Term
|
Definition
-it is avascular; made of two major layers (stratum corneum and cellular stratum) and a basement membrane.
-function: physical barrier.
-Basal layer is deepest layer of epidermis; composed of single layer of rapidly proliferating cells that slowly migrate upward, keratinize and are slowly shed from stratum corneum; process takes about 4 weeks |
|
|
Term
|
Definition
-contains papillary and reticular layers; it is vascularized connective tissue that separates epidermis from cutaneous fat;
-composed of elastin, collagen and reticulin fibers; also contains sensory nerve fibers and autonomic motor nerve fibers.
-Deepest layer has hair follicles, sebaceous, eccrine and apocrine glands. |
|
|
Term
|
Definition
-subcutaneous layer filled with fat
-Functions include heat generation, provide insulation, shock absorption and store calories. |
|
|
Term
|
Definition
-2-3 million small coiled glands
-controlled by sympathetics
-distributed all over the body (profuse on forehead, axillae, palms, soles; can produce over 6L of watery sweat a day
|
|
|
Term
|
Definition
-larger and found close to hair follicle
-controlled by androgens
- mostly in axillae, pubic area, and perineum
-Mature at puberty, milky sticky substance
-odor when bacteria present here
|
|
|
Term
|
Definition
-surrounds fair follicle and found all over body except on palm, soles and feet
-directly influenced on androgen production;
-produces sebum that is deposited into lumen of the hair follicle and it lubricates hair shaft and works its way to skin surface; amount of sebum produced based on size of gland (largest are on back and face) |
|
|
Term
|
Definition
dead keratinized structure that grows out of hair follicle
-Vellum is short, fine, inconspicuous (like on your arms)
-Terminal is long and coarse (like on your head).
None on eyelids, palms, soles, gland penis, or labia minora
-Erector Pili to the hair for goosebumps |
|
|
Term
|
Definition
-derived from keratinization of cells from the nail matrix
-firm, rectangular and usually curved; nail plate gets pink color from the vascular bed in which its attached; about ¼ of the nail plate is covered by proximal nail fold;
-Lunula is the whitish moon and the free edge of the nail plate
-Cuticle extends from the proximal nail fold and functions as a seal and protects the space between the fold and plate
-Lateral nail fold covers the sides of the nail plate. |
|
|
Term
| medical history that are pertinent to the evaluation of the skin |
|
Definition
| Previous skin problems; tolerance to sunlight; systemic or severe disease; sensitivity to sensory stimuli; hair (loss, thinning, growth, brittleness and breakage); thyroid/liver disorder; malnutrition; associated skin disorder; nail injury or infection; congenital anomalies |
|
|
Term
|
Definition
Need a centimeter ruler, wood’s lamp (optional), flashlight with transilluminator, magnifying glass (optional) and episcope (optional).
-palpate for moisture, temperature, texture, turgor and mobility |
|
|
Term
|
Definition
Primary: may arise from previously normal skin; example is a macule
Secondary: may arise from changes in primary, like a scale
tertiary: neither prim nor secondary, talengiectasia |
|
|
Term
|
Definition
cluster, linear, annular, round, oval, stellate, target, seripiginous, reticulate, polycystic |
|
|
Term
| Life threatening reactions to drugs |
|
Definition
Urticaria, Mucous membrane erosions, Facial edema, Swelling of the tongue, Palpable purpura, Skin necrosis, Positive Nikolsky’s sign (epidermal separation from dermis with lateral pressure) |
|
|
Term
|
Definition
Immune mediated allergic rxn, IgE - mediated, complement mediated, Immune complex mediated, Nonallergic urticaria (ex. cold weather)
|
|
|
Term
| Physical exam findings with urticaria |
|
Definition
Large wheals- pink with white central area surrounded by erythematous halo-oval, arciform, serpentiginousdistribution- local, regional, or generalizedangioedema- extensive tissue swelling with involvement of deep dermal and subcutaneous tissues. Skin SymptomsPruritisBurning of palms and soles- with airway edema, difficulty breathing |
|
|
Term
| IgE mediated Urticatia signs (Life threatening) |
|
Definition
| Symptoms if IgE mediatedSIGNS OF LIFE THREATENINGFlushingbroncospasmfatiguesneezingnausea, vomiting, diarrheaabdominal pain |
|
|
Term
| Immune mediated urticaria |
|
Definition
-Initial sensitization 7-10 days,could be up to 28 days,
-in previous sensitized individuals symptoms may occur 12-36 hours after drug is administered |
|
|
Term
| Treatment for Urticaria And Prevention |
|
Definition
Epinephrine - 0.3 -0.5mg 1:1000 dilution subcutaneously, maintain airway, IV access,
Antihistamines, Systemic Corticosteriods |
|
|
Term
