shingles
anti-virals
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complications of shingles
post-herpetic neuralgia persistent pain in the area where the rash was
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5 bacterial skin infections
```
Impetigo
Abscess
Furuncle
Cellulitis
MRSA (staph)
```
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Causative agents for impetigo
Staphylococci & Streptococci
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characteristics of impetigo
Organisms carried in the nose
| Acute & CONTAGIOUS
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appearance of impetigo
vesicles, pustules, honey-colored crust on red base
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treatment of impetigo
Topical antibacterial = Bactroban
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5 characteristics of Abcess
Skin inflamed and red with collection of pus
Area often raised with palpable borders
Tender
May drain purulent discharge or feel ‘fluctuant’ (fluid-filled)
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Treatment for Abcess
incision & drainage (I&D) and antibiotics
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Furuncle
Furuncle is a bacterial infection of HAIR FOLLICLE
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carbuncle
Carbuncle is a painful, deep swelling of the skin caused by bacteria
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Treatment for Fuuncle and carbuncle
I&D and antibiotics
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what causes cellulitis
bacterial infection of skin and surrounding tissues (usually staph or strep bacteria)
May be an initial injury or wound that becomes infected and spreads to surrounding healthy tissue
May be caused by animal or insect bites
Often occurs on the lower extremities
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Is cellulitits contagious
No
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Appearance of cellulitits
red, painful, swollen and warm to the touch
| Blisters may form on the skin
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Treatment of cellulitis
PO systemic antibiotics, IV depending on severity
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Methicillin resistant staph infection (mrsa)
MRSA is caused by a type of staph bacteria that is resistant to many antibiotics
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Hospital acquired-MRSA
associated with invasive procedures, such as surgeries, IV tubing, artificial joints
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Community acquired-MRSA
often begins as painful boil
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how is mrsa transmited
person-to-person
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High risk for MRSA
high school wrestlers, child-care workers, and people who live in crowded conditions
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MRSA symptoms
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warm to touch
purulent drainage
fever
abscess can develop quickly
Bacteria can burrow deep into the body
potentially life-threatening infections of bones, joints, surgical wounds, bloodstream, heart valves and lungs
```
86
Treatment of MRSa
hospital acquired = IV vancomycin or Zyvox
Community acquired = Bactrim or dicloxacillin
Prophylaxis = Bactroban nasal ointment prior to surgery
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3 types of skin cancers
Basal cell
Squamous cell
Melanoma
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2 types of precancerous lesions
Actinic keratosis
| Solar lentigos
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Actinic Keratosis
Benign lesions
Due to damage by sun’s UV rays
Common in fair skin persons
Rough, scaly, red plaques
90
Solar lentios
Benign lesions
| Also known as liver/age spots
91
basal cell carcinoma
Most common skin cancer in white-skinned people
Increased risk with sun exposure
Most curable usually a non-metastasizing, slow growing skin tumor
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characteristics of basal cell
nodular form that begins as a small, flesh-colored or pink dome shaped bump
Translucent, shiny, pearly nodule
Eventually will form an ulcer surrounded by a shiny border
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squamous cell carcinoma
2nd most frequent skin cancer
Increased risk with sun exposure
Curable with early treatment
Can metastasize to lymph nodes or internal organs
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characteristics of squamous cell
red and scaling
| Keratotic, slightly elevated lesion, with an irregular border, usually with shallow chronic ulcer
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Melanoma
Cancer of the melanocytes
Malignant cells grow on the skin = radially spreading in the epidermis & vertically spreading deep into the dermis
Can also form internally, in the eyes, and under the nails
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risk factors for melanoma
Family history of melanoma,
blond/red hair,
presence of freckling on the upper back,
history or more blistering sunburns before age 20,
history of more of 3 or more years of an outdoor job as a teenager
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Where does melanoma orginiate on the body
Originates on skin surface but penetrates deeply into the skin
Invades the blood and lymphatic vessels ant then metastasizes to distant sites
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characteristics of melanoma (ABCDE)
A: Asymmetrical: lesions vary in size and shape
B: Borders: are irregular
C: Color: varies from one area to another.
