Skin disorders of old age Flashcards
(24 cards)
What are RFs for venous legs ulcers? What is the most common cause?
- Venous insufficiency causing venous HTN
- Varicose veins
- DVT
- Poor calf muscle function
arterio-venous fistulae - Obesity
6.Leg fracture
What are the features of venous insufficiency?
oedema
brown pigmentation
lipodermatosclerosis
eczema
What is lipodermatosclerosis/
subcut fibrosis and hardening of the skin of the lower legs
What are both deep and superficial venous insufficiency associated w?
Deep - prev DVT
Superficial - varicose veins
What investigations can u do for venous insufficiency?
doppler US to look for presence of reflex
Duplex - looks at anatomy and flow of vein
What is the management of venous leg ulcerS?
- 4 layer graded compression after exclusion of arterial disease (measure ABPI make are is >0.8)
how wold u treat varicose eczema?
emollients and topical steroids
what are the causes of infection related to venous leg ulcerS
staph. aureus
pseudomonas
beta-haemolytic strep
How would u treat infections related to venous leg ulcers?
broad spec penicillin
avoid topical abx - increase risk of resistance and contact dermatitis
What would you do if a patient still had ulcers after 3m of rx?
investigate further
e.g. biopsy for malignancy
What are the differences between arterial and venous ulcers?
1. CAUSE: Arterial - ischaemia Venous - pooling of blood -> venous HTN 2. LOCATION Arterial - toes, foot and ankle (weight bearing) Venous - behind malleoli 3. PAIN Arterial - severe Venous - minimal 4. APPEARANCE Arterial - shiny hairless pale skin, cool temp, well defined edges Venous - leathery, brown/puprle colour, gradual edges, 5. PULSES Arterial - decreased or absent Venous - normal
what are skin causes of pruritus in the elderly?
eczema scabies pemphigoid eruptions asteatotic eczema generalised xerosis
what is xerosis
abnormally dry skin
What is asteatotic eczema?
usually connected to dry skin
polygonally fissures
give emollients and soap substitutes
What are medical causes of pruritus in the elderly?
anaemia polycythaemia lymphoma solid neoplasms hepatic/renal failure hypo/hyperthyroidism DM (candidiasis)
What are some predisposing factors to pressure soreS?
malnourishment
incontinence
lack of mobility
pain - leads to reduction in mobility
What score is used to screen for pts at risk of developing pressure sores?
Waterlow score - includes BMI, nutritional status, skin type, mobility and continence
What is involved in management of pressure sores?
Hydrocolloid dressings and hydrogels to create moist wound environment
Referral to tissue viability nurse
Certain cases - surgical debridement
elevation to increase perfusion around heel pressure sores
What is stage 1 of pressure sores
non blanching erythema over intact skin
What is stage 2 of pressure sores
partial thickness skin loss e.g. shallow crater
What is stage 3 of pressure sores
full thickness skin loss extending into fat
What is stage IV of pressure sores
destruction of muscle, bone or tendons
What is a complication of pressure sores?
osteomyelitis
How can pressure sores be prevented?
proper positioning
regular turning (every 2 hrs) alternating between supine, R or L lateral position
anatomical foam on ITU
functional electrical stimulation