| fixed drug reaction (FDE) |
|
Definition
| adverse skin reaction to an ingested drug. |
|
|
Term
|
Definition
| -Lesions form a solitary plaque , bulla , or erosion. Some reactions may be multiple.-If re-challenged with offending drug, the FDE will occur at the same site, within hours of ingestion. |
|
|
Term
| Drugs associated with FDR/FDE |
|
Definition
| Acetaminophen, anticonvulsants, aspirin/nonsteroidal anti-inflammatory drug (aspirin/NSAID) barbiturates, benzodiazepines, butalbital, dapsone, metronidazole, oral contraceptives, penicillins, phenacetin, phenolphthalein, sulfonamides, tetracyclines |
|
|
Term
|
Definition
| -The characteristic lesion is an erythematous, dusky red, violaceous sharply demarcated macule round , oval in shape.-Most commonly solitary, but may be multiple.-Size varies few mm to 10-20cm in diameterwithin a few hours lesions become edematous and form a plaque |
|
|
Term
Stevens-Johnson Syndrome. - often due to which drugs |
|
Definition
| Sulfa drugs, Allopurinol, amino-penicillins, Certain NSAIDS, Cephalosporins, Floroquinolones |
|
|
Term
|
Definition
-Prodromal Rash - Morbilliform, erythema multiforme like, diffuse erythema- Early - Necrotic epidermis first as macular areas - enlarge and coalesce.Late- sheet like loss of epidermis. Raised flaccid blisters (+ Nickolsky’s Sign) on erythematous areas.
-Any trauma leads to full thickness epidermal detachment-Lesions are pink red early then dusky cyanotic later lesions are tender
-Usually occur on face, extremities then becoming confluent over hours or days.
-widely distributed mostly trunk and face TEN- generalized 90% of patient have mucousmembrane involvement85% have conjunctival leasions |
|
|
Term
|
Definition
Push on skin and have separation of the dermis Skin peels right off |
|
|
Term
| Treatment and monitoring of SJS |
|
Definition
Management
Early diagnosis very important.
Patients should be in an ICU or Burn unit.
IV fluid replacement.?
Systemic steriods.
Debridement of necrotic tissue |
|
|
Term
| Mortality rates with SJS and TENS |
|
Definition
-Mortality rate for TEN 30% mainly elderly.
-Mortality for SJS ,5% related to sepsis, GI bleed, fluid and electrolyte imbalance. |
|
|
Term
| exanthemous drug reaction VS drug hypersensitivity syndrome |
|
Definition
Exanthemous Drug Reaction: An adverse hypersensitivity reaction to an ingested or parenterally administered drug, Characterized by an eruption that looks like a measles- like viral exanthem
Hypersensitivity Drug Reaction: Severe idiosyncratic adverse drug reaction, characterized by fever, rash, hepatitis, arthralgias, lymphadenopathy, or hematologic abnormalities |
|
|
Term
Skin manifestations of SLE (Lupus) |
|
Definition
Lupus: spectrum of diseases that are linked by distinct clinical findings and distinct patternsof polyclonal B immunity, onset 30-40 esp in Females and AA
-Malar rash - butterfly (bright red, sharply defined, slight edema, minimal scaling)
- Edema
-Fine scaling
-Alopecia
-Vascular lesions (calcinosis cutis (calcium deposits in the skin) and ulcerations)
-Fever, arthritis,CNS, rnal, cardiac, and pulmonary |
|
|
Term
|
Definition
| Plaques of alopecia, with erythematous/violaceous border, white atrophic center, telangiectasia and keratin-filled follicles |
|
|
Term
|
Definition
| Occurs mainly in Young cauca women, not as aggressive as SLE, mild manifestations - skin lesions annular or psorasisform (mimics psoriasis), non-scarring, widerly scattered, red-violet, and scaling. |
|
|
Term
|
Definition
Multisystem disorder with inflammatory, vascular and sclerotic changes of the skin and other internal organs. Esp Heart, Lung, and GI
Females more likely
30-50 years old
Unknown cause
Sclerodactyly - localized thickeneing and tightness of the skin of fingers and toes - common with atrophy of underlying soft-tissues (finges pulled in due to tightening of the skin)
-Edema (non-pitting)
-Mask-like facies (not well-demarcated, loss of skin lines, shiny skin)
- Alopecia
-Hyperpigmentation esp on trunk
-CREST |
|
|
Term
|
Definition
· C: Calcinosis Cutis: appears over bony prominences/ fingertips, may ulcerate and exude a white paste · R: Raynaud’s Phenomenon: digital ischema (will look cyanotic) when exposed to cold (patient feels pain when in cold) · E: Esophageal dysfunction · S: Sclerodacyly: tapering down of fingertips/ toes to a point · T: Telangectasias: small broken vessels on face and other areas of the body (Small, superficial blood vessels that become visible because they are dilated. ) |
|
|
Term
| Dermatomyositis - (definition) |
|
Definition
-Systemic disease characterized by inflammatory changes of the eyelids and periorbital area, erythema of the face, neck and upper trunk and flat-topped papules of the knuckles.