Shades of tan, brown, and black; sometimes white, red, or blue
D: Diameter: greater than 6 mm/size of a pencil eraser
E: Evolving: a mole or skin lesion that looks different from the rest or is changing in size, shape or color
Most deadly form of skin cancer
Superficial spreading type = 70%
Nodular form is the most aggressive
99
6 types of misc skin disorders
```
Eczema
Stasis dermatitis
Psoriasis
Drug reactions
Urticaria
Angioedema
```
100
eczema
Group of skin conditions that cause the skin to become inflamed or irritated
Not contagious
Atopic eczema: most common type; inherited tendency to develop eczema, asthma, and hay fever
101
characteristics/symptoms of eczema
pruritis,
rash on face/back of knees/wrists/hands/feet,
skin very dry/thickened/scaly,
lesions may appear reddish and then turn burn;
lesions can ooze & crust over;
can be exacerbated by heat, cold, detergents, URI, and stress
102
eczema treatment
```
Relieve itching/prevent infection
Lotions and creams to keep skin moist
Cold compresses
OTC hydrocortisone cream or prescription strength
Immune modulator medications
```
103
Stasis dermatitis (Chronic venous insufficiency)
Condition found primarily in the lower extremities = also know as ‘venous eczema’
Cause: poor venous circulation
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characteristics of statis dermatitis
More common in people over the age of 50
One way valves in legs fail and fluid and pressure builds up
Blood leaks out of the veins into the skin
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symptoms of statis dermatitis
redness & scaling present
Ulcerations may develop and a secondary bacterial infection may occur
edema around the ankles is often 1st sign
Skin can appear reddish, yellowish, or brown color
Itching, pain, sores that ooze/crust/scale, thickened skin around the ankles/shins, hair loss on ankles or shins
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treatment of statsis dermatitis
compression stockings, elevate feet above the heart, exercise, diuretics for edema, antihistamines for the itching, surgery to repair valves
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Psoriasis
over-active immune system, may be autoimmune
Long-term, chronic condition
Most commonly begins in young adulthood
NOT contagious
Affects 1-3% of population
Most common in adults
Research shows that there is a link between psoriasis/obesity/cardiovascular diseases
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characteristics of psoriasis
skin cells grow too quickly causing skin to be thick, white, silvery, or have red patches of skin plaques
Normal skin cells grow gradually and flake off about every q 4 weeks
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treatment of psoriasis
keep skin moist, UV light phototherapy, corticosteroid creams/lotions, topical medications, immune modulating medications
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T/F MOST drugs can cause a local or generalized skin eruption
True
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Drug-induced skin reactions Appearance
typically, maculo-popular rash, bright red
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Drug-induced skin reactions Distribution
usually starts on trunk, spreads to limbs, usually does not affect face
Itches and burns
May start at any time during course of drug therapy through 2-3 weeks post-medicinal course is completed
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T/F Penicillins and cephalosporins often cause Drug-induced skin reactions
True
114
Urticaria/Hives
Manifestation of an allergic reaction
| Characterized by edematous plaques that cause INTENSE ITCHING
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Describe Urticaria lesions
raised pink/red areas surrounded by a paler halo that blanch with pressure
May see swelling of the tongue or pharynx, larynx usually spared
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Common causes of Urticaria
food, drinks, medications, insect stings, viral infections, dust mites, exposure to pollen or chemicals
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Histamine's role in Urticaria
is mediator in most cases, causing hyper-permeabilty of the micro-vessels in the skin and allowing fluid to leak into the tissues causing edema and wheal formation
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Angioedema
Severe form of urticaria
| Will see thicker lesions from massive transudation of fluid into the dermis/subcutaneous tissue
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Where does Angioedema usually affect
Typically affects the lips, periorbital area, hands, feet, penis, or scrotum
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Potential complications of angioedema
airway obstruction due to laryngeal edema