- It is associated with polymyositis, interstitial pneumonitis, myocardial and vascular involvement. |
|
|
Term
| 3 eruptions with dermatomyositis |
|
Definition
- HELIOTROPHE: purple-red periorbital discoloration that may extend to the scalp; edema of lower lids
- GROTTEN'S PAPULES: Flat topped papules with varying degrees of atrophy at the nape of the neck, shoulders, and knuckles
- POIKILODERMA: Plaque-like areas of Atrophy and hyperpigmentation |
|
|
Term
| NECROBIASIS LIPOIDICA DIABETICORUM: Signs |
|
Definition
| Small, slow growing, dusky nodules with sharp borders which eventually flatten and become depressed and atrophied with a brown-yellow coloring |
|
|
Term
ACANTHOSIS NIGRACANS: signs |
|
Definition
| Diffuse, velvety thickening and hyperpigmentation of the axillae and other body folds. |
|
|
Term
|
Definition
Circumscribed brown lesions on the lower extremities that appear in crops and resolve in 1-2 yrs
- Sclerema Diabeticorum Rapid onset of Scleroderma-like indurations of the subq tissue of the upper back, neck and proximal extremities.
- Atrophy due to insulin injections, especially on the abdomen and thighs
-Angular Stomatitis due to yeast infections |
|
|
Term
| Lesions of those with Herpes Simplex: In HIV pop |
|
Definition
active lesions are mostly the result of reactivation of latent infection; recurrences can be progressive and persistant. a. Clinical manifestations: pain, acute vesicular eruption rapidly evolves into a chronic, non-healing ulcer; most common sites are perianal, genital, & orofacialb. DX: mostly clinical, viral culture/ Tzanck smearc. TX: anti-virals such as acyclovir d. Complications: lesions can extend from oropharnynx to esophagus; secondary infections (esp. of perianal ulcers) |
|
|
Term
|
Definition
- Clinical manifestations: sensory disturbances in the area prior to the lesions appearance like burning, tingling, or pain, followed by the lesion 3-5 days later; appear first as papules, then vesicles on an erythematous base, then crust over as they heal.
- Treat with Acyclovir
- Complications: postherpetic neuralgia and scarring, secondary bactyeruia infections, infection to CNS and viscera; ocular involvement (via Trigeminal n.) |
|
|
Term
| Human Papilloma Virus (HPV) SSX |
|
Definition
- cause both common warts and anogenital warts
- Clinical manifestations: flesh colored, red, or pink lesions, or can dev. into the common cauliflower mass
-Treatment: cryotherapy, electrotherapy, laser surgery, and topical podophylli
- Complications: HPV of cervix is most common cause of abnormalities on PAP smears |
|
|
Term
| Molluscum contagiosum SSX |
|
Definition
Clinical manifestations: flesh-colored, umbilicated papules, 1-3 mm in diameter on face, neck, scalp, or trunk.
- TX: liquid nitrogen, currattege, electrocoagulation, Retin-A Complications: scarring with tx |
|
|
Term
|
Definition
Clinical manifestations:
Primary - chancre
Secondary - Condylomata lata (watery lesions), rash, mucocutaneous lesions and adenopathy
Tertiary - has cardiac, nuerologic, opthamic, or auditory manifestations; Gumma (deep skin lesions- often necrotic)
Test via - darkfield examination of lesion, RPR, VDRL, FTA-ABS
TTX - Penecillin G |
|
|
Term
|
Definition
-multifocal neoplasm that most commonly affects the skin but can affect any organ in the body
- pink to dark purple lesions, indurated or macular- plaque like; can have surrounding edema; commonly on head and neck region.
TTX - excision if small, radiation, chemo |
|
|
Term
| Common fungal infections SSX |
|
Definition
a. Candida: thrush, angular cheilitis (fissures at the sides of mouth) b. Tinea: Tinea pedis, Tinea Cruris, Tinea Corporis c. Histoplasmosis: systemic d. Cryptococcus: systemic |
|
|
Term
Skin evidence of Hyperthyroidism versus hypothyroidism |
|
Definition
HYPOTHYROIDISM - Pretibial Myxedema (mucopolysaccharide deposition, non-pitting edema of the shins) - Coarse, dry hair - Alopecia b. HYPERTHYROIDISM - Vitiligo depigmentation of the skin (in patches) - Fine, thin hair - Alopecia |
|
|
Term
|
Definition
| A syndrome resulting from adrenocortical insufficiency caused by infections and characterized by an autoimmune disease; Insidious and characterized by progressive brown hyperpigmentation and associated with weakness, fatigue, nausea and anorexia; may demonstrate vitiligo, nail changes and alopecia |
|
|
Term
|
Definition
A chronic granulomatous inflammation affecting diverse organs, but it presents primarily as skin lesions, eye lesions, lymphadenopathy and pulmonary infiltrations. Affects all races, equal gender preference and age of onset is under 40 y/o. Etiology is unknown.
-With Lupus Pernio and Erythema Nodosum,
-treat with intralesional steroid injections, systemic steroids and antimalarials |
|
|
Term
|
Definition
“Purple nose,” violaceous, soft, doughy infiltrations on cheeks and nose
(assoc with sarcoidosis) |
|
|
Term
|
Definition
Indurated, very tender inflammatory nodules mostly in the pretibial region; see the lesions as red, ill-defined erythemas, but palpated as deep-seated nodules.
(associated with sarcoidosis) |
|
|
Term
|
Definition
a. Kaposi’s Sarcoma: vascular neoplasm, seen as mucocutaneous violaceous lesions and edema; usually a purple-brownish macule/ plaques b. Mycosis Fungoides: also called Cutaneous T Cell lymphoma; lesions are randomly distributed plaques that may be red and scaly. c. Paget’s Disease: sharply demarcated red plaque (mimics psorasis or eczema) on the nipple that is slightly indurated. |
|
|
Term
|
Definition
| -Autosomal dominant trait manifested by changes in the skin, nervous system, bones and endocrine glands. -Café au lait spots-light or dark brown pigmentation with sharp margins, lesions vary in size fro 2mm to 20 cm. -Common siz e is 2-5 cm
-Axillary Freckles (Crowe’s Sign) tiny freckle lesions in the axillae.
-Button Holing- multiple, sin colored, flat domed shaped cutaneous tumors |
|
|
Term
|
Definition
-Autosomal dominant disease arising from a genetically programmed hyperplasia of ectoderm and mesodermal cells manifested by lesions in the skin., CNS, heart and kidneys.
-Early manifestations include seizures, mental retardation and congenital white spots on the macular. Facial angiofibromata are pathognomonic but don’t appear until the 3rd or 4th year.
lHypomelanotic Macules-Present at birth in > 80%, off white and > 3 – Thumb print .5-2 cm in size– oval /Ash Leaf-linear on trunk and limbs, 3-4 cm– Confetti 1-2 mmlShagreen Patch-connective tissue nevi, skin colored and appear on back and buttockslKoenen’s Tumors- periungal fibromas that arise late in childhood Treat with Laser surgery |
|
|
Term
| Function of emollients and creams and lotions |
|
Definition
| · Restore water and lipids to epidermis· Prevent further water loss· Creams are thicker and more lubricating than lotions· Most effective when applied to moist skin (after bathing)· Emollients can be applied as often as needed |
|
|
Term
|
Definition
Lubricating vehicles, primarily grease - leave greasy feeling on the skin, greater penetration of medicine than creams, best for dry rashes, not good for skin folds |
|
|
Term
|
Definition
-ointments with water whipped in
-less occlusive than ountments but easier to use
-cosmeticlly acceptable
- white in color, somewhat greasy
- for use on any part of the body
- |
|
|
Term
|
Definition
Mostly water with some lipid whipped in
-clear or milky
- leave little residue
- can be used in skin folds and scalp
- may sting
- less lubricating, may be drying |
|
|
Term
|
Definition
Alcohol and propylene glycol so evaporates but leaves active ingredients on the skin
- ideal for scalp and moist skin folds
- drying
- may sting crcked skin, or intertriginous areas |
|
|
Term
|
Definition
greaseless mixtures of propylene glycol and water
- clear base, jelly-like consistency
- leave little residue
-good for active inflammation (Poison ivy,) or on scalp |
|
|
Term
|
Definition
| -New medication for moderate to severe plaque psoriasis is clobetasol propionate spray (Clobex) |
|
|
Term
|
Definition
| • Mainstay of therapy for superficial inflammatory dermatoses.• Safe when used properly• Match drug potency and delivery to disease severity• Corticosteroids produce vasoconstriction in small blood vessels of upper dermis.• This decreases neutrophil migration to sites of inflammation. • The vehicle in which corticosteroid is dispersed (cream, ointment, gel) enhances effectiveness of medication by enhancing penetration. • Vehicle may act as drying agent or emollient.• Occlusive dressings enhance absorption and increase effectiveness. Only if prescribed.• Topical corticosteroids can be absorbed into systemic circulation. • Depends on duration of use and amount of surface area covered.• Absorption is higher where skin is more permeable (scalp, axilla, face, eyelids, neck, genitalia)• Apply 1-3 times/day• Taper potency and dose for 2 weeks |
|
|
Term
|
Definition
Super potent (of I through VII)
- for psoriasis, hand eczema, use on palms, soles where thick
- Not for face, groin, under breasts --> atrophy
- 45-60 per week
- limit 14 days |
|
|
Term
|
Definition
Diflorasone, (psorcon), Desoximethasone (topicort)
- for atopic dermatitis IN ADULTS
- not for face, axilla, groin, under breasts
- Limit use 21 days |
|
|
Term
|
Definition
• Triamcinalone (Aristocort, Kenalog)Hydrocortisone valerate (Westcort)
- Can be used on children (for atopic dermatitis)
- limited use on intertriginous areas
- Limit use in children to 7-21 days
- |
|
|
Term
|
Definition
| Use for eyelid dermatitis, diaper dermatitis, mild dermatitis• Warnings: re-evaluate if no response in 28 days. Avoid long term continuous use. |
|
|
Term
| Adverse reactions for long term use |
|
Definition
| - Local reactions: infection, irritation, atrophy of dermis-thinning of skin, Striae- stretch marks, Purpura-red spots from local hemorrhage, Telangectasia-red lesions from dilatation of capillaries• Systemic toxicities: (with prolonged therapy) growth retardation in children, adrenal suppression Pediatric Considerations in Topical Corticosteroid Use• NOTE! : Children under 12 years of age should not use topical corticosteroids greater than intermediate strength. |
|
|
Term
| 2 non-steroidal immunosuppressants - VS atopic dermatitis |
|
Definition
may be risk with skin cancer and lymphoma, not for preggers
Tacrolimus Ointment (Protopic)
- Reduces inflammation by decreasing release of inflammatory mediators from mast cells and basophils.
- Low systemic absorption.
-Well tolerated
Pimecrolimus 1% Cream (Elidel) • Topical immunosuppressant • Decreases release of inflammatory mediators from mast cells and basophils.• In studies, bid application X 3 weeks reduced SSX of eczema by 72%• Well tolerated
For both: • Adverse effects: erythema, pruritis, burning sensation at application site. Sensitizes skin to UV light. Sunscreen. Decrease exposure to natural and artificial light.
|
|
|
Term
| Retapamulin ointment 1% (Altabax) |
|
Definition
Topical antibacterial, first in nearly 2 decades, vs S. Aureus and S pyogenes.
- Low resistance chance
-Inhibits protein systhesis of bacteria by interacting with bact ribosomes
- wel tolerated
- irritation is most common adverse effect |
|
|
Term
Aging changes with
Epidermis |
|
Definition
| • Flattening of dermal-epidermal interface leads to easy skin tearing and greater propensity for bullous disorders. |
|
|
Term
|
Definition
| decreased production and uneven dispersement lead to "liver spots |
|
|
Term
| Aging with Langerhan cells |
|
Definition
| • function to present Ag to immune system • decrease by 50% in aging skin • decrease in immune response leads to increase in infections. cancers and anergy of skin. ie: false negative TB skin tests. |
|
|
Term
|
Definition
-Decreased density (atrophic paper skin)
- Thickened collagen, decreased elasticity --> skin tears
- Decreased vascularity, predisposes to thermoregulatory disturbances |
|
|
Term
|
Definition
- Decreased elastin leads to sagging skin
- decreased sweat glands in number and function
- sebaceous glands maintain in number but increase in size while decreasing output --> dry skin |
|
|
Term
|
Definition
| Decrease in number and thickness with decreased melanin in bulb which leads to grey hair |
|
|
Term
|
Definition
| Nails decrease growth rate |
|
|
Term
| aging and sensory receptors |
|
Definition
| decrease leading to risk of heat injury |
|
|
Term
|
Definition
| decreased insulation, risk of hypothermia and pressure-related trauma |
|
|
Term
|
Definition
-accelerated skin aging due to cumulative sunlight exposure
- leads to leathery deep furrowed skin, blotchy skin, actinic keratoses
- Can increase risk for Favre-racouchot - deposition of elastic material in dermis, follicular cysts and comedones |
|
|
Term
| Chronologically versus photoaged skin: |
|
Definition
| Photoaged skin more leathery, deeply furrowed, blotchy skin, actinic keratoses Chronically aged skin –thin, sagging skin, less hair, decreased vascularity |
|
|
Term
|
Definition
| pruritis (most common cause of it in elderly), |
|
|
Term
| Seb derm in Elderly (SSX and TX) |
|
Definition
chronic dermatitis with red, scaling eruption affecting the scalp, ears, nose, chest.
- Pruritic
- Recurs even when treated successfully previously
- treat with topical ketoconazole (Nizoral) |
|
|
Term
|
Definition
capillaries rupture leaving pruritic, subQ hemorrhage
- Common, usually due to capillary fragility and thin dermis
- no ttmt needed if skin remains intact |
|
|
Term
| Lentigo (liver spots, solar lentigo) |
|
Definition
-Caused by sun exposure to unevenly dispersed melanocytes
- smooth brown patches on sun-exposed areas |
|
|
Term
| seborrheic keratosis in aging - Oatmeal Cookie! |
|
Definition
| common, affects seborrheic regions (face, chest, back, beneath breasts), - waxy Brown/black "stuck on" appearing, no tx unless cosmetic |
|
|
Term
| Epidermal Tag (Acrochordans) in aging |
|
Definition
| common, pedunculated fleshy tumors of normal skin, no TTX needed |
|
|
Term
| Capillary hemangioma/ Cherry hemangioma in aging |
|
Definition
benign vascular lesions
- bright red, small, non-dibilitating, can laser off. |
|
|
Term
|
Definition
| benign vascular lesions, flat blue/red soft compressible lesions, common on the lower lip, no Tx |
|
|
Term
| Bullous Pemphigoid in aging |
|
Definition
Acute, severe, episodic, blistering disease resulting from autoimmune rxn to epidermal basement membrane. Rare before 60yrs old, remission and relapse common,
-treat with systemic steroids |
|
|
Term
|
Definition
Varicella dormant in nerve root until trigger.
- Segmental bands of vesicles on erythematous base along a dermatome
- elderly and immunocompromised
- pain and tingling before eruption
- lasts 14-21 days (similar looking to chicken pox)
- 1/3 have post herpetic neuralgia pain
- shingles of 5th nerve can cause uveitis ( to inflammation of the middle layer of the eye) and corneal ulcers
- some associations with underlying malignancy
TX - famvir adn acyclovir, and analgesics |
|
|
Term
| Oral Candidiasis (thrush) of elderly |
|
Definition
Candida of oral pahryngeal mucosa
- Caused by candida albigans (yeast)
- red, sore tongue with white adherent plaque
- risk factors - antibiotic therapy, elderly, immunocompromised, steroids
-TX - Nystatin |
|
|
Term
|
Definition
Fungal and sometimes bacterial infection of body folds
- glazed red rash with satellite pustules or macules in any body fold
- Tx keep cool and dry, typical antifungals
- High recurrence |
|
|
Term
|
Definition
Infestation caused by sarcptes scabiei and transmitted byu direct skin-to-skin contact (Highly contagious), increased freqw in crowded living spaces
Progression - 2-4 weeks after initial exposure then INTENSE PRURITIS (worse at night)
- at fingr webs, wrists, forearms, axilla, ankles, breasts, penis, scrotum, usually spares head
- Excoriations due to pruritis
-Burrow-like papules in linear configuration made by females
- Secondary infection is common
- Tx - Lindane, Pennethrin (90% effective), treat all household contacts and launder all clothing and bedding |
|
|
Term
|
Definition
Caused by ischemia due to prolonged pressure to localized tissue,
- Esp Sacrum, coccyx, hips, elbows, heels
- More common with poor nutrition, extremes in weight, immobility, moist environment, irradiated skin, frequent dressing changes
- PREVENT - minimize friction and shears, contain drainage, turn ofte, special padding, dry environment
Graded I - IV (IV is worst) |
|
|
Term
|
Definition
| epidermis intact, Erythema not resolved within 30 min |
|
|
Term
|
Definition
| Tissue damage limited to epidermis or dermis - may present as a blister |
|
|
Term
|
Definition
| Tissue damage into sub Q tissue |
|
|
Term
|
Definition
Tissue damage extends into fascia and may involve muscled, joint and/or bone. A would with an eschar cannot be staged
|
|
|
Term
|
Definition
Acute - vesicles
Subacute - juicy papules
Chronic - lichenification
Secondary including oozing, crusting, inflammation |
|
|
Term
|
Definition
Pruritic, can occur at 2 months (infants - rash/erruption),
- related to immune, genetic, allergies, infections, irritation, climate, stress
- pruritic, lichenification (with chronic), **Antecubital popliteal fossa , |
|
|
Term
|
Definition
Like PI, chronic or acute, epid or dermis, irritant or allergic, more than 40% of occupational injury Reactions within hours
-Immune Rxn causing tissue inflammation, PI, cosmetics, nickel (belt buckle), rubber compounds, meds.
-Pruritic, lesion can vary with exposure, PI - linear vesicles on erythematous base, Note location for determining cause (Head/neck - cosmetics perfumes, eyes - makeup)
Tx - wahs, Abx, topical corts, |
|
|
Term
|
Definition
Cradle Cap, favors hairy regions, nasolabial folds, axilla, 3-5% of pop, esp in Parkinson's and AIDS
- redness, scaling
- Not always
- pruritic, erythematous yellow-greasy scaling, exudative, secondarily infected.
Tx- low potency cort 4-5 dyas and antifungal for yeast
(could also be rosacea, psoriasis, tinea, lupus) |
|
|
Term
| Nummular Eczema/Dermatitis |
|
Definition
Coin-shaped nummular plaques, with atopic people, elderly/youths, lasts potentially a long time
SSX - pruritic, (not fungal like- red beefy outer ring, with scaling edges) scrape and slide it
-Numerous, round, vesicles scales or crusts, may have lichenification, excoriations,
- Lower legs, trunk, and hands
-Difficult to treat, mousturize often, intralesional injections (refer to a dermatologist) into every spot |
|
|
Term
|
Definition
Elbows and knees, accumulation of stratum corneum, in 33%, hereditary, onset at 35, Silvery white plaques (Atopic was antecubital and popliteal)
- Check HIV status,
-Oil drop sign (yellow nails), psoriasis arthritis,
TTX - ointment, high-potency steroid, hot oil, tars, creams, Lightbox (assoc with cancer though) |
|
|
Term
|
Definition
Benign, self-limiting, unknown cause
- Think fungus but not
- Herald Patch for a week or 2, then more, may or may not itch, plaques, center-scale - Herald Patch, Collarette Scale, later many red patches
-Classically oval plaques eith central ring. X-mas Tree pattern over neck, trunk, proximal extremities
Rule out VDRL
- TTX - get some sun, pred if really bad |
|
|
Term
|
Definition
On sun-exposed areas, might have associated DM, elbows, dorsal hands, dorsal feet.
SSX -asymptomatic (so not tinea), flesh-colored, violaceous dermal plaques, can have central cleaning, but NOT ITCHING, NOT SCALING, looks like a fungus or wart, elevated borders.
|
|
|
Term
|
Definition
Severe itching, 5P's
Wickham's Striae - white lacy, reticular pattern, plaques but flat-topped, on the mucosa too
- Koebner Phenomenon, scratches, then lesions, postinflammatory hyperpigmentation, tan/darker color, often on buccal mucosa, can look like nail fungus.
TTX - topical cort, pred if extensive
Oral LP - can get SCC - may biopsy |
|
|
